Is it time to ditch sick note requirements? Doctors and patients are fed up

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Black Art White Coat26:30The high cost of sick leave

Patients hate having to ask for them. Doctors don’t like to write them. But some employers across the country still require their employees to receive sick notice so they can stay home for one or more sick days.

More and more doctors and other health care providers are speaking out against it.

They say the notes should not be required for minor illnesses, and for years they have done little more than cripple an already overburdened health care system.

“These patients don’t want to be there. They don’t want to wait eight, 10, 12 hours to see me,” said Dr. Kay Dingwell, an emergency physician in Summerside, Prince Edward Island. “They want to be home recovering.”

Dingwell says she can’t work in the emergency room without at least one person coming in to ask for sick leave. Many tell him they can’t have a day off to recover without it.

Photo portrait of a woman wearing a red shirt with Canadian flags and leaves.
Dr. Kay Dingwell says she can’t work in the emergency room without at least one person coming in to ask for sick leave. (@CanadianKayMD/X)

She sympathizes with employees who may be “stuck between a rock and a hard place,” but says doctors should not be involved in what is essentially a work issue.

“It’s not the health system’s role to monitor employee attendance,” she said. White blouse, Black Art’s Dr. Brian Goldman.

Hayley Bueckert-Dick, who lives in Roland, Manitoba, remembers the difficulty it took to get a sick note from a doctor in 2017, when she had a minor illness while working minimum wage in a fast food restaurant.

“They were really putting pressure on and implying that you might be warned if you didn’t receive (a grade) before your shift started,” she said.

She said doctors at a walk-in clinic were often annoyed when they realized she was there for a note and not medical advice regarding treatment for a common virus.

“I would say I found it really boring, and I found it really embarrassing too.”

Badi Bloodworth, a nurse practitioner who works at a walk-in clinic in Winnipeg, says low-income workers are more likely to need sick leave than those in higher-paying office jobs.

“They’re taking time off work or (coming to the clinic) when they could just be at home recovering, so it disproportionately affects this population that is already disproportionately affected by everything else,” said Bloodworth.

Trust your employees and pay sick leave: experts

Calls for more paid sick leave have increased with the COVID-19 pandemic, as staying home to keep everyone safe has become a regular refrain.

More Canadians have guaranteed access to paid sick leave in recent years, according to a January 2023 CBC News report.

A 2023 report from Statistics Canada found that self-reported paid sick leave coverage “increased moderately” between 1995 and 2022.

He noted, however, that this remains “far from universal” for many front-line workers, such as those who work in grocery stores, daycares or nursing homes.

Dingwell says more paid sick leave is one of the best ways to reduce sick leave requests.

Five adults, including two elderly people in the foreground, wait in the waiting room of a doctor's office.
Some health care providers and medical organizations have taken steps to discourage sick leave requests after seeing such requests fill waiting rooms for years. (Monkey Commercial Images/Shutterstock)

“I think if we can make people feel like they have the right to stay home when they’re sick, we might see fewer disease outbreaks in workplaces,” she said. declared.

Mike Salveta, president of human resources management at Pivotal Integrated HR Solutions, says it’s best for companies and managers to trust their employers when they tell their bosses they need a day leave, particularly in the event of minor illness.

“You don’t want sick people in your workplace getting sick because it can destroy your whole environment in no time,” he said.

Dingwell said this could be seen in places like crowded factories, where one person with gastroenteritis could spread it to half the workforce, making them unable to come to work.

“If the first sick person felt like they might take a day or two to get better, then maybe we wouldn’t see so many illnesses clustered like that,” she said.

Salveta says absences will happen whether you like it or not, whether it’s a cold or a sudden injury, so it’s best to prepare for them.

He advises companies to, for example, train their employees — including supervisors and managers if necessary — to perform the most critical tasks in the event of a colleague’s short-term absence.

WATCH | An association of doctors denounces the obligation to obtain a medical certificate for benign illnesses:

A group of doctors denounces the proposal to impose a medical certificate for minor illnesses

The Canadian Medical Association is concerned about the Ontario government’s decision to allow employers to require workers to provide a doctor’s note to explain even minor illnesses, such as the common cold. The president of the association believes that this measure could pose a public health problem

Refusal of sick leave requests

Some health care providers and medical organizations have taken steps to discourage sick leave requests after seeing such requests fill waiting rooms for years.

In 2020, the Canadian Association of Emergency Physicians (CAPE) released a statement that advocated for employer sick note requirements to be prohibited by federal or provincial legislationand encouraged employees to stay home to recover “if they do not feel they need an acute medical evaluation.”

In 2023, new rules came into effect in Nova Scotia which only allowed employers to request sick leave if an employee had been absent for more than five consecutive work days, or two absences of five days or less in the past 12 months.

Photo portrait of an adult Caucasian man wearing a red and green striped shirt.
When Dr. Gregory Sawisky, a physician in Ponoka, Alberta, receives a patient’s request for sick leave to take a day off, he sends his employer an invoice to pay for the ticket, which he calls an uninsured health service. (Submitted by Gregory Sawisky)

Dr. Gregory Sawisky, a physician in Ponoka, Alta., takes a different approach when a patient requests sick leave: He sends a bill to their employer.

“I tell them what I can do is provide a note that a sick note is a non-insured health benefit…and if the employer requests it, then that payment is the responsibility of the employer,” he said.

If the patient insists on paying the costs themselves, Sawisky encourages them to file a reimbursement request with their employer.

He says he “never, ever” received payment on the bill. He suspects that many employers accept it as a sickness certificate, as it is proof that the employee saw a doctor in the first place.

Part of a printed note written by a doctor asking a patient's employer to pay $35 for a sick note and advising that the workplace end the need for sick notes for short-term illnesses.
Part of a memo from Dr. Gregory Sawisky asking a patient’s employer to pay $35 for a sick note to allow the employee to miss work. (Submitted by Gregory Sawisky)

At the very least, the ironic request may improve the patient’s mood.

“Patients … often have a little smile on their face and say, oh, they’ll be happy to give this to their boss and see what their boss says,” Sawisky said.

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