Biopsychosocial incapacity assessments: a survey of occupational physicians' opinions.

Background: Assessing incapacity (lack of fitness for work) is a core activity for occupational physicians (OPs). However, it is increasingly thought that biomedical approaches to this assessment are not ideal and there is a need to move to a biopsychosocial paradigm.

Aims: To seek the opinion of practising OPs about long-term fitness to work and assess the degree of consensus within the group surveyed.

Methods: A group of OPs attending a conference considered five case scenarios concerning possible unfitness to work and gave opinions using electronic keypads.

Results: Up to 72 OPs responded to the cases. In four out of five cases, there was generally good agreement (by over two-thirds of respondents) with results which appeared to be consistent with biopsychosocial principles.

Conclusions: While consensus in this group was generally high, it is unclear whether these results would be replicated in other OP groups. Although the speciality in the UK is looking to speak with one voice, it is unclear whether there is a current consensus within it on forming opinions on cases in which complex biopsychosocial factors apply. Additionally, speciality training does not yet address biopsychosocial concepts.