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CAMHS won't see you now

Zealous guardian of the sickie

Who am I to be judge and jury over sick leave? Well, I'm the one holding the pen, and that's exactly how it should be, says Copperfield

Who am I to be judge and jury over sick leave? Well, I'm the one holding the pen, and that's exactly how it should be, says Copperfield

'Work's doing my head in, doc, so I'd like some time off.' Somehow, the patient immediately realises he's increased my tension levels - perhaps because I've just snapped the drug company pen I'm holding. So he hastily adds 'Just a week or two.'

Of course, there are those among the great and good who believe we GPs shouldn't be the arbiters of sick notes. They'd argue we're not adequately trained in occupational health and that disagreements might upset the fluffy doctor-patient relationship.

And I'd argue that those with woolly brains, lily-livers and bleeding hearts should keep their ideas to themselves. Because I enjoy giving out sick notes (a quick consultation) almost as much as I do refusing them (a fun consultation).

True, I'm wound up by punters trying to wheedle a subsidised fortnight in Ibiza on the basis of, say, 'work-related stress'.

I point out that I'd no more manage work-related stress by signing them off sick than I'd treat social phobia by advising they avoid all contact with the human race. And if this is met with blank incomprehension, I summarise with the words, 'bugger' and 'off'.

After all, I can't see how moping around at home on the sick will resolve the fact they believe their boss is a bastard. But, of course, that's where Ibiza comes in: 'It'll do me good, doctor.' Yep, so would a trough load of crack cocaine, no doubt, but you're not having that, either.

Frankly, I'd rather eat my own spleen than issue a certificate under those circumstances. But I don't have to. Because I'm in charge, which is the other great joy of being guardian of the sickie. The Med 3 represents one of the few areas of power GPs still wield, now that all you need to be entitled to prescribe is a cycling proficiency badge.

Besides, the cosy doctor-patient relationship needs shaking up once in a while. Heck, I like a fight, especially if it means I'm not colluding with the sort of people who view a cold as an opportunity to have a medically sanctioned fortnight catching up on Big Brother.

And though I gag whenever I hear the phrase 'GPs are ideally placed to....' (insert drum-banging, doctor-bashing, awareness-raising pressure group's wishlist here) I have to admit that, where sick notes are concerned, we are. There's nobody better positioned than me to decide which of my sickie-pitching patients are workshy chancers - the limping, coughing, emotionally incontinent majority - and which are genuinely ill - like the one who popped an aneurysm last week.

So, who am I to be judge and jury over who merits sick leave? I'm the one holding the pen over the pad, since you ask, and that's exactly as it should be.

And as for your 'week or two off' with work-related stress? A week, sure, and you can put dengue fever on the self-certificate for all I care, because it's you, not me, committing fraud. But two? Afraid not. Get a less stressful job or take it on the chin. Besides, I couldn't sign if I wanted to - my pen's broken.


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