Doctors call in sick on notes

Doctor’s notes a drain on health-care system but how else can employers combat absenteeism?
By Sarah Dobson
|Canadian HR Reporter|Last Updated: 02/25/2014

Looking to lower absenteeism rates, the Toronto Transit Commission (TTC) negotiated a new policy around sick days in a 2011 collective agreement. Instead of requiring a doctor’s note after five non-consecutive sick days, the TTC now requires a note, within 72 hours of the absence, after just one sick day.

Since then, absenteeism rates have dropped to around 7.5 per cent from 8.5 per cent, while the non-unionized side is around three or four per cent, according to Brad Ross, executive director of corporate communications at the TTC.

“We felt that a five-day, non-medical-note sick day provision benefit was being used by some as vacation, to be perfectly frank,” he said.

The TTC relies on workers to show up to their scheduled shifts to provide service to the public, said Ross.

“If they do not show up for work and call in sick and don’t have a sick note, then there are consequences because of the kind of business that we’re in.”

But Scott Wooder, president of the Ontario Medical Association (OMA), caused quite a stir recently when he recommended employers stop requiring sick notes and encourage workers to stay home when ill.

“What concerns me is that requiring sick notes based on a short absence from work brings patients into waiting rooms and encourages the spread of germs. It puts other patients at risk, particularly those who are more vulnerable,” he said. (For more, see Wooder’s commentary on page 23.)

This argument, however, is frivolous and lacks common sense, according to Howard Levitt, senior partner at Levitt & Grosman in Toronto.

“The statement that ‘We don’t want people not going to the doctor’s office’ is ludicrous — where else are people supposed to go than their doctor’s?” he said.

“We have an increasing epidemic of sick leave claims in this country, it’s been the biggest problem human resources managers have been experiencing in the last several years… and if employers simply have to accept employees’ word for it, it’s going to lead to a genuine pandemic of absenteeism and illness claims.”

Truant officers?

But helping employers police employees’ attendance is not the role of physicians, according to Wooder.

“Doctors understand the challenges that some workplaces may have, but it is not our responsibility to police employees. I don’t think it helps anyone when sick individuals come to the doctor’s office. This is especially true during flu season but would apply at other times too.”

Kevin Chapman, director of health policy and promotion at Doctors Nova Scotia, agreed.

“You take up a spot... or an appointment time for something which is essentially an administrative requirement — you’re really looking to have the sick note that says you’re OK to return to work,” he said. “Oftentimes, all we’re really doing is satisfying that administrative requirement and essentially being the gatekeeper.”

But what other way is there for employers to know if someone’s really sick? said Levitt.

“There is no other way, unless you’re hiring private investigators to attend their homes, which might be even more intrusive.”

And the OMA isn’t just talking about the flu — it’s talking about doctor’s notes in general, said Levitt. “A very small portion of employees’ absences are related to the flu — the large majority relate to supposed stress days which is not, except in the extreme, disabling.”

The recommendation is also legally wrong, he said, because employers are required to accommodate employees and create modified work, if needed. And the only way to do that is with medical evidence, said Levitt.

“It’s not just a matter of proving they’re genuinely ill — they probably are after three days (away) — but to make sure they’re getting medical attention and also you’re in a position to accommodate them properly.”

Targeted response

But if there are individuals who are taking advantage of employers, policies and processes need to be directed at those people — and not put the burden on physicians, said Chapman, who is based in Dartmouth, N.S.

“We absolutely respect and acknowledge the enormous cost, I’m just not sure a blanket position is the best way to manage that and it puts a burden on the health-care system, particularly during the flu season, that is already incredibly overburdened,” he said.

“Oftentimes, I think what we do is we penalize the 95 per cent for the transgression of the five per cent, so we wrap everybody under the same umbrella.”

Employers should target those workers who are “cheating” with a policy that kicks in after a certain number of days absent, said Levitt. So if people are being honest and they’re sick two days per year, there’s no need for the notes.

“It’s got to be applied reasonably — if they have a pattern of absenteeism that suggests that they’re not actually sick, then they should be asked to prove their illness with doctor’s notes.”

And this shouldn’t upset employees overall, he said, as they know when a colleague is cheating the system — and often they have to pick up the extra work.

under the weather

Employees frequently sick at work

More than seven in 10 (71 per cent) workers admitted they frequently go to work when they’re feeling sick, and managers agree — 68 per cent said ailing employees head into the office at least somewhat frequently, according to an OfficeTeam survey of 404 workers and 304 senior managers in Canada.

How frequently do you (employees) go to work when you feel sick?

Very frequently

48%

Somewhat frequently

23%

Somewhat infrequently

22%

How often do you (managers) think employees come to work when they feel sick?

Very frequently

23%

Somewhat frequently

45%

Somewhat infrequently

29%

Never

2%

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