The influence of GP and patient gender interaction on the duration of certified sickness absence.

BACKGROUND Little research has focused upon how GP and patient gender interact to influence the outcome of consultation. In particular, no UK studies have investigated the effect of gender interaction on the duration of patients' certified sickness. OBJECTIVE To investigate associations between the four GP-patient gender interaction categories and patient risk of intermediate or long-term work incapacity. METHODS DESIGN Use of carbonized sickness certificates to collect routine sick note data over a 12-month collection period. SETTING Nine general practices in the Mersey Primary Care R&D Consortium. SUBJECTS A total of 3906 patients, certified sick by 67 GPs (including 45 GP principals). MAIN OUTCOME MEASURES The effect of gender interaction was measured against two outcomes: intermediate (6-28 week) and long-term (28 weeks or over) periods of certified sickness. RESULTS After univariate and multivariate analyses, it was discovered that certification of male patients by male GPs was significantly associated with increased prevalence of intermediate (6-28 week) certified sickness outcomes, compared with females certified by females (OR=1.38 P=0.009). This result was replicated in the subgroup of patients with mild mental disorder-related sickness absence. However, no association was demonstrated between gender interaction and long-term (>or=28 week) outcome, in the total patient group or within diagnostic subcategories. CONCLUSION GP and patient gender appear to have most impact upon sickness certification in the intermediate period. This period is already recognized as the optimum time for interventions to prevent onset of long-term incapacity, particularly in cases where the cause of sickness absence is reversible (as in psychological-related certified sickness absence). Further research is needed (particularly focusing upon attitudes and content of consultations) in order to shed more light on the gender differences found in this study.