Health care system burdened by requests for doctor’s notes

Legislative reform is needed to stem the flood of contagious flu victims who inundate doctors’ offices, walk-in clinics and hospital emergency rooms looking for doctor’s notes to prove they are too sick to work.

Left alone, the vast majority of these note seekers would recover on their own and simply return to work in a few days. But these employees have little choice but to waste their doctors’ time and expose others to infection because failure to produce a sick note can result in loss of pay and disciplinary action.

The Ontario Medical Association recently flagged this issue in the media by calling on employers to stop asking for doctor’s notes. Scott Wooder, the OMA’s president, noted that every day there could be “tens of thousands” of doctor’s visits for notes.

The OMA is right to protest. Our health system was never intended as a device for employers to control absenteeism. Its widespread use as a policing mechanism is unfair to both taxpayers and legitimate patients who face longer waits and the risk of infection.

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Action by government is clearly required to limit an employer’s right to insist on medical evidence of illness.

One reason why this situation exists is that Ontario’s Employment Standards Act, 2000 (ESA) provides virtually no guidelines for the use of medical evidence or mandatory sick leave provisions. This means that employers are generally unrestrained in their demands for medical evidence with the result that medical evidence policies are all over the map .Many employers, for example, demand a doctor’s note for absences as short as a single day and a majority of employers do not offer paid sick days.

The Ontario government now has an important opportunity to dramatically reduce the strain on our health care system caused be excessive demands for medical evidence. Bill 146, The Stronger Workplaces for Stronger Ontario Act, 2013, currently in first reading, proposes a broad list of amendments to the ESA. This is the first time in 13 years that employment issues have been substantively reopened in the province. This is an important opportunity to establish clear rules for the use of medical evidence and paid sick leave.

Specifically, Bill 146 should be amended to limit doctor’s notes to absences of more than five working days unless there are extenuating circumstances. Exceptions would include cases of chronic absenteeism and ensuring that employees who have been injured or have contracted an infectious disease are well when they return to work and pose no risk to themselves or their colleagues.

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Legislators should also use Bill 146 to establish a set number of minimum paid sick days. This would provide employees with protection against lost wages and further reduce the risk of employees returning to work while still sick for fear of losing pay.

Standardizing minimum paid sick days would also assist employers in maintaining a safe workplace as mandated by occupational health and safety legislation. A returning employee, for example, who is physically unable to perform their work safely could be a threat to themselves and those around them.

Limiting the use of medical evidence and mandating paid sick leave would also be consistent with the Ontario Human Rights Code which requires employers to provide reasonable accommodation for illness.

Today’s employers are under enormous pressure to reduce costs related to absenteeism and improve productivity wherever possible. Being able to demand medical evidence in certain circumstances is a perfectly valid way to curb unwarranted absenteeism.

Amendments to Bill 146 must balance protecting our health care system and the rights of employees with the legitimate need of employers to protect themselves against abuse. It is entirely reasonable, for example, for employers to combat chronic absenteeism with insistence on medical evidence.

Some businesses will likely protest these proposed reforms, particularly the imposition of mandatory paid sick days. Before reacting, these employers should consider the morale and productivity benefits, particularly among the vast majority of their employees who have good attendance records.

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Demanding a sick note from an employee with a strong attendance record clearly implies lack of trust. Hard working employees who are face demands to obtain a doctor’s note are understandably left with the impression that they are suspected of trying to scam the system.

The proposed reforms would foster trust and loyalty in workplaces and contribute to greater productivity.

There is also the issue of limited access to doctors. Employers who insist on medical evidence can shoot themselves in the foot by forcing their people to stay off work longer than necessary simply because they can’t get an appointment.

That said, limiting insistence on a doctor’s note through amendments to Bill 146 would greatly reduce the current strain on our health care system. The time for action is now.