Medical association calls for elimination of sick note requirements by employers

The Canadian Medical Association wants to eliminate sick note requirements by companies for employees with short-term minor illnesses, saying they burden physicians with unnecessary administrative tasks.
In a position paper released Monday, the association said that having to write sick notes detracts doctors from patient care, while burdening the health-care system with around 12.5 million unnecessary interactions per year.
A new survey conducted by Abacus Data for the CMA showed around one-third of working Canadians were asked by their employers to produce a sick note for a short-term absence at least once in the last year.
“That’s frustrating for the doctors because we want to be able to spend the limited time that we have caring for patients who really need medical care, not filling out paperwork to address a human resource issue,” said CMA president Dr. Joss Reimer in an interview.
“It’s also frustrating for the people who need to come in because if you’re having a migraine or you have a cold, the last thing you want to do is leave your house and have to go to a clinic and see a doctor, when really what you need to do is rest, relax and just get better so you can get back to work.”
Reimer said physician appointments, including evaluations that include writing up a sick note, should be reserved for patients who “really need medical care.”
For example, she said that may be a patient who has been sick for more than a few days, someone who potentially requires lab work, or a person that would need a prescription in order to get better.
“What we don’t want is somebody who knows that they’re going to have a self-resolving condition, they know that they just have a cold, they know they have their usual migraine, it’s going to get better,” she said.
The CMA’s position paper calls for legislative changes to restrict the requirement for sick notes and promote alternatives such as self-certification and flexible leave policies.
Adopting those changes would ease the administrative burden on health-care providers and improve patients’ access to care and the overall efficiency of the health-care system, the association said.
In May, the Ontario government proposed legislation to stop employers from being allowed to require a sick note from a doctor for the provincially protected three days of sick leave that workers are entitled to.
Under the bill, which received royal assent on Monday, employers retain the right to require another form of evidence from an employee such as an attestation or a receipt for over-the-counter medication.
Nova Scotia has also acted on the issue, implementing a change in July 2023 that restricts employers from requesting a sick note unless an employee is absent for more than five working days or has already had two absences of five or fewer working days in the previous 12-month period.
When employees do need to produce a sick note, other health-care professionals besides doctors are able to provide it. That includes nurses, pharmacists, physiotherapists and social workers.
Reimer said those changes were in the right direction, but should come with fewer caveats.
“We’d like to see it go beyond that to just say, ‘Let’s just not have physicians be part of the human resource process in the first place,’” she said.
This report by The Canadian Press was first published Oct. 28, 2024.