25 May 2005
Award for University researchers
Researchers at the University of Dundee are among a team who have been awarded the 2004 Royal
College of General Practitioners (RCGP)/Boots The Chemists Research Paper of the Year Award.
Dr Jon Dowell from the Community Health Sciences Division and Professor Rose Barbour of the School
of Nursing and Midwifery at the University, were part of the research team exploring how GPs
operated the sickness certification system, their views on the system and suggestions for change.
The research team, led by Ross and Cromarty GP Dr Susan Hussey and funded by the Chief Scientist's
Office, held 11 focus group discussions with a total of 67 GPs who worked in a range of settings:
inner city, suburban, small town, rural and remote. These included doctors in Dundee, Perth and
Angus.
Participants were encouraged to talk freely about their experiences although facilitators used a
brief topic guide to ensure important areas were covered.
The findings demonstrated that straightforward sickness certification is not a problem. However,
participants reported that for the significant minority where difficult decisions exist any, or all
of the stakeholders may substantially misuse the system.
Amongst the themes which emerged GPs described substantial conflicts of interest between patient
advocate and 'the system'. With rare exception they saw their responsibility as primarily to the
patient rather than the Department of Work and Pensions. They perceived their role as ‘reluctant
gatekeepers’ who risked endangering the doctor-patient relationship when challenging patients’
expectations. Any effort to renegotiate situations could also be circumvented in group practices
where they had access to more than one GP. Vague diagnoses were used on the certificates to
preserve patient confidentiality and 'sabotage' what was seen as a dysfunctional system.
The team was jointly awarded the Research Paper of the Year Award with a study from Surrey looking
at simple practice-based methods to improve early identification of patients with type 2 diabetes.
The authors of each study were presented with a cheque for £500 at an award dinner at the Royal
College of General Practitioners last week.
By Roddy Isles, Head of Press 01382 344910, out of hours: 07968298585, r.isles@dundee.ac.uk | 
