Sickness absence in the first quarter of 2026 stood at 5.8 per cent, higher than the long-term average of 5.0 per cent. Alongside that, 23 per cent of employees said their absence was wholly or partly work-related, with workload the most frequently named cause. That underlines the value of understanding how an on-site consultation with the occupational physician works, not only during absence but as part of prevention and sustainable employability.
A consultation on site is more than an appointment in a closed room. It lowers the threshold for employees to ask for advice in time, even anonymously and without the employer's permission. That can already be useful before complaints lead to someone dropping out. Spotting things early matters to employers and HR professionals because it helps prevent absence and get fitting adjustments in place sooner.
A consultation on site does raise practical and legal questions. What may an occupational physician share and what not? How does privacy work? When is a face-to-face consultation needed? And what part does the consultation play in the problem analysis and reintegration under the Gatekeeper Improvement Act? In this article we cover what to expect from an on-site consultation and how careful set-up contributes to better absence guidance and fitness for work.
What happens during an on-site consultation
An on-site consultation can have different purposes. Sometimes it is a preventive walk-in clinic, where an employee is not absent but has questions about health and work. In other cases it is absence guidance, for instance after a sickness report or in the run-up to the problem analysis under the Gatekeeper Improvement Act.
The basis is clear in law. Employees must have access to the occupational physician, without the employer's permission. According to the NVAB that may also be preventive and even anonymous, through a walk-in clinic. Arboportaal on the basic contract (in Dutch) also describes that this access has to be properly arranged in the agreement between employer and service or physician.
At an on-site consultation, the appointment is usually easier to reach. The physician already knows the organisation, the floor and sometimes the nature of the roles. That helps get to practical advice faster. At the same time the heart of the conversation does not change: the physician assesses the relationship between health and work, maps limitations and possibilities and advises on employability, recovery or prevention.
Preparing for the consultation
For the employee, good preparation matters. The NVAB advises putting complaints, questions and relevant information on paper beforehand. Think of:
- which complaints you have
- since when they have been going on
- whether work seems to play a part
- which tasks are difficult
- which solutions or adjustments you can see yourself
During absence it is often necessary to bring identification, so that it is clear the physician is speaking to the right person and records the information in the right file. The consultation is not only about the complaint itself but above all about the consequences for work: what can you still do, what is temporarily out of reach and what support would fit?
For employers, preparation starts earlier. An on-site consultation calls for a room where privacy is guaranteed. That means a room that can be closed, out of sight and hearing of colleagues. Precisely because a walk-in clinic also has to be accessible anonymously, that practical set-up matters. The clinic has to be known within the organisation, but without unnecessary thresholds.
How the conversation usually runs
During an on-site consultation the physician usually starts with the purpose of the appointment. Is it about preventive advice, absence guidance, a follow-up appointment or an assessment for reintegration? Then follows an inventory of the complaints, the work situation and the strain in the work.
The physician looks wider than a medical diagnosis alone. That fits the practice of occupational medicine. Factors such as workload, physical strain, working hours, autonomy, room to recover, tension in the team or circumstances at home can all affect what someone can bear. That is relevant, because figures from Statistics Netherlands show that work-related absence accounts for a large share of total drop-out. In the first quarter of 2026, absence stood at 5.8 per cent, higher than the long-term average, while 23 per cent of absent employees said work played a part in whole or in part. Workload is the factor named most often, according to Statistics Netherlands on absence in 2026 (in Dutch).
Because the consultation takes place on site, the physician can take the working environment into the assessment more easily. That is especially valuable with complaints where the workplace may play a part, such as physical overload, ergonomic sticking points or exposure to certain risks. By law the physician also has free access to the workplace. Arboportaal on what the law says about the occupational physician (in Dutch) explains that role.
Privacy during an on-site consultation
A frequent question is whether privacy is sufficiently protected at a consultation on site. The answer is yes, provided it is properly set up. The physician is bound by medical confidentiality and may not share medical details or personal information with the employer. Only functional information needed for absence guidance, continued wage payment and reintegration may be fed back.
In practice that means the employer may hear, for instance:
- whether someone is unfit for work
- which duties are temporarily unsuitable
- which adjustments might help
- roughly how long the limitations are expected to last
But the employer receives no diagnosis or medical background. That separation between medical and functional information matters for trust in the clinic. With a consultation on site in particular, it helps when employees know that an appointment does not automatically mean managers learn what is going on medically.
