More work must be done to keep employees in "good work" to stem the tide of sickies, stress claims, and mental illness, a leading medical practitioner says.

The benefits of having control, autonomy, and job satisfaction at work are well established and need to be more front-of-mind in workplaces, says Associate Professor Peter Connaughton, president of the Australasian Faculty of Occupational and Environmental Medicine (AFOEM).

"Claim rates are going up, and we are thinking about prevention in terms of control, autonomy, satisfaction... and that's where 2018 will be a tipping point," he says.

AFOEM has published a consensus statement on the health benefits of "good work" (revising an earlier statement about the benefits of work in general after complaints from unions), and he points out that "no work is very bad for people, and bad work in some circumstances is worse than being off work".

The statement says: "Good work is engaging, fair, respectful and balances job demands, autonomy and job security. Good work accepts the importance of culture and traditional beliefs. It is characterised by safe and healthy work practices and it strikes a balance between the interests of individuals, employers and society. It requires effective change management, clear and realistic performance indicators, matches the work to the individual and uses transparent productivity metrics."

Only when workplaces adopt this way of thinking will they see a reduction in stress claims and mental health issues, Connaughton says.

"There's a lot of talk about resilience," he notes, but "good work" is the missing and very important prevention strategy.

Communication and collaboration

Connaughton says occupational physicians see the "difficult 20 per cent" of workplace cases, and are usually brought in to deal with issues later than is ideal.

He advises treating practitioners to get occupational specialists involved earlier when people are mentally unwell and work issues are at play, and is part of a broader campaign to foster better communication within the workplace.

"If an occupational physician can ring the HR manager and say, 'I need a hand, this one is going off track', [that would be better]. Early intervention is vital and those of us who work with big organisations do it all the time," he says, but the practice isn't commonplace across the board.

"When you get good collaboration with HR specialists and specialists of health problems then you get good outcomes."

Addressing sickies

Meanwhile, closer communication between employers and medical practitioners would also help tackle 'sickies' and improve return-to-work rates after illness and injury, Connaughton says.

"We know the longer people are off work, it progressively reduces their chance of ever getting back to work," he notes.

"So if someone is certified [unfit] for 20 days then their chance of returning [to work] is 70 per cent, and if... they are off for 70 days then the chance drops down to 35 per cent... the underlying medical principle is: what is actually best for these people in the longer term, and in the bigger picture?

"It's not about doctors trying to get people back to work to make employers happy, but part of [AFOEM's] policy is to get doctors to think about what they are doing – and it's not necessarily all positive."

Workers now take an average nine days of 'sickies' each year, and Connaughton says doctors could try harder to foster a conversation with HR professionals on behalf of employees, where informed consent is given.

He says treating doctors also need to challenge any presumption or hesitation about encouraging patients to rethink their return to work. "A doctor will think [patients] don't want to go back, but often, it's the opposite, and maybe they want to hear the do's and don'ts," he says.

And while "fit notes" were lauded a few years back as having the potential to minimise sickies, Connaughton says they're yet to have a significant impact; he would prefer to see more active communication between all parties to make it easier for people to be at work.

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