Many sick notes are ineffective and getting rid of them would free up doctors’ time for patients who really need care

The Canadian Medical Association (CMA) released a position statement today calling for the elimination of sick notes for short-term minor illnesses, following a similar recommendation in Manitoba earlier this month. 

“Writing sick notes take time away from patient care, and research shows they aren’t an effective way of verifying illness-related absences from work,” said Dr. Randy Guzman, President of Doctors Manitoba. ​“We appreciate the CMA’s new policy statement, reinforcing recommendations from here in Manitoba and from organizations across the country calling for the elimination of sick notes for minor illnesses.” 

Doctors Manitoba has initiated a project to develop alternatives to sick notes, in partnership with employers, unions and other stakeholders. The project also aims to simplify common insurance and employer forms. 

The CMA’s position paper notes that:

• An estimated 12.5 million sick notes were required by employers in the last year.
• Writing sick notes distracts from providing more patients with medical care, and they burden physicians with unnecessary administrative tasks.
• Legislative changes are recommended to restrict sick notes and promote alternatives such as self-certification and flexible leave policies.
• Nearly three quarters (72%) of Canadians support legislation to limit sick notes, according to a new survey commissioned by the CMA.

“Sick notes are not a health systems issue, they’re a human resources issue,” noted Dr. Joss Reimer, President of the CMA, in a news release. ​“We understand that organizations have policies in place to manage their human resources, but when 6.5 million Canadians don’t have access to a family doctor and patients wait far too long for specialty care, physicians need to focus their time caring for patients who need medical care. We need to be there for patients who need us when they need us.”

The final report of the Manitoba Joint Task Force to Reduce Administrative Burdens for Physicians, released earlier this month, also called for the elimination of physician sick notes where medical advice is not required. The research to support this recommendation found that:

• On average, doctors receive 5 – 6 requests per week for sick notes, adding up to over 600,000 requests annually across Manitoba’s health care system.
• For more than a third of sick notes, the patient has no symptoms to verify by the time they see their physician.
• Manitoba is one of only three provinces, along with Saskatchewan and Alberta, with no limits on sick notes. The strongest rules are in Nova Scotia and federally regulated industries, though sick notes are still permitted after five days.

Further Reading:

• CMA release and policy statement on sick notes
• Sick Note Study by Abacus Data, commissioned by the CMA
• Manitoba Joint Task Force recommendation and implementation guide on sick notes
• News release about Manitoba’s project to support eliminating sick notes and introducing alternatives to managing short-term illness leaves from work.