Fit-for-purpose Med3s might keep me at work
Copperfield is sick of the current fit note system
Well, that’s good. Despite us being overpaid laggards, a Government commissioned review is kindly considering taking some work away from us. Specifically, Fit Notes.
To which I say Yaaaaaaaaaaaaaaaaaaaaaaay!!!!!!!!!!!!!! I don’t want to waste time outlining this new review, nor the inevitable holes in it. Nor do I want to explore why a proper overhaul of Med 3s is long overdue, because you know all that. Instead, I just want to bang on about how much I hate the current system.
So: I absolutely loathe Fit Notes or, as I insist on still calling them, for all sorts of correct reasons, Sick Notes. For example, it shifts my daily dial from drudgery to despair when I see the consultation flag, ‘Depression, needs ongoing sick note’. Because I know these patients are primed to deny improvement, occasionally because that’s true, but almost always because an admission of progress would imply that they might be able to get back to work.
And with these very common presentations, that doesn’t seem to be on the agenda, even when I explain how prognostically beneficial it is – at which point they usually drop some suicidal ideation hints, just to be sure I get the drift, and they get the sickie. I don’t mean to sound cynical, but after 37 years of this, I am.
I’m similarly unsympathetic about ‘stress’. Especially ‘work stress’. A person who has a work problem is just that; they’re not a patient with stress. I’m not saying they’re not stressed. But I am saying it’s not a medical issue, it’s an employer/employee one, and to medicalise it just avoids dealing with it properly. Also: if I don’t feel stressed in my day job then I fret that I might have forgotten something, like turning my computer on. Explaining this – ‘Stress at work is normal and can enhance performance’ – has the same effect on patients as a card trick has on dogs, but it does make me feel better.
Then there’s maybe the dodgiest of them all: bereavement. OK, I’m not a total bastard. I cave in sometimes. But, grief is normal right? And so is finding all the deadmin a bit time-consuming, which is how these requests are often framed. Look, you need some space, fine, rally the family round, take some leave, talk it through with your employer. It’s not a sickness though, so why is there the expectation that I’ll pretend it is and the incredulity when I won’t?
With all this going on, no wonder sickness absence and rates of ‘mental illness’ are spiralling. So, please, take these tedious, dysfunctional, pointless, emotive, manipulative, time-consuming, fractious and draining interactions away from me. Mind you, much trumpeted radical reviews of the system come thick and fast, just like requests for Med3s, and they never seem to achieve anything. Frankly, I’m sick of the whole thing. I mean actually physically, psychologically sick. Any chance of signing me off?
Dr Tony Copperfield is a GP in Essex
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READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
But what’s left, when all the new scheme salaried GPs, sick of doing sick notes, resign from £175k+ Dr Moneygrubber’s practice?
An ARRS-hole.
The problem is you’ll just be asked to do an appeal letter about the sick note decision instead, similar to letters about PIP
“Explaining this – ‘Stress at work is normal and can enhance performance’ – has the same effect on patients as a card trick has on dogs, but it does make me feel better.”
Excellent and hilarious!
Simply Brilliant! Like a breeze of fresh air and so much needed humour in my busy morning while dealing with list of sick requests via online portal, including from patients just registered within last 24hr, without any info at all and wanting a few months off…
Okay….so you’re fed up doing sick notes for shirkers…. and you don’t want to be a bastard, but did you really have to sign “fit to work” notes – for the one-legged amputee to return to her job as a pole dancer….. or the man with sudden blindness to go back to his bomb defusal job…. or the woman with severe urinary incontinence to go back to her job testing pogo sticks….or the patient with 2 arms in POP following RTA to return to her job signing for the deaf…or the TV celebrity who developed Tourettes to go back to presenting Songs of Praise…??
That’s pushing it a bit.
Just sign it and tick maybe can work and explain not ina position to judge and advise OH. I used to get stressed
Out trying to to be fair to society and the patient but gave up and now fit notes are no longer stressful.
I can never understand why employers would want to increase staff sickness statistics and reduce to zero stats for compassionate leave for bereavemeent – which they should be giving staff in this situation instead of insisting on a ‘sick note’. It just results in a business whose stats show they have zero compassion for staff, and have a high level of staff sickness, which prospective employees, purchasers, or reviewers will correctly interpret as because the business is a ‘Bad Employer’. I see nothing wrong with writing on the note : diagnosis: bereavement; duration : as per employer’s bereavement/compassionate leave policy’. then staff will find out (including line managers!) what a poor compassionate leave policy the business actually has.