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Working effectively as a team requires an understanding of the approach others in the team take.  It requires common understandings of the team’s goals and the manner in which success in meeting these goals will be assessed. However, this research found that different stakeholders in the return to work team have different understandings of core aspects of return to work care, such as what should be included in an assessment of a person’s work ability.

Reaching a common understanding of the factors to be taken into account when assessing an individual’s work ability is crucial.  Should work capacity be based on the person’s heath problems, or should factors such as the person’s motivation and the doctor’s perception of the workplace demands influence their assessment of work ability?

Policy makers need to coordinate discussion so that stakeholders develop a shared understanding of how a person’s work capacity should be assessed.

Why the research matters

Rehabilitation and assisting people to remain at work or return to work involves multiple stakeholders. Cooperation between all the parties has been recognised as an important factor in successful outcomes.

What the research involved

Researchers from Sweden interviewed and analysed information from a range of people involved in return to work. They interviewed claims or insurance managers, doctors, physiotherapists, occupational therapists, social workers, coordinators and primary health care centre managers. The aim of the assessment was to analyse whether there were common goals and a culture of cooperation, and how the relationships between professionals were functioning.

Summary of research findings 

The researchers indicated that there was a disconnect in how varying stakeholders viewed or assessed an individual’s work ability:

• The social insurance agency had a specific view about an individual’s work ability, based solely on the health of the person; while
• The researchers felt that doctors:
  • Had a limited knowledge of working conditions, leading them to make subjective interpretations of a person’s ability to work; and
  • Tended to account for non-medical factors in assessing the workability, such as the patient’s motivation to work and the social context of the workplace. 

These different ways of determining work ability were felt to indicate a major disconnect.

The second issue flagged was a difference in the varying roles different doctors saw themselves as playing. The researchers identified two types of doctors:

1. The traditional physician, who reported scepticism about cooperation and had concerns regarding loss of authority.
2. The cooperative physician, who was happy to work with other professionals in the assessment and management process.

Original research

The work ability divide: holistic and reductionistic approaches in Swedish interdisciplinary rehabilitation teams.
Ståhl C, Svensson T, Petersson G, Ekberg K.
J Occup Rehabil. 2009 Sep;19(3):264-73. Epub 2009 Jun 2.

Link to PubMed abstract