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Gold, incentives and meh

Pulling a sickie


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I’m still feeling the remnants of a warm glow as my next patient enters, but it’s fading and about to be unceremoniously extinguished. This happy flush resulted from a lady I saw this morning.

Apparently, 14 years ago, I turned down her request for a sick note for workplace unhappiness and suggested, instead, a new job, which she pursued and which resulted in, I quote, ‘The best ten years of my life.’ This was the first time she’d seen me since and she wanted to say a genuine and warm thanks. Wow. The smallest things etc.

Anyway, with blogworthy symmetry, this next customer is also unhappy at work. He explains this to me, without pause, for significantly more than his statutory ten minutes, by which time I decide the ‘open’ part of the consultation has outstayed its welcome and it’s time to cut to the chase.

‘So I understand that you’re stressed at work and feel you’re being bullied?’ Yes, he says. I explain that I am, of course, sorry to hear that, but wonder just how I can help, exactly, as if I don’t know.

He attempts to trump this by suggesting that my attitude is just adding to his stress

Ah yes, quelle surprise. He wants me to sign him off for a couple of weeks. I gently and politely explain that this is not appropriate, and, despite my CSA-approved attempts to soften the blow, he looks at me as though I’ve just taken a dump on the carpet.

So I decide to elaborate. ‘While I accept that work related stress is a thing,’ I say, ‘It’s not a medical thing, it’s a work thing, and it’s certainly not a medical or work thing that will be sorted out by being signed off sick, because that just avoids, rather than solves, the issue. This is a problem for your employer, not me.’

Now, I believe that to be impeccable logic. But he attempts to trump this by suggesting that my attitude is just adding to his stress, thereby making him worse and therefore even less capable of work.

‘So let me get this straight,’ I say. ‘You now want a sick note for stress because my refusal to give you a sick note for stress is making you so much more stressed that your stress has now reached a level that justifies the sick note for stress that I wouldn’t just a moment ago give you?’

He thinks about this for a moment. Then he storms off, only to storm back in to say, ‘You’re the worst doctor ever,’ before storming out again.

I doubt this is a life transformed, but I am certain of a complaint and a one-star NHS Choices rant. It’s not all bad, though. I seem to be glowing again.

Dr Tony Copperfield is a jobbing GP in Essex


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Readers' comments (16)

  • I tell them there is no stress free job in the world.Give them the sick note as it has to work with the 10min. People will milk and do what the system allows. It is the system that needs changing. Hack, let us all sign each other off for work stress from unilateral contracts and constant changes. That will wake the system up.

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  • |IDGAF | Salaried GP|03 Aug 2018 5:13pm

    His point is that we shouldn't be responsible for this. Its the state exercising its power by intervening in what should be a negotiation between a worker and their employer. and Lorna, I appreciate the situation that you detailed for us, however, were you paid when you took your time out? Would your decision have been different if you weren't? Was there a chance there could've been a negative outcome anyway?

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  • Bravo Copperfield.Each time we surrender to the sickie demands,we reinforce unrealistic expectations.The best definition I read of workplace stress was: "the consequences of the mismatch between employee's expectations and employer's expectation".As Copperfield rightly notes, there is no place for the GP in this equation.

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  • Lorna I had the exact same. I had a great GP who saw how close to the edge I was and signed me off and I went back to the same job and have thrived since.

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  • Just give the note.
    Stress is their perception, not yours.
    Why let it put your blood pressure up?
    By stating work stress on the note, this should be picked up and addressed by the employer.
    I always encourage engagement with employment processes and make sure pt engages with treatments.
    I wouldn't give notes to those not bothering to engage - I explain to pt this would be fraudulent.

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  • although I agree with Tony I issue a note
    "feels unable to attend work due to work related stress"
    in the next box
    "can return to work sooner than duration of this certificate if feels able-does not need to see a GP first or get a return to work certificate"
    and period "12 weeks"!! -have yet to have one object or return to see me!!
    So I am not saying they cant work -just "they feel they cant work" -if the employer cant work out what it means then its up to them!!

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