The term social-medical guidance dates from the 1980s. It refers to the collaboration of doctors in the treatment of people with absenteeism. Social-medical guidance is a rather national subject because of the unique doctrine of the separation of treatment and control. Everywhere else, the treating physician has a more pronounced role in the approach to absenteeism. As a result of the absence-health approach to absenteeism, insurance medicine and occupational health care are charged separately. This makes these disciplines relatively extensive and professionalized in our country. As a result, there are usually at least 4 doctors involved in the treatment of long-term incapacitated people: the family doctor, the medical specialist, the company doctor and the insurance doctor. With PubMed articles from libraries you can find the best options now.
The right Choices
Many attempts have been made to improve the difficult communication between these doctors. The National Council for Public Health described cooperation models in 1987 and added a 4th one itself. In essence, those models were based on the primacy of either the general practitioner or the company doctor or the insurance doctor. In addition to the labor expert who always remained somewhat on the margin, more experts became involved in social-medical counseling in the 1990s. After the privatization of the Sickness Benefits Act, a commercial circuit emerged where absent employees could be treated with medical or psychological priority. The attention then shifted to the waiting list problem, on which the Social and Economic Council advised in 1998.
All proposals on social-medical counseling from the 1980s and 1990s came about against the background of the international appeal that arrangements were made in the Netherlands for absenteeism and incapacity for work. 4 The guiding idea was that better collaboration between doctors and faster diagnostics and treatment would ‘reduce’ that profession, as it was called in official jargon.
The plans stemmed from the consensual culture of manageable society and had high drawing table content they were not tailored to practice. But they were mostly outdated by social developments. Within a few years, almost all known social security organizations disappeared. Occupational health care was extended to all employees, creating a market for competitive health and safety services. A large number of these services were killed or merged within a few years. The doctors involved in social-medical counseling increasingly worked part-time and at different workplaces, which certainly did not simplify their mutual coordination. Moreover, there was a shortage in the labor market, which led to the emphasis on resuming work by those who were unable to work or who had already been rejected. For that, considerable amounts of public money were put on the table. A second commercial sector developed on this breeding ground and claimed specific expertise in reintegration: back counseling centers, burn-out and stress coaching, fitness training and reintegration companies. In this way, the circle of officials involved in social-medical counseling continued to expand.
In the meantime, in connection with individualization, the knowledge and assertiveness of the absent employees increased. Nowadays they often make their own diagnoses via the internet and have copies of letters of resignation or laboratory results with them. And when it suits them, the self-employed people with disabilities no longer have a message to doctors who guide them and discuss what would be good for them in regent-like traditions.