Another ethical muddle for GMC

doi:10.1136/bmj.39542.452662.3A

BMJ 2008;336:788-789 (12 April), doi:10.1136/bmj.39542.452662.3A

Letters

Health of the workers

Another ethical muddle for GMC

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

I note that it is now acceptable for a highly respected senioroccupational physician to use the phrase "unaudited farce" inpublic and in the BMJ in relation to sick notes.¹ A major partof the workload of many occupational physicians entails sicknessabsence, and much of this entails disagreeing with the advicegiven by general practitioners via sick notes. In most areasof medicine, specialist doctors guide and advise generalists.To employ one doctor just to disagree with another is an unusualconcept in health care.

The reason for this is said to be ethics. GPs are ethicallyobliged to be the patient’s advocate, so when patientssay they do not feel well enough to work, the GP is expectedto support them. A fine principle perhaps, but clearly muchabused. GPs say that advising on fitness to work is an areathey are untrained for. Often, however, the . . . [Full text of this article]

Anthony N Williams, consultant occupational physician

¹ Working Fit, PO Box 389, Dover CT16 9BF

tonywilliams@workingfit.com