Evaluation of doctor-worker encounters in occupational health: an explanatory study.

In this paper workers' evaluations of various types of doctor-worker encounters in occupational health (the open consultation hour, required visits after absence from work and visits for periodic medical examination) are described and explored. The aim was a better understanding of the consultation processes and its determinants in the field of occupational health. Semistructured interviews were conducted in a sample of 313 employees. Quantitative and qualitative analyses were carried out in order to explain the variations in the outcome parameters. The quantitative analysis showed that workers' evaluation of their encounter with the occupational physician was rather indeterminate and only correlated positively with the variable 'meeting workers' expectations'. The qualitative analysis generated a classification of the variety of workers' expectations. In the Role Differentiation Model this classification of workers' expectations is related to three specific role aspects: the expert-, the counsellor- and the mediator-role aspect. The model assumes that the occupational physician should be able perform the behavioural requirements of these role aspects, in order to meet the expectations of the workers in various situations. The Role Differentiation Model is a hypothetical model, partly based on the outcome of the study, which explains the variation in workers' evaluations and could also be used to develop practice guidelines.