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Independents' Day

There's no need for GPs to fall out with occupational physicians

I refer to the Practice Q&A 'Can occupational health doctor overrule a GP?' (January 27). As a part-time GP and occupational physician (OP), I found the answer to be too simplistic. First, the OP will often have personal knowledge of the patient and the job, the GP usually only knows about the patient.

Second, although the patient may be unfit to do his usual job, it is usually easy for the OP to arrange for him to be given a much lighter job during the recovery period. This helps to prevent long-term sickness absence, as it is well-recognised

that the longer the period off

work, the less likely it is the patient will ever return to employment.

Rather than encouraging entrenched positions, your answer should have emphasised the need to develop a dialogue between the OP and the GP, and not raised the spectre of litigation. In most cases, return to work ­ any sort of work ­ is better for the patient than staying at home or doing nothing.

Adopting this approach can also have the added benefit of reducing the burden of repeated certification from the shoulders of the GP, by helping to prevent the onset of feelings of depression and inadequacy that are often associated with unemployment from all causes, including sickness or injury.

Dr Arthur Boyns

Blaenau Ffestinog, Gwynedd

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