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The changing of the guards: Can family doctors contain worker absenteeism?. By Kevin deBettencourt. Introduction. Administrative data collected from Norway Why Norway? Efficacy of physicians as gatekeepers in relation to absenteeism
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The changing of the guards: Can family doctors contain worker absenteeism? By Kevin deBettencourt
Introduction • Administrative data collected from Norway • Why Norway? • Efficacy of physicians as gatekeepers in relation to absenteeism • Does a family doctor have a significant influence on the level of sickness absence in his or her group of patients?
Economic issues and Efficiency • Physicians incentives to certify sick-leave • Competition • Sick-leave is mainly patient driven • 87% of GP’s certify sick-leave even when it is not seen as recommendable • Information advantage of physicians over patients • Both positive and negative effects
Problems with data collection • Patients are not randomly allocated to physicians • Hard to identify influence of physicians • Patients might seek out a more lenient physician • No empirical evaluation of the family doctor’s influence on their client absence has solved this problem
Key Findings • Family doctors have a significant impact on their patient’s benefit claims • Family doctors have more of an influence on duration of sick-leave than occurrence. • Their influence is larger the more difficult it is to find a new physician.
Conclusion • Physicians as gatekeepers in relation to absenteeism is possible • Family doctors have less influence over their patients’ absence behavior in areas where it is easy to find a new doctor