It seems sick certificates stimulate the same concerns the world
over ( I
have worked in the UK, Australia and now in Canada). Sick certificates
(and their grander cousins the "insurance form") particularly seem to
challenge the patient doctor relationship because it is often a third
party
that demands them and not the patient. If we are honest with ourselves
how much is "time off work" part of the treatment plan for a patient. In
fact, when providing certificates we are, as mentioned by one
respondent, more often being policemen for employers, not doctors for
our patients.
From another angle we also must be mindful of the potential harm we
can do by providing a sick note "just because the patient demands it". We
certainly don't provide benzodiazepines or opiods based on the same
premise. I would argue that any professional relationship that is based
on fear of losing the patient or just "giving them what they demand" is
dysfunctional and needs to be terminated anyway.
And what is my cop out solution? Well here in Canada I am free to say
to
the patient that, unfortunately their government medical cover does not
include the cost of sick notes and there is a charge for them.
(actaully I believe the same applies in the UK does it not?). Very
quickly
they seem to become far less necessary when they are not free.
Rapid Response:
Prostituting ourselves for certificates?
It seems sick certificates stimulate the same concerns the world
over ( I
have worked in the UK, Australia and now in Canada). Sick certificates
(and their grander cousins the "insurance form") particularly seem to
challenge the patient doctor relationship because it is often a third
party
that demands them and not the patient. If we are honest with ourselves
how much is "time off work" part of the treatment plan for a patient. In
fact, when providing certificates we are, as mentioned by one
respondent, more often being policemen for employers, not doctors for
our patients.
From another angle we also must be mindful of the potential harm we
can do by providing a sick note "just because the patient demands it". We
certainly don't provide benzodiazepines or opiods based on the same
premise. I would argue that any professional relationship that is based
on fear of losing the patient or just "giving them what they demand" is
dysfunctional and needs to be terminated anyway.
And what is my cop out solution? Well here in Canada I am free to say
to
the patient that, unfortunately their government medical cover does not
include the cost of sick notes and there is a charge for them.
(actaully I believe the same applies in the UK does it not?). Very
quickly
they seem to become far less necessary when they are not free.
Competing interests:
None declared
Competing interests: No competing interests