Presentation T O36

T O36 (Oral Presentation):
Inter-professional cooperation between family, occupational and social insurance physicians in managing long-term sickness absence

Presented by: Philippe Mairiaux


Mairiaux Ph1, Vanmeerbeek M2, Schippers N1, Govers P1, Donceel P3, Mortelmans K4

  1. Department of Occupational Health and Health Education, University of Liège, Liège
  2. Department of General Practice, University of Liège, Liège
  3. Department of Occupational, Insurance and Environmental Medicine, Catholic University Leuven, Leuven
  4. Department of Research & Development, Occupational Health Services Group Mensura, Brussels, Belgium



In the Belgian health system, sickness absence (SA) management implies complementary roles for general practitioners (GPs), social insurance physicians (SIPs) and occupational physicians (OPs): GPs deliver sick notes and treatment, SIPs control SA benefits and OPs strive to adapt work environments to workers’ remaining capacities. In practice however, there is little cooperation between the three physicians. In 2009, the Ministry of Employment commissioned a study to identify GP-OP-SIP cooperation channels in order to prevent long-term work disability.


The study involved two phases. 1) Researchers from the three groups agreed on 15 proposals to enhance cooperation: to establish a formal contact between GP, SIP and OP for patients with > 3 months SA (n=3) ; SIP decision to end SA benefit to be forwarded to the GP (n=2) ; work-related information to be provided by the OP to GP and/or SIP (n=4); website giving contact data of GPs, SIPs, and OPs (n=2) ; initial and continuous education focusing on inter-physician cooperation (n=3); electronic data exchange when dealing with long-term SA (n=1). 2) A Delphi study was conducted in 2012 to validate these proposals: 61 experts representing professional groups of physicians (GP, SIP, OP), patients, government, employers and labor unions were asked to participate. A 18-items questionnaire (the 15 proposals and 3 open questions) was used in a 2-round Delphi study. Proposals were accepted if 80% of experts agreed. For drafting the final proposals, the research team relied on a multidisciplinary expert group.


Participation rate was 77% (47/61 experts) in round 1 and 7 out of the 15 proposals were accepted. During round 2, participation rate was 94% (44/47); 2 of the remaining proposals reached agreement level. Public authorities were thus advised to invest in a) promotion of pre-return to work visit with the OP for sick-listed patients; b) a website with OPs contact data; c) joint guidelines for return to work guidance; d) joint training of the 3 physician groups; 5) methods ensuring safe electronic information exchange.


The need for inter-physician cooperation in disability management may exceed individual goodwill and should best be organised by public authorities. The current study may be a first step in this process.

Schedule Details

Tuesday September 30
15:45 - 17:30 Afternoon Concurrent Sessions (T O25 - T O38 and Seminar 6)
Session: Social Interventions for work disability
Room A