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‘Unnecessary’ sick notes a burden on Manitoba, Canada health-care systems, docs say

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The Canadian Medical Association (CMA) says you shouldn’t need to bring a sick note to work if you have a short-term illness.

A new Abacus data survey commissioned by the CMA says around one-third of Canadians were asked by employers to bring in a note to prove their illness at least once in the past year.

Association president Dr. Joss Reimer, formerly a Manitoba public health official, told 680 CJOB that eliminating the sick notes means millions of unnecessary health-care interactions could be prevented each year, freeing up medical resources.

“Maybe you have a migraine, maybe a cold or some GI (gastrointestinal) illness. The last thing you want to do is leave your house and go see the doctor. Really you just need to rest and get better and get back to work,” Reimer said.

“When six-and-a-half million Canadians don’t have access to a family doctor, anything that takes away that family doctor’s ability to take care of Canadians is a problem.”

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Reimer said there are times when a visit to the doctor and a note are absolutely warranted, but not always, and not for minor illnesses.

“Most of these are just the employer saying any time you’re sick … you need to get a note from a doctor.

“We don’t want them to expose other people in the waiting room to a virus when they have a cold, for example,” she said, “and sometimes people are coming in when they’re not even sick anymore … so it’s not even a useful way for us to help employers by verifying illness, because a lot of the time we’re just saying, ‘They told me they had a headache yesterday.'”

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The problem with sick notes, according to doctors

Lukas Neville, associate professor of organizational behaviour at the University of Manitoba, says part of the challenge when it comes to the sick note debate involves the post-pandemic situation in which many workers are returning from remote or hybrid work situations.

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“There was a moment, I think prior to COVID in particular, where people just came in to work sick all the time,” Neville told Global Winnipeg.

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“As the in-person work routine seems to be returning to normal, there’s this return to needing documentation, and I think part of this is there’s a fear that employees will misuse the freedom that they’re granted.

“I think it’s a little bit of a medicalization of some of the politics around remote and hybrid work, and employers who are dragging people back into offices and facing resistance.”

The situation, Neville said, goes beyond sick notes, and is more about the trust relationship — or lack thereof — between employers and employees. While there’s no easy answer, he said he’d recommend that employers avoid creating barriers for employees to stay home if they’re sick, and avoid situations where the actions of leadership seem punitive and create an adversarial relationship.

“Most jobs have the opportunity for people to do the right thing or not, so we have to think about how do you create a sense of responsibility in people?

“Well, we have to trust them. But it actually goes both ways,” he said. “The evidence shows that you get people to behave responsibly by giving them trust and by giving them opportunities to have some freedom, have some autonomy, be able to control their own working lives.

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“And if you grant that trust and you give them a sense of purpose and vision and why their work matters, I think you’re much less likely to see people behave opportunistically.”

Lisa Thompson, president of Brand Revival & Design Inc. said she can see why some companies opt for a sick-note mandate, but hers has been better off without.

“We have open and honest communication, relationships, and that trust (where) as a team where, you know, (sick notes) are one more thing we don’t have to track and worry about,” she said, adding it facilitates a people-first environment.

“(Employees) are obviously relying on you for support, income and all of that, and you’re really relying on them. So, it’s a two-way street and a good opportunity to build a good relationship on trust and empathy.”

“That trust is really appreciated, and shows up in how many sick days are actually taken,” Thompson said. “When a team feels trusted, supported, respected, and taken care of, they also feel more unified. The work that we all love doing together is just that much better for that.”

Brianna Solberg with the Canadian Federation of Independent Business (CFIB) said the CMA actually consulted with the CFIB organization before making its recommendation.

Solberg said most of the federation’s members would like to see a requirement for doctors’ notes scrapped — except in specific situations.

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“While the majority of our members indicated they don’t currently require employees to provide doctors’ notes, 84 per cent still believe that they should retain the right to request them in certain conditions — such as cases of suspected abuse.”

In a statement to Global News, Uzoma Asagwara, Manitoba’s minister of health, seniors and long-term care, said the province takes the concerns of frontline workers and health care experts seriously.

“I have discussed the issue of administrative burden placed on physicians and how that affects the broader system with local advocacy groups, including carefully reviewing the recent report from Doctors Manitoba on reducing physician admin burden, which includes a recommendation on sick notes,” the minister said.

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