Docs forced

Dr Abdon DaSilva (right) and Tony Walcott.
Dr Abdon DaSilva (right) and Tony Walcott.

A member of the Barbados Medical Council and former President of the Barbados Association of Medical Practitioners, told a breakfast panel discussion on absenteeism that doctors were being forced to sign sick certificates.

Speaking on the subject “Absence Management”, this morning at the Savannah Hotel, panellist Dr. Abdon DaSilva, stopped short of saying that medical practitioners were being bullied into writing certificates for patients.

In an “unapologetic” presentation, DaSilva cited a case in Britain which was published in 2002 in the British Journal of General Practice, which he suggested was a metaphor for what happens in most doctors’ offices in Barbados.

“It remains very hard to refuse a Med 3 to an angry patient who is bigger than me, and between myself and the door,” DaSilver read from wrote general practitioner Lydia Stevens article in that publication.

He then added: “A lot of doctors are being forced to write sick certificates and have reduced themselves to being secretaries.”

The event, which was organised by the newly-elected committee of the Human Resource Management Association of Barbados, also heard DaSilva say the information on the certificates was based on what was told to the doctor, [and that] “not all patients tell you the absolute truth”.

“They get upset when you tell them you don’t believe them. It’s also based on what we find when we examine the patient.”

He pointed out that a sick leave certificate was a legal document, which could get doctors in trouble, if the contents were false. DaSilva also warned that a certificate must never be back dated.

“The chief offender here in my experience is the National Insurance Department. The patient would not be employed currently; because they would have contributed money to the NIS, they go in and they are told, ‘You are entitled to some money, go and get the doctor write you… Get your certificate, even though you haven’t seen a doctor during your illness,” the medical practitioner suggested.

He was of the view that the decision or instructions of the NIS should never be based on the information given by the patient of what may have happened a week or two previously. He recommended that employers include in their policies, provisions to address cases where workers failed to turn up for duty after a weekend or Kadooment.

DaSilva also referred to the Medical Professions Act to warn that a doctor should not issue a certificate for anything, if he or she knows, or ought to know it is untrue, misleading or otherwise improper. He pointed out that patients go to doctors and demand sick leave certificates.

“It is true, and there are lot of doctors who are being forced to write certificates and they have really just reduced themselves to becoming secretaries. That’s my take on it, no apologies — ‘I want two weeks home’; ‘there you go’,” he asserted.

DaSilva said it was a myth that a sick certificate was mandatory for all absences, or that an employer had to accept the advice on a fit note. (EJ)

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