Why don't doctor's make a greater effort
to return their patients to work?

Physicians have a responsibility to not only treat their patients, but also to return
them to being functional, productive individuals. As part of this responsibility, it
is often necessary to require patients to return to work earlier than they might
otherwise want to.

Occupational physicians were surveyed regarding the necessity of days off work.
The majority said that less than 10% of employees / patients would actually require
a few days off work. And, nearly 1/2 said that the number was probably less than
5%. In spite of that, the national average is 24%. In other words, it would appear
that 60-80% of lost workdays involve medically necessary time off work (Talmage
and Melhorn, 2005)

So why don't more physicians recommend an early
return to work for their patients?

According to one study, 2/3 of physicians interviewed gave the following reasons;

• the treating physician is unwilling to force a reluctant patient back to work
  (the most common reason),
• the treating physician is not equipped to determine the right restrictions
  and limitations on work activity,
• the employer has a policy against light duty work,
• the employer cannot find a way to temporarily accommodate the worker
  or modify the job,
• the treating physician feels caught between the employer's and the employee's version of events regarding the injury or illness,
• the treating physician has been given too little information about the physical demands of the job to issue a work release for the patient, and
• a conflict exists between the opinions of 2 physicians.

It is worth noting that employee satisfaction with the job has been shown to be the best predictor of return to work (Abramson et al, 1994).

References;
Abramson JH, Gofin J, Habib J. Work satisfaction and health in the middle-aged and elderly.
J Epidemiol. 1994;23:98-104
Talmage JBV, Melhorn JM. A Physician's Guide to Return to Work. AMA Press, 2005