<p>Den här undersökningen handlar om vårdcentralens läkare och deras sjukskrivningspraxis. Till vårdcentralen kommer patienter med olika sjukdomsbilder och ohälsoproblem. Det är läkarnas grannlaga uppgift att utfärda sjukintyg även om en stor del av de sjukdomsbilder som läkaren möter är oklara. I de fallen ska läkaren inte bara diagnostisera och försöka avhjälpa patientens medicinska problem, läkaren ska också bedöma i vilken mån patientens arbetsförmåga är nedsatt av sjukdom. Dessutom ska läkaren bedöma hur omfattande nedsättningen är och hur länge patienten kan förväntas behöva avstå arbete eller att stå till arbetsmarknadens förfogande.</p><p>Hur går det till när läkare bedömer patienters sjukdomsgrundade arbetsoförmåga och hur går det till när de bedömningarna översätts till sjukintyg? I den här explorativa studien söks svaren på dessa frågor utifrån ett teoretiskt perspektiv som fokuserar på de olika och ofta motstridiga rollförväntningar som riktas på läkarna i deras sjukskrivningspraxis.</p><p>Sammanfattningsvis ger undersökningen om sjukskrivningspraxis på vårdcentralen en bild av läkare som strävar mot att förena det goda terapeutiska arbetet med korrekt regeltillämpning och en patientanpassad service, men där logikerna för professionellt, byråkratiskt och marknadsorienterat arbete skapar spänningar. Läkarna tillgriper medicinska, sociala och tekniska strategier för att hantera de osäkerheter som är förbundna med att bedöma och intyga patienters sjukdoms grundade arbetsoförmåga och för att överbrygga de konflikter som uppstår i mötet mellan skilda arbetslogiker.</p>

Den här undersökningen handlar om vårdcentralens läkare och deras sjukskrivningspraxis. Till vårdcentralen kommer patienter med olika sjukdomsbilder och ohälsoproblem. Det är läkarnas grannlaga uppgift att utfärda sjukintyg även om en stor del av de sjukdomsbilder som läkaren möter är oklara. I de fallen ska läkaren inte bara diagnostisera och försöka avhjälpa patientens medicinska problem, läkaren ska också bedöma i vilken mån patientens arbetsförmåga är nedsatt av sjukdom. Dessutom ska läkaren bedöma hur omfattande nedsättningen är och hur länge patienten kan förväntas behöva avstå arbete eller att stå till arbetsmarknadens förfogande. Hur går det till när läkare bedömer patienters sjukdomsgrundade arbetsoförmåga och hur går det till när de bedömningarna översätts till sjukintyg? I den här explorativa studien söks svaren på dessa frågor utifrån ett teoretiskt perspektiv som fokuserar på de olika och ofta motstridiga rollförväntningar som riktas på läkarna i deras sjukskrivningspraxis. Sammanfattningsvis ger undersökningen om sjukskrivningspraxis på vårdcentralen en bild av läkare som strävar mot att förena det goda terapeutiska arbetet med korrekt regeltillämpning och en patientanpassad service, men där logikerna för professionellt, byråkratiskt och marknadsorienterat arbete skapar spänningar. Läkarna tillgriper medicinska, sociala och tekniska strategier för att hantera de osäkerheter som är förbundna med att bedöma och intyga patienters sjukdoms grundade arbetsoförmåga och för att överbrygga de konflikter som uppstår i mötet mellan skilda arbetslogiker.

No description available.

