Doctors rebel against course

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Norwegian doctors all over the country are mounting a revolt against a new state measure aimed at reducing sick leave. The measure requires doctors to take a refresher course on requirements for sick leave, and if they don’t take the course, they’ll lose their right to excuse patients from school or work for medical reasons.

Health Minister Jonas Gahr Støre often visits the state-funded hospitals around the country, like here in Northern Norway. Now many doctors are frustrated over a course imposed by Støre's government colleague, Labour Minister Anniken Huitfeldt. PHOTO: Helsedepartementet

Health Minister Jonas Gahr Støre often visits the state-funded hospitals around the country, like here in Northern Norway. Now many doctors are frustrated over a course imposed by Støre’s government colleague, Labour Minister Anniken Huitfeldt. PHOTO: Helsedepartementet

Not only are many doctors professionally offended by what they view as state intrusion into their medical evaluations, Norwegian Broadcasting (NRK) reported that they also see the course and its requirements as yet another layer of unnecessary bureaucracy. A vast majority of doctors are simply refusing to take the course.

NRK reported on its national nightly news program Dagsrevy that round 23,000 doctors in Norway were told in January that they must take the new mandatory course in order to continue to have the authority to place patients on paid sick leave, which is mostly funded by the state with contributions from employers. Workers in Norway, except those who are self-employed, are allowed to call in sick themselves for up to three days at no loss of wages. After that, however, they must obtain a doctor’s permission to prevent their wages from being cut. Self-employed persons face much stricter requirements, and generally receive no sick pay compensation for the first two weeks they’re away from work.

NRK reported that to date, only around 1,800 of the 23,000 doctors have taken the obligatory three-hour course, either because they haven’t taken the time for it or object to it as a matter of principle. “I don’t see this as an expression of arrogance on my part,” Dr Sverre Støren in Tønsberg, who refuses to take the course, told NRK. “It’s rather an expression that someone needs to put their foot down when we get hit with meaningless bureaucracy.”

He faces losing his right to place his patients on sick leave but claims that’s not his responsibility. “It’s the health authorities who are making things very difficult for my patients,” Støren said. “And that’s their responsibility, not mine.”

State officials at both ends of the political spectrum have been trying to reduce the levels of sick leave in Norway for years and it has come down in recent years. The current left-center government, running for re-election at the moment, links the reduction to a program it launched in 2007 called Raskere tilbake (roughly translated, “A quicker return to work”) that has included a wide range of measures like quicker treatments, programs where patients can work on a reduced schedule and closer cooperation between employers, health authorities and the patients themselves.

Concerns have been raised that many doctors are too sympathetic or lenient in granting patients’ requests for sick leave, hence the mandatory course outlining what criteria must be met in order to grant paid sick leave. Most doctors think the medical evaluation for sick leave should lie with them, and some like Dr Kjetil Karlsen in Tromsø also claim the course itself has no documented effect. He also seemed offended by the order to attend the course, telling NRK that the state also “threatens punishment if I don’t take the course.”

Bjørn Gudbjørgsrud, a director at the state welfare agency (NAV) that administers sick leave compensation in Norway, told NRK that the ambition is simply to further reduce sick leave, and the course is a way for doctors to take their share of the responsibility for that. “Increased competence (in granting sick leave),” he said, should be documentation enough that the course will have some effect.

Labour Minister Anniken Huitfeldt said she has no plans to drop sanctions against doctors who refuse to take the course. “Doctors, like all other workers, must update themselves,” Huitfeldt insisted, claiming that a refresher course on requirements for sick leave will have a major effect on lowering it.

newsinenglish.no/Nina Berglund