In the first quarter of 2025, sickness absence in the Netherlands stood at 5.8 per cent, with 22 per cent of absent employees saying that work was wholly or partly the cause. Which raises the question: what does an occupational physician actually do? For you as an employer, HR professional, manager or physician, this is not only about guiding people through illness, but above all about preventing it.
An occupational physician is the medical specialist who works at the meeting point of work and health. The role reaches further than assessing a sickness report: they advise on safe and healthy work, guide absence and reintegration, and think along about prevention, through the walk-in clinic or a periodic occupational health examination for instance. In doing so the occupational physician works independently, with an eye for both employee and employer, and within strict rules on privacy and medical confidentiality.
With absence staying high and the shortage of occupational physicians growing, it is worth understanding what this specialist does and does not do. That insight helps you take the right steps, work together better and make sustainable employability concrete. In this article we set out plainly what an occupational physician does, when to bring one in and why it matters on the floor.
What does the physician do around absence and reintegration?
When people wonder what an occupational physician does, many think straight away of sickness absence. That is partly right, but the role is broader. The occupational physician is a medical specialist in the field of work and health. In cases of absence they assess not only whether you can work, but above all what you can still do and under what conditions a return is possible. That matches the explanation given by the Dutch association of occupational physicians NVAB (in Dutch).
For you as an employee this means the physician looks at what you can bear, at recovery, at the risk of relapse and at a sensible build-up of work. For you as an employer it means you get advice on the return to work, on temporary adjustments and on the steps required under the Gatekeeper Improvement Act (Wet verbetering poortwachter).
Within that Act the occupational physician is a fixed link. After a sickness report, the physician or occupational health service is brought in. By the sixth week of absence at the latest, the physician draws up a problem analysis. It sets out the limitations, the possibilities, the expected duration of the absence and a direction for reintegration. That problem analysis then forms the basis for the action plan between employer and employee. The step-by-step guide from the Dutch employee insurance agency UWV (in Dutch) shows how much timely cooperation matters here.
What does the physician do in the first weeks of absence?
In the first weeks the physician maps the situation carefully. That usually happens during a consultation, by phone or in person. The physician assesses not only the complaints but also the relationship between health and work. Sometimes work is not the cause of the absence but does affect recovery. In other cases workload, physical strain or social tension on the floor do play a part.
The physician then advises on questions such as:
- is temporarily adjusted work possible?
- which tasks are and are not suitable?
- is a build-up in hours sensible?
- are adjustments to the workplace needed?
- when is a new assessment needed?
For employers this matters because well-founded advice helps you offer suitable work and keep the reintegration file in order. For employees it matters because it becomes clear what is expected, without medical details being shared with the employer.
What does the physician do around prevention and healthy working conditions?
Anyone searching for what an occupational physician does misses a large part of the answer if they look only at absence. The physician also has a clear preventive task. Under the Dutch Working Conditions Act (Arbowet) they advise on measures that promote healthy and safe work. According to Arboportaal on what the law says about the occupational physician (in Dutch) that is explicitly part of the statutory tasks.
In practice that means the physician thinks along about risks such as:
- high workload and mental strain
- physically heavy work
- screen work
- exposure to noise, substances or vibration
- irregular shifts
- a socially unsafe environment or unwanted behaviour
For employers this matters because prevention goes further than meeting the rules. It also helps limit absence. That is all the more relevant now that sickness absence remains high. According to Statistics Netherlands, absence in the first quarter of 2025 stood at 5.8 per cent. On top of that, 22 per cent of employees who were absent in 2024 said their absence was wholly or partly work-related. High workload, infection at work and physically heavy work were named most often.
For us as an occupational health practice, it means we do not only react to people dropping out, but also try to pick up signals beforehand. Think of recurring complaints within one team, striking patterns in absence, or risks that are already visible in conversations on the floor.
What does the physician do at the workplace?
The occupational physician has free access to the workplace in order to assess working conditions properly. That is more than a formality. Seeing how work is really done gives a better view of physical strain, pace, cooperation and possible sticking points. Advice on a return to work is simply stronger when the physician knows the practice.
For employers a workplace visit often produces concrete improvements. For employees it is reassuring when a physician does not judge on the basis of a file alone, but also understands what the work actually demands.
What does the physician do when you are not yet ill?
An occupational physician is not only there for people who have already dropped out. Every employee must be able to speak to the physician, without the employer's permission and also when there is no sickness report yet. That can be done through a walk-in clinic, for instance. Arboportaal explains what the walk-in clinic is for (in Dutch).
