Actions of familly physician *

Familly physician *

IMPORTANT NOTE: Some of these elements may also be handled by other healthcare professionals, such as rehabilitation professionals. Of course, this sharing of actions depends on the acts reserved for the various professionals in your part of the world.

Steps in the RTW process Actions

Time off and recovery period

1. Listen to the worker and systematically assess the intensity of his/her symptoms as well as the extent of his/her functional limitations.
First contact with the worker by the workplace
2. Focus on the worker’s stressors, taking into account work-related psychosocial risk factors (e. g., workload, labour relations).

3. Review the duties and responsibilities of the worker’s position.

4. Communicate to the worker the diagnosis related to his/her health condition and suggest solutions adapted to his/her situation. If necessary, provide a sick leave certificate.

5. † Take into consideration the influence of a mental disorder (e.g., depression) on the worker’s interactions with others, particularly when designing a treatment plan.

6. In case of a relapse, meet with the multidisciplinary team (especially with its coordinator) which monitored the worker, and implement treatment effectively.

First contact with the worker by the workplace

Not applicable

Evaluation of the worker (abilities) and his/her work (job demands)

7. Meet with the worker on a regular basis (suggestion of once a month) to reassess his/her symptoms, functional limitations, and work ability. When deemed necessary, initiate, adjust or modify the treatment. Prolong the sickness absence accordingly.

8. At the very beginning of the treatment/rehabilitation process, assess the worker’s intention to RTW.

9. Inform the worker that taking medication is not a sign of illness only (i.e. identifying yourself as a sick person could prolong your sick leave).

10. Encourage the worker to cultivate his/her professional identity.

11. † Talk about the influence of mental disorders (e.g., depression) on self-perceptions (e. g., self-stigmatization) with the worker.

12. Be aware that the worker’s feeling of self-efficacy in overcoming identified barriers to the RTW predicts his/her readiness to RTW.

13. Encourage the worker to participate gradually in activities that can lead to his/her recovery. In a timely manner (suggestion of the first 6 weeks), prioritize multidisciplinary and action-oriented rehabilitation interventions that help the worker develop and implement strategies for recovery.

Development of a RTW plan with workplace accommodations

14. Talk with the insurer or employer (e.g., via forms) to inform them of the worker’s functional limitations and clarify the required work accommodations to be implemented in the workplace to meet his/her needs.

15. Consider the resources (both human and material) offered by the organization and the insurance company when preparing the RTW plan.

Work resumption (day 1)

Not applicalbe

Follow-up of the RTW

16. Ensure that the duration of the gradual RTW is adequate considering the duration of the sick leave.

17. † Identify with the worker the situations that might trigger a relapse. Raise awareness among mental health workers of warning signs of relapse.

18. Re-evaluate the worker’s coping mechanisms and workplace accommodations to support recovery.

19. † In the event of a relapse, refer the worker to appropriate mental health professional resources (e.g., a psychotherapist or rehabilitation clinic) that specializes in this type of situations.

Information adapted from Corbière et al. (2020).
* In Quebec, clinical nurses and nurse practitioners share certain actions with physicians. They can therefore take charge of some of these elements.
† Applies more specifically to workers with a common mental disorder.