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The status of the doctor and variations in the percentage of unfit declarations in medical examinations of shipping and offshore employees in the Netherlands.

BACKGROUND
Both shipping medical examinations in 2012-2013 and 2015 and oil and gas offshore medical examinations in 2009-2011 in the Netherlands show a decline in the percentage of declarations of unfitness as the number of examinations performed annually by each physician increases.


MATERIALS AND METHODS
The data from the electronic databases for shipping employees 2012-2013 and 2015 and the data collected from doctors examining offshore workers from 2009 to 2011 (based on data from a voluntary questionnaire) were subject to a statistical analysis to be able to assess which variables affect the rate of unfitness declaration.


RESULTS
Both shipping and offshore data show a decline in the percentage of declarations of unfitness as the number of examinations performed annually by each physician increases. The shipping examination data suggests that neither the type of physician (family physician, company's physician or other physician) nor the number of years of experience correlates with any trend in the percentage of such declarations. However shipping physicians working as employees had half the percentage of declaration of unfitness when compared to the self-employed physicians. The self-employed physicians, who performed the largest number of examinations per year, had an almost three times lower percentage of declaration of unfitness than the self-employed physicians, who performed few examinations. The percentages of declarations of medical unfitness by physicians working as employees are constant whether they perform many or few examinations per year.