Table I.

Areas and categories of problems in sickness certification of patients as experienced by physicians in Sweden

A. Society and the social insurance system	B. Organization of healthcare	C. Performance of other actors in the system	D. The physicians’ working situation
Policies and laws Different levels of compensation in the social insurance system Changes in the labour market Lack of overview and management	Lack of leadership and management Not enough physicians in primary healthcare Referral systems and fragmentation of care Routes of contact and access	Communication with the social insurance office Cooperation with other stakeholders Actions of other physicians Actions of other healthcare professionals Patients’ attitudes	Handling patients with symptoms difficult to diagnose (i.e. physical or mental pain) Assessing patients’ work ability Lack of advice and counselling from other professionals Handling the various roles as a physician The lack of scientific knowledge on consequenses of being sickness absent	The action orientation in the physicians’ profession Ethical dilemmas Pysicians’ psychosocial working conditions Medicalization of patients non-medical problems Contribution to prolonged/non-optimal sickness absence