General practitioners in the United Kingdom do not use the sickness certification system according to national guidelines, but develop individual strategies to deal with certification requests. Hussey and colleagues (p 88) interviewed 67 Scottish GPs, and found variations between their certification strategies. These strategies were either fixed or flexible and based on acquiescence, negotiation, and challenging requests. Most GPs prioritised the doctor-patient relationship, and did not want to refuse requests for certificates.
Figure 1.
Credit: HULTON GETTY