Insurance doctors in training buckling under workload as UWV waiting lists mount
While the benefits agency UWV is struggling with massive waiting lists of people applying for an occupational disability benefit (WIA), its insurance doctors in training are buckling under an excessive workload and unsafe work culture, EenVandaag and AD discovered.
These mainly young doctors are training to be insurance physicians at the NSPOH in Utrecht or the SGBO at Radboudumc in Nijmegen. They have all completed medical school and are qualified general practitioners. The training to specialize as an insurance physician takes 4 years. In general, these doctors work four days a week at a practice location, the UWV in this case, and attend lessons on one day.
But instead of focusing on their training, the doctors' primary task is to clear the long waiting lists. “Training is under pressure, and production takes precedence. If you spend time on training, you have to make up for that time,” one insurance doctor in training told EenVandaag and AD. Due to the pressure to produce, the doctors feel unsafe, and their job satisfaction is declining.
“Everything indicates that there is a culture of fear and intimidation here. We regularly have a crying colleague on the work floor and a screaming supervising physician,” a doctor said. Another: “We have to survive. It is a regime.”
Journalists from these media spoke extensively with a large group of trainees working at the UWV in the Amsterdam region and saw many documents that confirm their story.
These insurance doctors in training currently make up nearly half of the doctors working at the UWV. They also perform half of the work while still in training, AD and EenVandaag found. Dropping out is not an option. Contracts seen by the media show that not completing the training will result in fines of up to €70,000 to be paid to the UWV. So many doctors hang in there until two years after completing their training, when their training contract expires.
The professional association NOVAG is assisting these doctors and has written to the UWV and the Registration Committee for Medical Specialists (RGS), the regulator responsible for certifying the UWV as a training location, multiple times. NOVAG raised concerns about insecurity, intimidation, and abuse of power and requested an investigation by the UWV’s integrity office. No such investigation has happened yet.
“We have been seeing problems for some time, and it appears that the UWV does not see the urgency to do something about it,” NOVAG vice chairman Mirko Bal told EenVandaag. “It cannot be the case that an atmosphere of insecurity or a culture of fear exists at a time of shortages among insurance physicians.”
RGS has been intensively supervising the training of insurance physicians at the UWV for a year. Several issues have improved, but the training climate still has problems. The RGS will launch another investigation after EenVandaag and AD’s reports of a culture of fear.
The doctors in training worry that the RGS may pull the UWV’s license as a training location. “If the UWV no longer has the accreditation to train people, the whole thing will collapse,” doctors told the news media. If they’re not training under the UWV, they can no longer perform WIA assessments for the benefits agency. That will have enormous consequences for all the people on the ever-increasing waiting lists.
The UWV told EenVandaag that it considers “a safe working environment extremely important” and therefore takes these reports very seriously. "We have recently discussed this and will continue to do so with the employees involved, NOVAG, the Works Council, and management, because improvements are always necessary."
The benefits agency added that it is in a critical situation in clearing a major backlog, which has consequences for the workload. "Too many people are waiting too long for an assessment associated with a WIA application. As a result, tens of thousands of people are left in uncertainty, and the pressure on employees is increasing. This is especially true given the limited capacity of insurance physicians who have to perform the assessments," the UWV said.
Minister Hans Vijlbrief of Social Affairs and Employment told EenVandag that he takes these signals “very seriously” and has contacted the UWV. “I understand that the UWV has announced that they will investigate this thoroughly. That is a good thing. The UWV is an organization under great pressure, and that is also felt in the workplace.” He has instructed the agency to improve its organizational culture.