Independent medical evaluation for sick-listed workers in Norway: A focus group study of the experience of IME doctors

Scand J Public Health. 2019 Feb;47(1):70-77. doi: 10.1177/1403494817745001. Epub 2017 Dec 4.


Background: Norwegian politicians have proposed the use of an independent medical evaluation (IME) as a possible solution for reducing long-term sick leave. The use of an IME implies that a new doctor interferes in the relationship between sick-listed workers and their general practitioner (GP). The aim of the current study was to explore experiences of IME doctors from an ongoing randomized controlled trial (the NIME trial evaluating the effect of IME in Norway).

Methods: Two focus group interviews were conducted with eight of the nine IME doctors employed in the NIME trial. The discussions were audio-taped and transcribed. Systematic text condensation was used for analysis.

Results: The participants reported that the IME provides important second opinions, which they felt empowered the sick-listed workers and provided new insights into their condition. Beneficial IME working conditions and enhanced insight into different sick leave measures were crucial to this perceived usefulness. Some of the participants expressed disappointment with GPs acting as passive conductors and struggled to provide feedback politely. Some adjustments were proposed as necessary for the IME to be implemented nationwide.

Conclusions: The participants seemed to have gained a different stakeholder identity by sometimes seeing GPs, their peers, as obstacles to return to work and welcomed the use of IME on a regular basis.

Keywords: General practice; independent medical evaluation; qualitative research; sick leave; workers’ compensation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Female
  • Focus Groups
  • General Practitioners / psychology*
  • General Practitioners / statistics & numerical data
  • Health Policy
  • Humans
  • Independent Medical Evaluation*
  • Male
  • Middle Aged
  • Norway
  • Physician-Patient Relations
  • Qualitative Research
  • Sick Leave / statistics & numerical data*