On doctor’s notes, there has to be a better way (Guest Commentary)

In 28 years, I’ve rarely denied anyone a sick note – and requiring them creates shocking waste

Requiring sick notes for absent employees might seem like a good idea from an HR perspective, but consider it from my vantage point — I’ve been a family doctor for the past 28 years and I probably see an average of two patients per day who are only there for illness documentation.

That’s two extra patients crowding my waiting room, possibly spreading the flu to pregnant women, cancer patients and small children.

And for what? In 28 years, I’ve rarely denied anyone a sick note. If a patient says they’ve been vomiting or have a sore throat or otherwise feel terrible, of course I take them at their word.

If I’m typical — and I have no reason to doubt it — the waste this creates is shocking. Even one sick-note patient per day times 12,500 family doctors in Ontario times roughly $35 per visit equals far too much money down the drain of our health-care system — funds that could be spent on medical advances or improving the quality of care.

Over the years, I’ve also noticed that an increasing number of patients require a sick note for even one day of missed work. This is a harsh and irresponsible policy, not least because it forces a sick patient out of bed and into contact with others at the very height of their illness.

Many work for small and medium-sized companies, often in low-wage positions, and they tell me they don’t get paid for even one sick day.

There has to be a better way.

In my other capacity as president of the Ontario Medical Association (OMA), I spend a great deal of time worrying about how to make our health-care system sustainable in the face of a growing and aging population.

And how to make sure we have the resources to pay for the exciting new medical treatments and equipment coming online. Polls show health care is the most important priority for the Ontario public.

We can’t afford to squander any more health-care resources forcing doctors to police absenteeism on behalf of industry.

Maybe that’s why this issue hit a nerve when I spoke out about it last month to a couple of reporters. Within a day, I found my remarks had gone viral.

Judging from the online comments and other feedback, the public is onside with doctors.

It’s not that I don’t understand concerns over absenteeism. As a physician, I’m a small business owner myself. I agree that if an illness drags on, medical documentation is warranted.

That’s why I’m happy to sit down with industry to find a better way of dealing with the sick-note issue. There’s a body of research on this issue that can be explored. We can look to other jurisdictions for guidelines and laws that have worked.

But let’s do something — it’s in everyone’s best interest.

Scott Wooder is president of the Ontario Medical Association, which represents the province’s physicians, medical students and residents. He is a doctor with a practice based in Stoney Creek, Ont. For more information, visit www.oma.org.

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