Sickness certification system in the United Kingdom: Maybe charging for certificates clarifies matters

doi:10.1136/bmj.328.7437.461-a

BMJ 2004;328:461 (21 February), doi:10.1136/bmj.328.7437.461-a

Letter

Sickness certification system in the United Kingdom

Maybe charging for certificates clarifies matters

The first 150 words of the full text of this article appear below.

EDITOR—It seems sick certificates stimulate the same concernsthe world over,¹ I have worked in the United Kingdom, Australia,and now in Canada. Sick certificates (and their grander cousin,the "insurance form") particularly seem to challenge the relationshipbetween patient and doctor because it is often a third partythat demands them and not the patient. If we are honest withourselves, how much is "time off work" part of the treatmentplan for a patient? When providing certificates we are, as mentionedby one respondent, more often being policemen for employers,not doctors for our patients.

From another angle we also must be mindful of the potentialharm we can do by providing a sick note "just because the patientdemands it." We certainly don't provide benzodiazepines or opioidson the basis of the same premise. Any professional relationshipthat is based on fear of losing the . . . [Full text of this article]

Paul V Mackey, general practitioner

Fort St John, British Columbia, Canada V1J 2B1 paulori@solarwinds.com