Letters Why doctors don’t take sick leave

The need to develop occupational health services for doctors with ill health

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i292 (Published 20 January 2016) Cite this as: BMJ 2016;352:i292
  1. Drushca Lalloo, consultant physician in occupational medicine1
  1. 1Glasgow, UK
  1. drushca{at}hotmail.com

While I accept the points raised in Oxtoby’s articles,1 2 doctors’ attitudes and behaviours are gradually changing over time. As highlighted, a key concern for most doctors who become ill is the potential impact on their ability to do their job, and for those off sick, when they will be able to return to work. NHS occupational health services can therefore play an important role in the management of doctors’ ill health.

Earlier studies showed that doctors seldom consulted occupational health services and did so only when forced by regulatory requirements.3 A more recent report on occupational health attendances and management reported sickness absence in doctors and dentists found that the doctors studied did use these services and that they attended for a wide range of health problems and services.4 A three year trend analysis in the same health board reaffirmed these findings and found that occupational health management and self referrals for doctors, absent from work, significantly increased over time.5

As an NHS occupational health physician, I have noticed a gradual shift towards acceptance of ill health, the support available, and the need to seek medical care, especially in those affected by serious medical conditions that cause longer term absence. Potential reasons for this could be cultural, generational, increased awareness, or GMC requirements.

Work is still needed to improve perceptions of occupational health, understanding of the expertise and support the specialty has to offer, and access to services. Specific fears around confidentiality need to be effectively addressed and consultant occupational health physicians appointed to manage these often complex consultations. Where high quality, competent occupational health services exist, doctors are likely to use them. While a case has been put for specific occupational health services for doctors in the UK, in the absence of additional resources and funding in wider parts of the country, the development of existing NHS occupational health services to effectively manage doctors’ health should be supported.


Cite this as: BMJ 2016;352:i292


  • Competing interests: None declared.


View Abstract

Log in

Log in through your institution


* For online subscription