The Sick Note Paradox
…The practice meeting was interrupted by the phone ringing, “it’s the police” said the receptionist as she put the call through…
The patient had reported the practice to the police because one of the doctors had not given them a sick note.
The police informed us that if the patient didn’t get a sick note that they were threatening to kill themselves, hence shouldn’t we be giving her a sick note?
I thought to myself, that this was one of those problems that really didn’t have a logical answer because;
If the patient was really serious about killing themselves they wouldn’t really be asking for or needing a sick note.
Then what also crossed my mind was a more famous paradox of ‘what would happen if Pinocchio said my nose is going to grow’?, but it was a pity the patient’s nose wasn’t like Pinocchio’s because then we might know what to do, it was either this patient was either desperately depressed or just desperate not to work.
The cold blooded dinosaur of NHS England are ready to power up their complaints process and get their teeth into any practice who doesn’t give the patient what they want, NHS Choices have nothing better to do than to post unproven slander online, and now it looks like even the local police are getting in on the game.
So after this event, I kept a check on how many sick notes I write, last week I spent over 2 hours signing and reviewing sick note requests, whereas a colleague of mine who now works as a GP in the more affluent leafy suburbs said he only signs about one sick note a week.
It’s also ironic that most of the requests that I get to sign someone off work are actually from people on benefits and don’t actually have a job.
Despite the work load, I’m yet to roll over and hand in the towel or be a soft touch and give patients whatever they want just to make life a little easier for them and my self.
I’m still a traditionalist, and every time I get a request to sign a sick note, am I wrong to ask ‘why’?
Unfortunately the answer I often get is ‘so I can get my benefits’, and this is why I despair, at the least feign illness, make something up, or perhaps go old school and limp into the surgery, (oh and perhaps limp out again as well if you want another note next time).
I once saw a young man who had just left school, he had been brought into the surgery by his mother, the reason for the consultation was that I was informed by her that ‘he’s now old enough for benefits so obviously he needs a sick note’;
Confucius said ‘choose a job you love and you will never have to work a day in your life’.
Whereas it seems to some people that because they can’t find the job they love they too would rather never work a day in their lives either.
At times like this in my job I think of the words of Picasso who said ‘I put my heart and soul into my work and I’m loosing my mind in the process’.
…the tower block opposite the practice had been filled with Kurds, all asylum seekers, the young Kurdish chap sat down next to me and with his rapidly improving English he asked for a sick note, he said he needed a day off, I eyed him up suspiciously and asked why?
He said his legs were hurting, he had 2 jobs and was finding it difficult due to the pain, I asked him to show me where it hurt, he rolled up his trouser legs, his shins were a jigsaw of badly set bone jutting out at sharp angles just under the skin. “This is where they beat me he said”.
I replied “how long do you want”?