Stereotyping of medical disability claimants' communication behaviour by physicians: towards more focused education for social insurance physicians

van Rijssen, H. J.; Schellart, A. J. M.; Berkhof, M.; Anema, J. R.; van der Beek, A.J.
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p666
Academic Journal
Background: Physicians who hold medical disability assessment interviews (social insurance physicians) are probably influenced by stereotypes of claimants, especially because they have limited time available and they have to make complicated decisions. Because little is known about the influences of stereotyping on assessment interviews, the objectives of this paper were to qualitatively investigate: (1) the content of stereotypes used to classify claimants with regard to the way in which they communicate; (2) the origins of such stereotypes; (3) the advantages and disadvantages of stereotyping in assessment interviews; and (4) how social insurance physicians minimise the undesirable influences of negative stereotyping. Methods: Data were collected during three focus group meetings with social insurance physicians who hold medical disability assessment interviews with sick-listed employees (i.e. claimants). The participants also completed a questionnaire about demographic characteristics. The data were qualitatively analysed in Atlas.ti in four steps, according to the grounded theory and the principle of constant comparison. Results: A total of 22 social insurance physicians participated. Based on their responses, a claimant's communication was classified with regard to the degree of respect and acceptance in the physician-claimant relationship, and the degree of dominance. Most of the social insurance physicians reported that they classify claimants in general groups, and use these classifications to adapt their own communication behaviour. Moreover, the social insurance physicians revealed that their stereotypes originate from information in the claimants' files and first impressions. The main advantages of stereotyping were that this provides a framework for the assessment interview, it can save time, and it is interesting to check whether the stereotype is correct. Disadvantages of stereotyping were that the stereotypes often prove incorrect, they do not give the complete picture, and the claimant's behaviour changes constantly. Social insurance physicians try to minimise the undesirable influences of stereotypes by being aware of counter transference, making formal assessments, staying neutral to the best of their ability, and being compassionate. Conclusions: We concluded that social insurance physicians adapt their communication style to the degree of respect and dominance of claimants in the physician-claimant relationship, but they try to minimise the undesirable influences of stereotypes in assessment interviews. It is recommended that this issue should be addressed in communication skills training.


Related Articles

  • Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants. Samoocha, David; Snels, Ingrid A. K.; Bruinvels, David J.; Anema, Johannes R.; Kowalczyk, Wojtek; van der Beek, Allard J. // BMC Medical Informatics & Decision Making;2011, Vol. 11 Issue 1, p10 

    Background: The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek. nl. This intervention was aimed at empowerment of disability claimants,...

  • Are tribunals given appropriate and sufficient evidence for disability claims?  // Occupational Medicine;Jan2008, Vol. 58 Issue 1, p35 

    Background Occupational physicians are sometimes surprised at the decisions made by employment tribunals. Aim To assess employment tribunal judgements on disability discrimination in order to determine whether the evidence placed before the tribunal was appropriate and sufficient. Method...

  • 'Flawed' test will still be used for reassessments.  // Community Care;6/3/2010, Issue 1821, p8 

    The article focuses on the reassessment of incapacity benefit claimants on their fitness to work by using the new work capability assessment (WCA) in Scotland.

  • Introduction to the Special Issue on Functional Capacity Evaluations: From Expert Based to Evidence Based. Reneman, Michiel F.; Dijkstra, Pieter U. // Journal of Occupational Rehabilitation;Dec2003, Vol. 13 Issue 4, p203 

    Introduces a series of articles on Functional Capacity Evaluations.

  • Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders. Wind, Haije; Gouttebarge, Vincent; Kuijer, P. Paul F. M.; Sluiter, Judith K.; Frings-Dresen, Monique H. W. // International Archives of Occupational & Environmental Health;Feb2009, Vol. 82 Issue 4, p435 

    To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). A post-test only design was used in the context of disability claims....

  • Social Security Disability Application Process Moves to Electronic Signatures.  // American Family Physician;5/1/2012, Vol. 85 Issue 9, p856 

    The article focuses on the call of the U.S. Social Security for the support of doctors and others in recognizing the online application for disability claims.

  • GPs' secret codes on benefits.  // Pulse;7/16/2005, Vol. 65 Issue 28, p1 

    The article cites a British Government-commissioned report according to which, general practitioners (GPs) in the country are resorting to using coded messages on incapacity forms to make their true opinions on the ability of their patients to work, known. A study of 43 GPs and practice managers...

  • Integrating evidence in disability evaluation by social insurance physicians. Kok, Rob; Hoving, Jan L.; Verbeek, Jos; Schaafsma, Frederieke G.; van Dijk, Frank J. H. // Scandinavian Journal of Work, Environment & Health;Nov2011, Vol. 37 Issue 6, p494 

    Objective The aim of this study was to explore applying the method of evidence-based medicine (EBM) to resolve common questions in the field of disability evaluation. Methods We used three clinical questions corresponding to problems encountered by insurance physicians in daily practice to...

  • The disturbing truth about disability assessments. Mccartney, Margaret // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;8/11/2012, Vol. 345 Issue 7869, p34 

    The author presents his views on Atos Healthcare's disability assessment programme. He questions the medical criteria used in assessments and cites example of two television programmes which have shown that the benefits tests by Atos are unfit for purpose. The author suggests that evidence for...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics