Abstract
Incapacity for work after inguinal hernia repair: survey of general practitioners’ and surgeons’ prescribing behaviour
Inguinal hernia surgery is a very frequently performed procedure. Since this pathology often presents in professionally active patients, the procedure and resulting incapacitation have socio-economic repercussions. Additionally, a laparoscopic repair has become the standard procedure, a technique that involves significant additional costs. The aim of this study was to investigate the period of incapacity after a uni- or bilateral, open or laparoscopic repair, prescribed by GPs and surgeons, as well as their main motivations.
A survey was sent to 17 GP associations in the province of Limburg (Belgium) with the request to distribute it to their members. Additionally, 73 abdominal surgeons were asked to complete the same survey. The prescription behaviour with regard to the incapacity period was evaluated as a function of the surgical technique used and the type of physical exertion required during professional practice or sports. The motivation for this prescribing behaviour was also surveyed.
107 GPs and 35 surgeons fully completed the survey. It demonstrated a wide variation in the prescribing behaviour. There was no correlation with the years of professional experience. The average prescribed incapacity period was significantly higher among GPs than surgeons. Hardly any distinction was made between a uni- and bilateral recovery. Avoidance of recurrences was the most frequently mentioned factor determining the prescribing behaviour among both GPs (89.9%) and surgeons (79.4%).
The survey reveals a lack of consensus regarding the prescribing behaviour in primary and secondary care. This is mainly based on fear of recurrence, which is unfounded. Developing evidence-based postoperative guidelines for the return to work and to the normal activities is recommended.