RTW relationship hurdles 1: Doctors and employers

Gabrielle Lis

Part One - What are the barriers to good doctor / employer relationships?

The relationship between the employer and the primary care practitioner can sometimes seem peripheral to return to work. However, a recent RTWMatters poll showed that approximately 75% of return to work professionals find doctors "hard work". To makes matters worse, evidence-based research suggest that, when poorly managed, the doctor / employer relationship can become a stumbling block tripping up even those stakeholders with the best of intentions. (And no one wants to trip someone holding a stake. That’s just not safe!)

In this double-header quick guide, we draw on an insightful interview with Dr Carlo Ammendolia of Toronto Western Hospital, Canada, and the wealth of knowledge floating around the RTWMatters office to examine…

Part One: Barriers to a good doctor / employer relationship; and
Part Two: How to hurdle those barriers once they’re up (and how to pre-emptively dismantle them, so that they don’t bother anyone in the first place!)

Without further ado, the main barriers to a healthy doctor / employer relationship are...

Daunted doctors

It’s easy to be daunted by doctors, but in fact doctors often find the requirements of the return to work process daunting because:

  • They may lack knowledge about the workplace; and
  • The employer may ask them to provide information in an intimidating format, for example by filling out a form that requires them to specify such things as:
    • How much can the injured worker lift?
    • For how long can the injured worker lift?

According to Dr Ammendolia, doctors tend to respond poorly to such questions, because they feel that they lack the expertise to answer them accurately.


Loyalty is good for return to work, right? Well, right and wrong: some doctors’ loyalty to their patients can actually limit both the doctors and employee’s willingness to engage in the return to work process.

According to Dr Ammendolia, these doctor’s thoughts run along the lines of, “I’ve known this patient long before he had his injury. I’ve developed a relationship with this patient. I don’t want to jeopardise our relationship so I don’t want to contact the insurer, nor do I want to contact the employer.”

This kind of return to work endangering attitude is much more likely if the doctor picks up on an adversarial employee / employer relationship. When return to work collaboration has failed and it’s down to picking teams, doctors are unlikely to pick the employer over the patient.


Another factor which can cause doctors to clam up is concern about confidentiality. Such concerns are more likely to be a problem when:

  • The employer seems uninformed or lax about confidentiality provisions; or
  • There is a poor employer / employee relationship.
Inadequate remuneration

Managing return to work from a medical perspective can be time-consuming and complex. Unfortunately, not all employers realise this, or if they do they’re certainly not ‘fessing up about it! Doctors who spoke with Dr Ammendolia told him that they didn’t have the time, nor did they feel that they were adequately compensated, to do the extra work sometimes required to help a patient return to work quickly and safely.

These barriers are probably familiar, but they're certainly not insurmountable. Make sure you've got your jumping shoes handy: in Part Two, we teach you how to hurdle!