“Patients, not doctors, get sick”: A study of fifteen Swedish physicians on long-term sick leave

Based on in-depth interviews with 15 physicians on long-term sick leave in the north of Sweden, the aim of this paper is to describe and understand what happened before, during and after sick leave. A constructivist grounded theory approach was used to construct a framework inductively from the stories of the physicians. As a result of hierarchical coding procedures in terms of initial, focused and theoretical coding, the circular or helical road back to well-being was constructed. This core category, formed in response to structure and to the culture of the medical profession, is constituted of five categories, including dealing with changing working conditions, resisting sick and patient role, resisting sick leave, spending time on sick leave and, finally, returning to work. Not only were the physicians expected to work very hard, but also they were expected to take charge, and did take charge, of their own treatment and rehabilitation. They reinforced these phenomena, by employing strategies to deal with high workload and to avoid sick leave. None of them later returned to full-time work. Notwithstanding that, some aspects of the culture of the medical profession are destructive; in this case, it promoted a strong will and motivation to return to work.