The consultation during absence and reintegration
When an employee is absent, the on-site consultation often takes a more formal character. The physician then assesses whether and to what extent someone can work, whether adjusted work is possible and which steps are needed for recovery and return. By the sixth week of absence at the latest, the physician has to draw up the problem analysis. That analysis forms the basis for the action plan between employer and employee.
The first consultation leading to the problem analysis cannot be delegated. The occupational physician has to do it personally. That is important for employers to know when setting up their occupational health services. In practice, follow-up contacts can sometimes be prepared or supported by a competent delegate, but the formal responsibility stays with the physician.
For employers who want to organise their process well, it can help to look at your obligations as an employer. That makes clear how the consultation fits within the wider obligations around guidance and prevention.
Why a consultation on site often works better
In many organisations, an on-site consultation has the advantage that signals come to the surface earlier. Employees experience less distance than at an external location and sometimes ask for advice sooner when complaints are just starting. That fits the purpose of the walk-in clinic well: preventing complaints and drop-out before absence arises.
For employers this offers several advantages:
- a faster view of work-related risks
- better-fitting advice through knowledge of how the work is done
- shorter lines between physician, HR and manager
- more attention for prevention alongside absence guidance
For employees, accessibility matters above all. Anyone unsure whether their complaints relate to work can raise it sooner. That applies to rising workload, early stress complaints, physical overload or questions about employability. Even in organisations where the physician is regularly present, it remains important to guard the physician's independent position clearly.
An organisation considering how to arrange this in practice may find footholds on our page about an in-company occupational physician.
What it means for employer, employee and physician
For employers
For employers an on-site consultation means arranging more than availability alone. You have to provide accessible ways to make contact, a suitable room, clear communication to employees and working arrangements in the basic contract. The walk-in clinic also has to be accessible without the employer's permission.
It also helps when managers know what they may and may not ask. The physician discusses health and capacity; the manager focuses on working arrangements, support and reintegration.
Anyone still exploring how to set up the cooperation with an occupational physician can also look at engaging an occupational physician: how it works and what it costs.
For employees
For employees an on-site consultation means help is often closer than you think. You do not have to wait until you drop out. With questions about workload, physical complaints, tension or doubts about capacity, you can get in touch preventively. That is allowed without your employer's permission, and at the walk-in clinic it can also be anonymous.
If you doubt the physician's advice, there is also a right to a second opinion from another occupational physician. That too is part of the employee's statutory protection.
For the occupational physician
For the physician an on-site consultation offers more context. Knowing the floor means advising more precisely on strain, adjustments and preventive measures. A workplace visit is easier to organise when there is reason for one. That can matter with physical complaints, safety questions or signals that working conditions are contributing to absence.
At the same time, working on site calls for extra attention to professional independence, privacy and clear limits in communication. The physician remains an adviser on medical and occupational health matters, not an extension of the employer.
When an alternative is needed
Although a face-to-face consultation on site is often preferable, tailoring is sometimes needed. When an employee is not able to travel, or attending on site is temporarily not feasible, a conversation about a telephone or online consultation may be needed. During absence in particular, the employer has to take such signals seriously and align with the physician.
In practice the starting point remains that a fitting consultation has to contribute to a careful assessment. Sometimes face-to-face contact is needed for sufficient insight, and sometimes another form offers a better temporary solution. What matters is that access to the physician stays easy and that the process does not get stuck on practical objections.
With a consultation on site we spot complaints earlier and help prevent people dropping out.
With a well-organised on-site consultation you make preventive, easily reached contact about health and work possible. That creates room for timely advice, better guidance during absence and more attention to sustainable employability.
Key takeaways
- A consultation on site lowers the threshold for employees to ask questions early about health, workload and capacity.
- Clear communication, good scheduling and safeguarded privacy increase confidence in the clinic and in the physician.
- The physician looks not only at complaints but above all at what an employee can do and which working arrangements fit that.
- Employers receive practical, functional advice, while medical information stays strictly confidential with the physician.
- Knowing the floor and the work process lets the physician reach concrete, workable solutions and preventive advice faster.
- A structural consultation on site supports both absence guidance and reintegration and helps prevent drop-out sooner.
By investing together in a well-organised consultation on site, you take an important step towards healthy and fitting work for all your people. That way you build, with your organisation and your physician, towards sustainable employability, less drop-out and a floor where health and work go hand in hand.