Doctors react: Is Canada Post’s request for doctor’s note a good idea?
TORONTO – Doctors may see more traffic in their offices after Canada Post announced that it’ll need medical information from people who need home delivery.
The national postal service is phasing out its home delivery in favour of community mailboxes. But it’s accommodating anyone who says they’re physically unable to get their mail – as long as they provide a doctor’s note.
“We’re going to need to enhance our accommodation approach,” Canada Post spokesman Jon Hamilton told Global News.
“There’s no one size fits all – we need to have solutions we can tailor to individual circumstances,” he explained.
The crown corporation is mailing out questionnaires that’ll ask Canadians to indicate if they can pick up their mail from the community mail box. If they can’t, they’ll need to share the details of their medical history, disability and a doctor’s note to prop up their claims.
For now, the questionnaire is meant to help the corporation “gain a better understanding” of personal situations so it can discuss the various types of assistance that might be appropriate.
The Canadian Medical Association says it’s ‘surprised.’
“This demonstrates a complete lack of awareness of the challenges facing health care professionals and the patients seeking access to care. Physicians are already burdened with administrative process that comes at the expense of face time with patients,” CMA president, Dr. Louis Hugo Francescutti, said in a statement.
“It appears little consideration has been given to the confidentiality and privacy of patient information. We ask that Canada Post immediately interrupt the application of its policy and give thorough consideration to all aspects of this issue through consultation with all stakeholders,” the statement read.
Canada Post says that it came up with this solution after consulting dozens of national organizations that look after seniors and people with disabilities or mobility issues.
The issue may not be about getting to the mailbox, but retrieving the mail because of arthritis of dexterity issues. To resolve that, Hamilton suggests that special keys could be made, or trays could be pulled out to get the mail. Mail could be placed in the community box, then collected and delivered at the end of the week.
Other options include delivering mail to a relative or adjusting the mailbox height. Those situations won’t require a doctor’s note.
But if you’re requesting at-home delivery, you’d need “some type of validation.” After evaluating other accommodation programs, Hamilton says that a doctor’s note was the best option.
Doctors’ notes are contentious, though. Some critics say they take up valuable resources and eat into doctors’ already time-strapped schedules.
Toronto-based family physician Dr. Christopher Culligan says the process could be a nuisance or it could be a breeze – it all depends on how Canada Post decides to standardize the process.
Doctors already fill out Workplace Safety and Insurance Board forms in Ontario, for example, along with other forms such as parking permits for disability. The criteria are clearly laid out, so the physicians check off any medical conditions that apply to their patients and sign off on the details.
“It doesn’t have to be an onerous form, it could actually be very streamlined. But if they expect physicians to lay out the details without clear categories, then it’ll be a problem,” he explained.
The ideal scenario would be Canada Post covering its bases, determining what conditions merit at-home delivery, and doling out an easy-to-use form for Canadians and their doctors to fill out.
The questionnaire could even quantify how long at-home delivery is required – it could be on a monthly basis, yearly or indefinitely.
But Dr. Roy Wyman, a Toronto-based family doctor and College of Family Physicians of Canada spokesman, says that simply checking off boxes may not suffice.
“It should be patient-centered, and it makes much more sense for individuals to make the declaration. I’m not sure if you need a physician to sign off,” he told Global News.
The college wrote to Canada Post about its concerns after consulting with patients. They may not have a medical condition, but they could have their own concerns about how to get to their mail.
“There will be individuals who have difficulty accessing the application or having trouble with the process when someone has to sign off,” Wyman said.
He’s also wondering who is making the decisions on what merits an exemption, if there’s an appeals process, and if there are any issues with sharing patient’s confidential information.
Family physicians aren’t the only experts who can sign the forms – occupational therapists, physiotherapists and other specialists can, too. If doctors charge fees for their sign off, Canada Post says the patient is on the hook – it’ll cover the costs of the special accommodations made, though.
Last winter, the Ontario Medical Association urged employers to stop asking for sick notes during the flu season. It warned that doing so may be forcing sick employees into doctors’ offices, potentially infecting others and taking up valuable appointment time.
Hamilton said a “small percentage” of Canadians could be affected. If you live in an apartment building, seniors’ home or other complexes that already have a community mailbox, nothing changes.
Canada Post serves about 15 million homes – only five million have door service. About 100,000 addresses are making the transition this year. By 2019, the transition from home delivery to community mailboxes should be complete.
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