That walk-in clinic matters for questions such as:
- I have complaints but am not sure whether they have to do with my work
- my workload is rising and I notice I am recovering less
- I am pregnant and want to know what is sensible in my work
- I take medication and want to know what that means for my duties
- I have a chronic condition and want advice on what I can do
For employees this lowers the threshold to ask for help in time. For employers it is a chance to prevent someone dropping out. Talking early is exactly what keeps early complaints from turning into long-term absence.
What does the physician do with privacy and medical information?
An important part of the answer to what an occupational physician does is about independence and confidentiality. The occupational physician is a doctor, falls under medical confidentiality and must advise independently. That means your employer may not hear what your diagnosis is, what treatment you are receiving or which personal circumstances are medically relevant, unless you expressly give permission.
The physician shares with the employer only the information needed for absence guidance and reintegration, such as:
- whether you are fit for work
- which limitations apply at work
- which adjustments are needed
- what timeframe or review moment is expected
That distinction matters. An employer may hear that someone temporarily cannot do night shifts or lifting, but not which medical condition lies behind it. That independent position is also stressed in the information from the Dutch government on engaging an occupational physician or occupational health service (in Dutch).
For employees this makes room to speak openly. For employers it gives clear boundaries: you get what you need to be a good employer and to shape reintegration, but no medical details.
What the physician does with PAGO and PMO
The occupational physician also plays a part in preventive medical examinations. A well-known example is the PAGO, the periodic occupational health examination. It is aimed at preventing damage to health and at spotting health problems caused by risks at work early. Arboportaal on the PAGO (in Dutch) sets out the difference with a broader preventive medical examination.
For employers this means a PAGO is not simply a general health check. Its content has to match the risks of the work. With screen work, neck, shoulder and eye complaints may be central, while in production environments physical strain, noise or exposure to substances are more relevant.
The occupational physician advises on:
- the content of the examination
- which employees are eligible for it
- how often the examination is worthwhile
- which follow-up actions make sense at group level
For employees a PAGO can help to recognise complaints early and to get targeted advice on working healthily.
What does the physician do around occupational diseases and reporting?
A less well-known task is spotting and reporting occupational diseases. When an illness or condition is likely to be connected to work, this has to be assessed and in certain cases reported to the Netherlands Center for Occupational Diseases. That is not only an administrative task. It also helps make patterns visible nationally.
The figures show this remains relevant. In 2024, 2,617 occupational diseases were reported by 690 occupational physicians. Most reports concerned psychological conditions and conditions of the musculoskeletal system. That matches what we often see in practice: long-term mental strain and physical overload have a great deal of influence on sustainable employability.
For employers this is a signal to look further than individual absences. If several employees develop similar complaints, that can point to structural risks in the work. For employees it matters to know that work and health are taken seriously as a pair.
What does the physician do for employer, employee and organisation?
The best way to sum up what an occupational physician does is to look at the different interests.
What does the physician do for you as an employee?
- assesses what you can bear in relation to work
- thinks along about returning safely
- protects your medical privacy
- advises when work affects your health
- is also available when you are not yet ill
What does the physician do for you as an employer?
- advises on absence guidance and reintegration
- helps you meet your statutory obligations
- draws up a problem analysis in time
- advises on workplace adjustments and suitable work
- supports prevention and health policy
That matters all the more because absence has a big impact on teams, planning and cost. Certainly in a labour market with rising absence figures and a continuing shortage of occupational physicians, bringing in the right expertise in time is important.
What does the physician do for the organisation as a whole?
At organisational level the physician helps bridge health, employability and work. Not only in individual cases, but also by spotting trends, discussing risks and making preventive measures concrete. That makes the occupational physician not only a guide during illness, but an adviser for healthier and more sustainable work.
An occupational physician does not only help with absence, but prevents people dropping out and keeps them healthy at work.
With an involved occupational physician and an active health and safety policy, you can organise absence, reintegration and prevention far more precisely and with more regard for people. That way you offer employees the support that fits, and together you keep a grip on employability and health.
Key takeaways
- In cases of absence, the occupational physician looks not only at limitations but above all at what someone can still do safely and responsibly.
- By bringing the physician in on time, you approach reintegration more carefully and meet your statutory obligations better.
- Prevention is an important part of the occupational physician's work, from workload and mental strain to physical strain and safety on the floor.
- Employees can also speak to the physician easily before there is any sickness absence, so complaints are spotted and discussed earlier.
- The occupational physician combines medical expertise, knowledge of workplaces and careful handling of privacy, and in doing so supports employee, employer and organisation alike.
- With a clear role for the occupational physician in your health and safety policy, you work actively on sustainable employability and stay ahead of absence.
By investing now in a preventive approach and in good cooperation with the occupational physician, you build step by step towards an organisation where working healthily becomes more self-evident and where you prevent people dropping out sooner. That is worth a great deal, for your people and for your organisation.