At 21:26 11/02/2007, you wrote:
>Who really knows whether a Pt is able to go to work?
>
>Ummmm...
>The Patient, The Adult, The Responsible Person.
>Most of the time
>
>Unless there is some power-knowledge-control thing going on, where Doctors
>are the only people who can be "responsible"
>
>Of course, sometimes adults lie.
>And sometimes doctors are incompetent or venal.
>
>Anyone know the Type 1 / Type 2 errors on this?
>
>How about everyone - even medical professionals - is allowed to sign their
>own certification?
>(Of course they may need advice from Doctors on physical symptoms /
>diagnosis / prognosis, which they can choose to request.)
>
>Which is not the same question as "Am I able to go to work?"
>
>S

Society may rightly expect that the proportion of doctors who are 
incompetent or venal is lower than the proportion of those who may 
abuse society's benefits.

The medical profession is certainly not without faults, but if you 
wish to suggest that the above proposition is untrue I hope you have 
good evidence, and I think we would all expect that evidence to be acted upon.

There are many circumstances, including infectious disease, 
psychiatric illness and even fever (because significant fever impairs 
judgement), where advice from a properly trained practitioner is 
useful and perhaps essential.  Patients, particularly in the past, 
were often advised to take excessive lengths of time off work 
following surgery (usually by nurses, data has been published though 
reference not to hand) compared to the advice given by surgeons or 
many GPs.  Finally for those working in medicine, or in other high 
commitment jobs where the temptation to return too early after 
physical illness is particularly high, a third party who can make a 
dispassionate judgement can be of great help.

There may be a training deficiency in general practice, though I 
suspect we are in fact better trained for and more capable of this 
role than most alternative professionals, but a referral service for 
complex situations would be of value.

FWIW one might suspect that a widespread adoption of long term self 
certification as the above posting appears to suggest would lead to a 
widespread reduction in employee sickness benefits.  This would seem 
profoundly regrettable.

Finally there are likely judgements regarding fitness for work that 
could be regarded as false negatives and false positives, but 
describing them as Type 1 / Type 2 errors seems at the very least 
odd, perhaps even an attempt to obscure or dazzle with 
pseudo-science, though if you're speaking American naturally the use 
of language may be strikingly different.

Julian