B.C. doctors create template letter to replace sick notes

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Family doctors frustrated with writing sick notes have created a template letter for patients to give to their employers, explaining that the notes place an unnecessary burden on physicians during an ongoing primary-care crisis. 

They are also calling on the province to restrict when and how employers can ask for sick notes. 

The template, addressed “Dear Employer” and signed by the B.C. Family Doctors organization and the B.C. College of Family Physicians, begins with the line: “Please treat this letter as a sick note.”

It goes on to say doctors are experiencing increasing workloads and burnout, and need to focus on medical care. 

“An appointment with a family doctor is a precious resource,” said B.C. Family Doctors president Tahmeena Ali, adding that the template, created in February, was drafted “to send a message that sick notes are unnecessary.”

Dear Employer, Please treat this letter as a sick note. British Columbia remains in the midst of a primary care crisis, with around one million residents unable to access a family physician due to the shortage. Sick notes place an unnecessary burden on the health care system at a time when family physicians are experiencing ever-increasing workloads and levels of burn-out. The provision of a sick note, similar to completion of an insurance form, is not considered a medically necessary service. Patients who have a family doctor can therefore be charged for this service and those who do not have a family doctor are also faced with long waits at walk-in clinics or Urgent Primary Care Centres (UPCC). As of January 1, 2022, eligible full and part-time employees in BC can take up to five paid sick days. Sick notes are not required for individuals to be eligible for paid sick leave or to return to their places of work or school. On January 18, 2022, the Provincial Health Officer (PHO) stated that if individuals become ill and take sick days, they do not require a note from their family physician to get back to work. We greatly appreciate your support for family physicians by allowing them to focus on those in need of medical care. With thanks,
The template letter drafted by B.C. family physicians for patients to give their employers. (B.C. Family Doctors)

Doctors’ groups have been speaking out against sick notes since at least 2014

Many family doctors spend between 20 and 30 per cent of their day doing paperwork, Ali says, and filling out sick notes only adds to that. 

Ali said it can also put a large burden on the patient. Because sick notes are not covered under health care, patients often have to pay out of pocket, with the typical cost being around $50. 

WATCH | Some B.C. doctors want an end to sick notes: 

Some B.C. doctors want to put an end to sick notes

Some B.C. doctors want the province to limit how often employers can require sick notes from employees, saying it puts an unnecessary burden on both physicians and patients.

Also, having to leave the house to get a note does not allow the sick person to rest, Ali said, and the task is made even more difficult for those who don’t have a family doctor and have to wait in walk-in clinics. 

“A person who feels under the weather — the last thing they want to do is possibly get on a bus, or into their vehicle, or ask someone for a ride to go to their doctors office,” said Ali. 

“You’re putting other people at risk, as well as your health-care provider.”

As of 2023, employers in Nova Scotia are only allowed to request a sick note if the absence is more than five consecutive work days. 

New legislation in Ontario, meanwhile, will force employers to scrap sick notes for the three days of provincially mandated annual sick leave. 

WATCH | The debate around sick notes: 

Is it time to scrap doctor’s notes when you’re sick? | About That

The Ontario government is moving to ban sick notes for short-term illness, in an effort to cut down on paperwork for family doctors. Andrew Chang explores the evolution of sick notes, how they’re used and misused, and why the idea of scrapping them is on the table for discussion across the country.

In a statement sent to CBC News, B.C.’s Ministry of Labour said employers are able to request “reasonably sufficient proof” of illness, but are encouraged to be thoughtful about when they request sick notes. 

It did not respond to questions about whether it is considering legislation to ban or restrict asking for sick notes.

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