<p>Summary</p><p>At the start of my employment at the Swedish National social insurance office I was a bit confused because there were two categories which I defined as belonging to the same category (working handicapped) but it wasn’t so. The persons I where going to meet was defined as having incapacity to work and therefore, they were defined as not standing to the labour markets conversion. They were defined as being to sick for being at the labour market. </p><p>The aim of this work is to shed light on what grounds a decision concerning a person which will be categorized as incapable of working and looking at the categorized person’s status. At the same time look if the statuses are marred to similarities or differences with the group of persons which are categorized as working handicapped defined through the definition according to enactment 2000:630 which is on of the Swedish Labour Market Board’s (AMS) laws for the Swedish labour market politic. </p><p>The way the author Mikael Holmqvist describes parts of his empiric in his book (2005): “Samhall, att bli normal i en onormal organisation” found an astonishing resemblance with my own experiences. I decided that Holmqvists book could fill a very important role in my work. To shedding more light over my question I looked very briefly on statistics concerning people with different impaired bodily functions from Statistiska centralbyrån (SCB), statistics from the National social insurance office (Försäkringskassan), and statistics from the project I was working in - FUNAKTIVA.</p><p>My theoretical perspective is in the intersection between human’s possibility to decide or not decide his/her own shape. Therefore I have chosen a role theoretical perspective. Talcott Parsons classical theory of the sick role is widely used, therefore I also used it. I also use Deborah Stones theory of explaining politics of disablement from the development of the western industrialism. </p><p>To reach some answers for my aim of the subject I have used a case method. I have analyzed five cases. I have found that my procedure for collecting data is most likely to conform to an ethnographic perspective. Conceptions for the analytical work are mostly done with the help of Pierre Bourdieu and parts of his conceptions. My empiric for this work are from journals from my work, different kind of conversations with persons in my daily work, different organizations, there are also three interviews which I had done with part of my empirics. My intention to compare the group which was defined as working handicapped with the group that I met which was defined as retarded/pensioned or incapable of working take place with Mikael Holmqvist study and my own practical experience. </p><p>The statement in the summary of the analysis is that I found an obvious perspective of conflict between the status of the persons´ when they where administrated within the Social insurance office and the local employment office as sick and the opinion that the persons in the empiric had of themselves. I also found out that there is an obvious perspective of conflict between the persons will to study and/or work and what the systems says that they are capable of doing.</p><p>The empiric shows that none of the persons were given topical interest to any of the roles in the system of work (working-handicapped and the different ways of employee one can be with the help of the code working-handicapped).</p>

Summary At the start of my employment at the Swedish National social insurance office I was a bit confused because there were two categories which I defined as belonging to the same category (working handicapped) but it wasn’t so. The persons I where going to meet was defined as having incapacity to work and therefore, they were defined as not standing to the labour markets conversion. They were defined as being to sick for being at the labour market. The aim of this work is to shed light on what grounds a decision concerning a person which will be categorized as incapable of working and looking at the categorized person’s status. At the same time look if the statuses are marred to similarities or differences with the group of persons which are categorized as working handicapped defined through the definition according to enactment 2000:630 which is on of the Swedish Labour Market Board’s (AMS) laws for the Swedish labour market politic. The way the author Mikael Holmqvist describes parts of his empiric in his book (2005): “Samhall, att bli normal i en onormal organisation” found an astonishing resemblance with my own experiences. I decided that Holmqvists book could fill a very important role in my work. To shedding more light over my question I looked very briefly on statistics concerning people with different impaired bodily functions from Statistiska centralbyrån (SCB), statistics from the National social insurance office (Försäkringskassan), and statistics from the project I was working in - FUNAKTIVA. My theoretical perspective is in the intersection between human’s possibility to decide or not decide his/her own shape. Therefore I have chosen a role theoretical perspective. Talcott Parsons classical theory of the sick role is widely used, therefore I also used it. I also use Deborah Stones theory of explaining politics of disablement from the development of the western industrialism. To reach some answers for my aim of the subject I have used a case method. I have analyzed five cases. I have found that my procedure for collecting data is most likely to conform to an ethnographic perspective. Conceptions for the analytical work are mostly done with the help of Pierre Bourdieu and parts of his conceptions. My empiric for this work are from journals from my work, different kind of conversations with persons in my daily work, different organizations, there are also three interviews which I had done with part of my empirics. My intention to compare the group which was defined as working handicapped with the group that I met which was defined as retarded/pensioned or incapable of working take place with Mikael Holmqvist study and my own practical experience. The statement in the summary of the analysis is that I found an obvious perspective of conflict between the status of the persons´ when they where administrated within the Social insurance office and the local employment office as sick and the opinion that the persons in the empiric had of themselves. I also found out that there is an obvious perspective of conflict between the persons will to study and/or work and what the systems says that they are capable of doing. The empiric shows that none of the persons were given topical interest to any of the roles in the system of work (working-handicapped and the different ways of employee one can be with the help of the code working-handicapped).

No description available.