As with any profession, returning to work after a long-term absence because of illness or injury can be daunting for healthcare providers. You might find yourself returning to an altered workplace environment and changes in your own abilities. The “aftershock” of your absence can be exacerbated by such changes, preventing you from becoming fully engaged with your work. Fortunately, there are steps both you and your employer can take to help you move forward.

Understanding Aftershock

Anyone returning to work after a lengthy absencecan experience aftershock, regardless of the reason for that absence. Andrew Parsons, PhD, a master’s student at the University of Hertfordshire in the United Kingdom, said, “The aftershock is related to changes in several areas that might not have been so apparent to the employee while they were away from work and receiving treatment. This can include physical changes, such as reduced energy and capabilities, or potential changes in relationships, such as negative attitudes about your absence and fewer social activities.”

To overcome aftershock and achieve work engagement, Dr Parsons advised that “Organizations should support the individual to develop their sense of empowerment, provide psychological resources, and create awareness of the trajectory of return to work.” He added that the process requires specific communication skills, such as coaching and mentoring, to rebuild the individual’s confidence.

The contribution of managers in the return to work of physicians cannot be underestimated. In particular, there are 4 key areas where the direct actions of superiors are crucial:1

  • Providing feedback
  • Offering assistance
  • Recognition of illness and limitations
  • Emotional support

If you do not feel you are receiving 1 or more of these, it may be time to arrange a meeting to discuss your progress and support needs.

Maintaining Contact

Long-term absence can lead to isolation and a loss of social contact with peers and colleagues,2 which can understandably cause you to worry about your position and value to the organization. Try to make a regular effort to communicate with your employer during your absence. It is important to brief them about your illness or injury, your recovery progress, any new challenges you may be facing, and any workplace adjustments you may require when you do return.

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Conversely, your employer also has a responsibility to stay in regular contact, keeping you informed of new developments in the workplace. This can help provide assurance that you will be supported on your return. If possible, go in to your workplace for occasional meetings to discuss your recovery progress and explore ways in which your employer can support you in the return-to-work process. Visiting your workplace can also help maintain social connections and reduce feelings of isolation.

In a study published in the Journal of Occupational Rehabilitation, researchers asked breast cancer survivors who returned to work which practices from their supervisors they found most helpful.3Maintaining communication during their absence was 1 of the 3 most helpful practices identified, alongside participating in planning their return to work process and flexibility in their work schedule for a certain duration after their return to work.

Phased Return

Phased return is only possible if you are well enough to perform some work and are likely to recover sufficiently to fulfil your previous role.2 The advice of a physician or occupational psychologist is required to determine whether a phased return is possible. It may be tempting to use your own medical expertise to make such decisions, but it is always better to seek independent advice.

There are a wide range of workplace adjustments that can be implemented to facilitate your return, including flexible working hours, alternative or light duties, training and assistance, and use of special equipment or furniture.4 As a physician, you are likely to already understand how your illness or injury may limit your ability to perform your regular duties. It is therefore important to be open and honest about your condition and limitations so that you can get the best support and adjustments available.

Taking a Person-Centered Approach

Each return-to-work case is unique because illness and recovery are individual experiences. Any support and adjustments must be based on your unique needs, rather than having a standard approach for all. As Dr Parsons emphasized, “It’s really important for organizations to realize a 1-size-fits-all approach is unlikely to be effective. There is a need to make processes bespoke or person-centered.”

Evidence shows that a person-centered approach increases the chances of a successful return to work. For example, researchers from the Karolinska Institutet in Stockholm, Sweden, found that people who had suffered a stroke and were offered a person-centered rehabilitation program focusing on their return to work expressed satisfaction at being given an opportunity to contribute to decisions around their rehabilitation. 5

Creating Awareness

In situations in which long-term absence is caused by illnesses such as cancer or chronic disease, it may be helpful for your employer to create awareness among staff about the issues you are facing. This might feel uncomfortable; perhaps you would prefer to do this yourself by talking to closer colleagues privately. Although your health is your own business and not something you need to discuss with colleagues, it can help them understand and support you better.

Researchers from the Ludwig-Maximilians-Univeristät in Munich, Germany, conducted an online survey across 7 European countries of participants living with chronic conditions. Survey participants cited the attitudes and support of others as major factors affecting their lives when they return to work.6 The study, published in the International Journal of Environmental Research and Public Health, highlighted the importance of changing the attitudes of coworkers and managers to counter the stigmatization of people with chronic health conditions returning to the workplace. Effective communication skills may play a role here, with Dr Parsons highlighting such skills as an area that colleagues and managers may need to work on to facilitate meaningful interactions with employees returning to work after a long absence.

Ensuring a Smooth Transition

The aftershock of returning to work after a long absence is common across all industries, but an effective return-to-work process can help people settle back quickly and achieve work engagement again. Key factors for physicians in facilitating a smooth transition back into the workplace is for you to maintain regular communication with your workplace and to be proactive in planning your strategy for reintegration. Your employer can help by allowing phased returns, flexible schedules, and light duties while you are still recovering.


  1. Negrini A, Corbière M, Lecomte T, et al. How can supervisors contribute to the return to work of employees who have experienced depression? J Occup Rehabil. 2018;28(2):279-288.
  2. Managing long-term sickness absence. University of Cambridge. Accessed February 11, 2019.
  3. Caron M, Durand MJ, Tremblay D. Perceptions of breast cancer survivors on the supporting practices of their supervisors in the return-to-work process: a qualitative descriptive study. J Occup Rehabil. 2018;28(1):89-96.
  4. Managing long-term/ongoing absence guidance. University of Glasgow. Accessed February 11, 2019.
  5. Öst Nilsson A, Eriksson G, Johansson U, Hellman T. Experiences of the return to work process after stroke while participating in a person-centered rehabilitation program. Scand J Occup Ther. 2017;24(5):349-356.
  6. Foitzek N, Ávila CC, Ivandic I, Bitenc Č, et al. What persons with chronic health conditions need to maintain or return to work—results of an online-survey in seven European countries. Int J Environ Res Public Health. 2018;15(4):595.