More sick leave given to men by male GPs compared with female counterparts

Sep 13 2007

Male patients are given more certified sick leave by male doctors compared with the amount of sick notes given to females by female doctors, a University of Liverpool study has revealed.

The report, written by primary care experts at the University, indicates that male GPs are more likely to give male patients a larger amount of intermediate sick leave (6-28 weeks) from work compared with female patients certified by female doctors. The study, which is the first of its kind in the UK, is based on a survey of 3,906 patients from nine general practices across Merseyside.

Dr Mark Gabbay from the University's Division of Primary Care explained: “The evident link between GP gender and consultation outcome could be down to differing assumptions about roles within work for male and female patients and hence capacity for work, between GPs of different gender.

“On the other hand, the key to gender interaction differences might be found with the patient. Male patients may be more demanding, or better negotiators, when facing a male GP. What is not clear is whether this group do indeed have relatively greater problems, poorer coping skills, or are more sympathetically dealt with by male than female GPs.”

Mild mental disorders (MMDs) such as depression and anxiety were the commonest cause of complaint by women, followed by musculoskeletal problems for which males sought a higher proportion of medical attention. The research revealed however, that male patients were granted a longer amount of sick leave for MMDs compared with female patients, by doctors of both genders groups.

Dr Gabbay explained: “Previous research suggests male patients do not often present clear psychological symptoms of MMDs thus complicating diagnosis of related diseases by the GP. The complexities involved with diagnosing MMDs in males could go some way to explaining the longer sick leave granted by the doctor.”

It has been reported that every week in the UK, approximately 17,000 people of working age reach their sixth week of sickness absence. The majority will return to paid employment but is it is estimated that around 3,000 of those people will subsequently exceed the 28-week incapacity episode and become eligible to claim incapacity benefit.

In the UK, the first week of sickness can be self-certified by the patient but thereafter must be certified by their GP. The GP has a contractual obligation to certify sickness absence on the basis of an assessment of a patient's capacity to conduct duties involved in their ‘usual occupation'.

Dr Gabbay added: “Sickness certification is an important outcome of a GP consultation – it has wide social and economic impact in relation to the workforce in the UK, as well as implications for the individual. We will be further investigating links between gender interaction and sickness consultation to determine the reasons behind this bias.”