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Dr Archibald raises some valid points and highlights the difficulty of interpreting studies relating to absence duration following surgery and the large number of imponderables that could affect this. In this study, we aimed to compare the variation in absence duration with the general advice they were given about this duration. We concentrated on external variables and in this study did not incorporate all the possible individual variables such as surgical complications or concomitant conditions or even the presence of psychosocial factors. However, it did identify the wide range of advice that was being given and the relationship that individuals tended to remain off work for the length of time they had been advised.Dr Archibald states that ‘by and large individuals will remain away from work as long as they perceive necessary’. Our data would suggest that this perception may be strongly influenced by the advice given by the specialist/general practitioner, hence the need for them to recognize the impact of their advice and the fact that many employers may be able to support an earlier graded return to work. As each patient may have different perceptions, pre-operative discussions with occupational health about return to work following surgery may facilitate an earlier return to work, although it may be difficult to modify any advice that has already been given by the specialist suggesting a prolonged period of absence.
e-mail: peter.verow{at}swbh.nhs.uk
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