Beware the pre-printed doctor’s note?

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Members of the HR industry are adding their voices to a debate around medical notes, with some criticizing doctors for contributing to absenteeism issues.

Last week, Ontario Medical Association (OMA) president Scott Wooder said HR pros should stop asking for medical notes because it was wasting time and spreading germs.

From the TTC, which demands a note for just one day’s absence, to companies like IBM Canada, which only ask for a note after 10 days leave, the policies vary widely. However, HRM readers were quick to note that some doctors were contributing to the problem by issuing medical notes regardless of the circumstances.

“In my last company I had a folder for 3 doctors who issued medical notes like candy to everyone and anyone,” reader Joanna commented.  “Now the doctors are crying wolf. I'm sorry but I have had to put up with difficult times because it was easier for the doctor just to give the notes. These doctors had them pre-printed and all the receptionist had to do was fill in the patients name and date and collect the fee. What goes around comes around.”
Reader John Fleck suggested that HR needed to focus on problem employees who abuse the system instead of inconveniencing the majority who follow the rules.

Most readers agreed that a policy requiring a note for one day’s absence was extreme, but said in their experience most HR professionals used their discretion and only enforced the policy under suspicious circumstances.

“It should be noted that many employers only require doctor's notes for very short absences where there is a history of excessive absenteeism unsupported by medical evidence,” Nancy Fisher said. “Absenteeism is a societal problem and hence the OMA should work with employers to deal with it. While Scott Wooder does admit that he has no HR expertise, I'd be curious to find out what he thinks that employers and the OMA should do rather than just scolding employers for what we're doing.”

Most suggested there was some middle ground available, such as offering a set number of personal days, which the employee could take at any time for any reason, including illness, child care or a “mental health day”. After those days are exhausted, longer term leave falls under benefit policy and any short term leave is unpaid.

Didn’t have your say yet? Let us know what you think in the comments below.

  • HR Professional on 2014-01-15 9:29:21 AM

    Recently I received a Doctor's note mentioning that the patient mentioned to him that he has seen another Doctor on a certain date. The Doctor also mentioned that he is unable to verify because he doesn't have any records available to him. What kind of note is this? The employees said to him that he saw another Doctor and wanted him to write a note for my Company. It doesn't mean anything to the Company and doesn't confirm that he actually went to the Doctor's office or not. The employee was charged a good amount of fees for writing the note.

  • S. Taylor on 2014-01-15 9:35:39 PM

    To require doctor's notes for less than 3 days absence is to put an undue burden on our healthcare system. Not only is it difficult for most patients to get in to see their doctors in that timeframe but for other ill people to have to wait while doctors are required to write notes for business purposes is unfair. Our health care system does not exist for the benefit of business but to care for the ill. Furthermore, not every illness requires a visit to a doctor and most people know when they need bed rest and over the counter remedies. Businesses have to accept that employing humans means that sometimes those employees will fall ill.
    Problem employees can be dealt with in other ways. We still have limits on the number of sick days permitted under legislation and there are many other means to deal with chronic absenteeism.
    Lastly, companies should be required to pay for these doctors notes, otherwise it could be argued that it is discriminatory based on disability for employees who become ill to have to suffer a financial loss to keep their job. If the businesses had to pick up the bill we would see a quick drop in the requirement to get doctor's notes and this would lessen the burden on an already highly stressed healthcare system.
    HR professionals need to stop reacting in knee jerk bureaucratic ways and see that our healthcare system is not meant to be abused in this manner.

  • Darlene Burns on 2014-01-16 6:46:46 AM

    This debate has been going on for the last 10 years at least, and still rears it's ugly head from time to time. Ethically-driven employers generally have excellent work attendance policies and recognize (and record) attendance abuse. As such the delinquent employee and his/her doctor should expect to have a 'note-required' consequence. I have been in HR management for many years, and getting to the root cause of excessive absenteeism is more important than requesting a doctor's note for 1 day absence.

  • Elizabeth Horlock on 2014-01-19 12:52:41 PM

    How about an agreement between employers and physicians?
    For their part, employers will only require a physician's note after a reasonable period of absence (for example, 5 consecutive days) and employers will reimburse employees a reasonable amount for the cost to obtain the note.
    In exchange, physicians agree to provide useful information about an absence that would benefit their patient (for example, the individual was unable to perform his/her job functions due to illness or injury, and an approximate date of recovery along with any restrictions upon return to work). Physicians also agree to only provide a note where it is medically warranted.
    Likely most concerns expressed by employers and physicians would be addressed by a little quid pro quo.

  • Cheryl Byrne on 2014-01-20 8:36:45 AM

    If an employer is having a problem with chronic absenteeism that they believe is culpable, they should consider investigating as to WHY employees do not want to be at their place of work and address those issues. The best defense against culpable absenteeism is happy, engaged employees.

  • Robin Bender on 2014-01-22 8:52:49 AM

    The solution is to have a company made doctor's note/form that must be completed by the employee's doctor. Do not ask for the doctor to provide the note - or you will get what they give.

  • HR Manager on 2014-01-28 1:15:28 PM

    Or, you can discover, as we did that the employee is writing their own notes, purportedly from the doctor. We had a change in personnel in the position and she discovered immediate issues with a proffered note and upon checking the file we found close to 10 false notes in a 6 month period.

  • HR Manager on 2014-01-28 1:16:30 PM

    We also had one where the doctor provided the note at the request of the Employee's relative without having examined the employee at all.

  • HR Advisor on 2015-11-17 1:28:00 PM

    It definitely depends what industry you are from. Personally, I've found working in a manufacturing environment with thousands of employees, we need to ask for Doctors notes regardless of length of absence. If the absence is not substantiated with a note, then it is not classified as an excused absence. If not enforced we would see a dramatic increase in our absenteeism rate.

  • RAZ on 2016-01-25 6:16:50 PM

    How about if the employee gets the doctors note for 3 months and after the end of 3rd month a new (cookie cutter note) for another 3 months and thats been happening for last 1 year. What suggestion would you have for HR?

  • Heather on 2016-01-30 12:56:00 PM

    interesting that we accept a statement from employees regarding expenses as valid up to a certain financial amount. Some are now requesting a statement for time away from the employee that includes that should it prove false for any reason it is then discipline for accessing a benefit they were not entitled to. We should be considering a philosophy of supporting employee success instead of punishing the ill which is most of them.

  • Karen Nash on 2016-02-16 10:12:02 AM

    To writer RAZ, I presume the workplace is non-union. Employers are not required to accept any skimpy doctor's note. If you don't already have a leave policy regarding excessive absenteeism, you might consider one that allows the employer to require the employee to undergo an IME (Independent Medical Exam) in these instances. They are co-ordinated with your benefit provider and at the employer's expense. They require the doctor to provide details on the prognosis (not diagnosis) of the employee's return to work based on the company provided job description and limitations if any. Although not inexpensive, balanced against the cost of lost productivity it is an option for an employer. Also, per Robin Bender, the employer can design their own detailed doctor's note. Typically the employer pays the cost of the docotor's note for reasons already cited. Before you implement the company's form of an acceptable doctor's note, have it legally reviewed, the circumstances of when it will be required, and the implementation and communication process to avoid allegations of human rights violations.

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