Body@Work

Interaction between insurance physicians and their claimants during medical work disability assessments

PERIOD
January 2007 until January 2011

FUNDING
Stichting Instituut Gak, a foundation that initializes and supports innovative projects in the Dutch welfare sector

INVESTIGATORS
H.J. van Rijssen, MSc ^{1, 2, 3}
A.J.M. Schellart, MBA, PhD ^{1, 2}
J.R. Anema, MD, PhD ^{1, 2, 3}
W.E.L. de Boer, MD ^{3, 4}
R. Steenbeek, PhD ^{3, 4}
Prof. A.J. van der Beek, PhD ^{1, 2, 3}

1 VU University Medical Center, Department of Public and Occupational Health, EMGO Institute for Health and Care Research
2 Research Centre for Insurance Medicine of AMC-UWV-VUmc (KCVG)
3 Body@Work Research Center on Physical Activity, Work and Health
4 TNO Quality of Life

OBJECTIVES
The first objective of this study is to map attitudes on interaction/communication and behavioural styles (working styles and coping styles) of insurance physicians and their claimants during medical disability assessments. Associations of these attitudes and styles with both satisfaction with the interaction process and communication during the assessment, and with the claimant’s acceptance of the outcome of the assessment, will be studied. This concerns the medical (dis)ability assessment according to the Disability Benefits Acts (WIA, WAO) deployed by the Institute for Employee Benefit Schemes (UWV). The knowledge thus gained, will be used for the second objective: to develop a training for insurance physicians in which they learn to effectively adjust their own behaviour to the claimant’s behaviour. The third objective is to evaluate the efficacy of this training.

METHODS
(1) Four questionnaires were administered, based on the ASE-model of De Vries (a derivative of the Theory of Planned Behaviour). Insurance physicians were surveyed on their attitudes on interaction and working styles (1). The physicians’ claimants were surveyed on their attitudes on interaction and handling of difficult situations, and on their coping styles (2), prior to their medical disability assessment. (3) After the disability assessment the physicians (3) as well as the claimants (4) will be surveyed on their opinion on the medical assessment, particularly on the course of and satisfaction with the interaction during the assessment.
(2) Using these survey results, focus group interviews, and an overview of systematic reviews as a starting point, we will develop a training for insurance physicians in which they learn to effectively recognise their own behaviour and minimize the influence of this behaviour on the assessment outcome. Subsequently, they learn to quickly see through the claimants’ behavioural style and adjust their own working style to it when thought necessary. Domain experts on insurance medicine and on the basic principles of the practical method that will be taught, will be consulted.
(3) The efficacy of the training will be determined in a efficacy Randomized Controlled Trail (RCT). The outcome are not yet established.

RESULTS
146 insurance physicians working for the Institute for Employee Benefit Schemes completed the first questionnaire. Of them, 36 also completed the second questionnaire for multiple assessment interviews, resulting in a total of 304 second questionnaires. The first claimants questionnaire was completed by 63 claimants and 56 of them also completed the second questionnaire.
Publications are not yet available.

More information:
Email: j.vanrijssen@vumc.nl
Tel: +31 20 44 48415