As cold and flu season ramps up in Canada, a group of medical professionals is calling for the elimination of sick notes for short-term illnesses.
The Canadian Medical Association (CMA) released a report Monday stating that around one in three working Canadians were asked by their employers to get a sick note for a short-term health absence at least once in the last year.
This translates to around 12.5 million annual sick notes, the CMA estimated.
“This is a big problem. The Canadian Medical Association is calling for the elimination of sick notes for those short-term minor illnesses — those that don’t need a medical intervention, a diagnosis or a treatment,” said Dr. Kathleen Ross, a family physician and former president of the CMA.
These short-term illnesses include sicknesses that can “typically be managed at home,” Ross told Global News, including the stomach bug, migraines or the common cold.
“They really just need rest and some time to recover from,” she explained, noting that the recommendations do not apply to long-term illnesses, such as cases that require antibiotics, X-rays or other diagnostic tests and treatments.
Sick notes, usually provided by a family physician, confirm a person’s inability to work due to illness or injury and are often required by employers to justify short-term absences.
This practice burdens physicians with unnecessary administrative tasks, detracts from patient care, exacerbates health-care system inefficiencies and inequities, and may contribute to the increased spread of viral illnesses, the report argues.
With 6.5 million Canadians lacking access to a family doctor, many are forced to visit emergency rooms or walk-in clinics to obtain sick notes, the CMA said.
A new Abacus Data survey commissioned by the CMA found that 44 per cent of working Canadians reported their employers have a sick note policy for short-term leave.
For those with a policy, 44 per cent of respondents said they are required to produce a sick note for any length of time off. For the remaining half, the average time off where a note was required was around three days.
Nearly three-quarters of working Canadians support new legislation that restricts requests for sick notes for short-term leave, the survey found.
The problem with sick notes
Sick notes not only burden health-care providers with administrative tasks but also place financial and physical strain on patients, the CMA argued.
Many patients face costs like transportation, parking or fees for the note itself when visiting a health-care provider. Patients may also lose wages if they need to take time off work for the appointment, which can be especially difficult for those with limited resources, the report stated.
Workers are also less productive and more prone to errors when working while sick. Many come to work to avoid the hassle and cost of getting a sick note, which increases the risk of spreading contagious illnesses to co-workers.
“We are very aware that the health-care system is under strain, and that’s particularly true in community care and emergency rooms, and that’s who fills out the bulk of these short-term illness forms,” Ross said.
“They’re an inefficient use of our health-care resources. They certainly burden physicians with unnecessary administrative work. You can imagine how hard it would be to generate a sick note if you don’t have access to a family doctor or do not have timely access to a family doctor.”
Would legislation help?
Several organizations, including the Canadian Association of Emergency Physicians (CAEP), have already expressed concerns about the current burden of sick notes and are calling for a ban on them.
With many Canadians unable to quickly access their family doctor — or not having one at all — emergency department physicians often find themselves issuing sick notes during nearly every shift, which further congests the health-care system, according to CAEP.
The CMA says policy changes to restrict sick note requests and promote flexible leave policies could help relieve some of the administrative burden on health-care providers and improve patient access to care.
And this shift is already underway in Canada.
In July 2023, Nova Scotia enacted legislation preventing employers from requiring sick notes unless an employee is absent for more than five working days or has had two absences of five or fewer working days within the previous 12 months.
Options for replacing sick notes include signed declarations from employees, employee check-ins or return-to-work interviews. Other viable alternatives are accrued sick leave days, flexible wellness days or personal leave days that do not require a medical note.
“It’s hard to know how this will land with employers. I think that there is a burden, both time-wise and financial-wise, on Canadians for covering these sick notes,” Ross said.
“If we can eliminate the need for sick notes, that will be reducing the burden on physicians, reducing the time and financial burden on Canadians. And I think employers will be able to work collaboratively with their employees, or educational institutions with their students to come up with better, more mutually agreed upon ways to address short-term illness.”
— with files from Global News’ Katherine Ward