Norway Doctors Rewarded for Not Issuing Sick Notes

Norway is overhauling its fee system for general practitioners, shifting financial incentives to discourage the issuance of full sick notes and encourage reduced sick leave. Previously, doctors earned more by signing patients off work, but under the new agreement between the government and the Norwegian Medical Association, the system is being reversed.

Health Minister Jan Christian Vestre expressed satisfaction with the agreement, stating, "I am glad that we have reached an agreement with the Medical Association on important measures that will strengthen the general practitioner scheme and contribute to reduced sick leave in the population." The new system aims to make it more financially attractive for doctors to engage in more in-depth conversations with patients about their health and work capacity, potentially leading to graded sick leave or alternative solutions rather than immediate full incapacitation.

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I am glad that we have reached an agreement with the Medical Association on important measures that will strengthen the general practitioner scheme and contribute to reduced sick leave in the population.

Anne-Karin Rime, president of the Norwegian Medical Association, highlighted the collaborative nature of the reform, noting, "The general practitioner scheme is based on partnership; we are therefore pleased that we have now laid the foundation for finding good solutions together." This collaborative approach is seen as crucial for the success of the new fee structure.

Data from Helfo indicates that in 2025, over 3.1 million of approximately 17.2 million consultations were related to sick leave. The revised fee structure will offer higher remuneration to general practitioners when patients are not fully sick-listed or are given graded sick leave, compared to situations where a full sick note is issued. This change is expected to directly impact the national sick leave figures by encouraging more nuanced medical assessments and patient discussions.

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The general practitioner scheme is based on partnership; we are therefore pleased that we have now laid the foundation for finding good solutions together.