Return to work after occupational injury. Family physicians' perspectives on soft-tissue injuries.

OBJECTIVE To document physicians' views about facilitating factors for and barriers to their helping workers recover after occupational soft-tissue injuries and to ascertain physicians' knowledge and attitudinal barriers to their involvement in return to work.

DESIGN Faxed survey.

SETTING Manitoba family practices and emergency departments.

PARTICIPANTS General practitioners, family physicians, and emergency physicians regularly caring for injured workers.

MAIN OUTCOME MEASURES Physicians' ranking of facilitating factors and barriers, changes to help their involvement in return to work, and their attitudes and knowledge about return to work.

RESULTS Respondents and nonrespondents were demographically similar, 232 physicians (51.3%) responded. Respondents believed the main facilitating factors were physicians' ability to explain the nature and prognosis of injuries to workers (69%) and the willingness of workplaces to accommodate injured workers (26%). The main barriers were workers' misunderstandings and fears about their injuries (70.7%) and non-supportive supervisors and co-workers (20.8%). The most frequently requested change was better workplace job accommodation (48%). Most physicians agreed they had a role in planning return to work and were aware of the effect of job satisfaction, psychosocial elements, and work-related factors. Despite supporting evidence, only one third of physicians stated they would say "try to continue usual activities" to patients with occupational low back pain.

CONCLUSION Most physicians seemed aware of their role in return to work and the effect of occupational factors, but their advice on activity after injury differed from that in practice guidelines.