Dr Kerryn Phelps, AMA President - ABC Radio 2BL

EPSTEIN: What we will talk about first is the great Australian institution of an Australian sick day.

A great institution if you're the worker, not so great if you're the employer. The Hotels' Association has been saying something about that.

CATTERNS: They have, indeed. They're concerned about the ease with which sick leave appears to be given by doctors. We have been joking about it, but I guess it's a serious matter. But I don't know anyone who's actually been knocked back when they've asked their doctor for a medical certificate.

We're joined now by Doctor Kerryn Phelps, who is the National President of the AMA. Doctor Phelps, good morning. Do you agree that they are a little too easy to obtain, medical certificates from doctors?

PHELPS: I don't think so. I think people do need to be questioned by their doctors and doctors need to be satisfied that the patient in fact is too sick to go to work. One thing that doctors cannot do is give people a backdated certificate. If the doctor hasn't seen the patient when they're sick, they can't backdate that certificate. The best you can do is to say that the patient consulted you and that their story is consistent with having been sick.

EPSTEIN: We had a caller earlier who runs a whole lot of subcontractors and he said that it's virtually impossible for any of his workers to get knocked back by their doctors, that as far as he could tell nobody gets knocked back. As soon as you tell the doctor you're sick, you get a certificate. Do you think that's true? Have you ever knocked anyone back?

PHELPS: Of course you do. If you don't think that people are genuine, you don't give them a certificate. It's a legal document. I think, where possible, patients can do the best thing for themselves by making an appointment to see their doctor on the day that they do feel too sick to go to work, and not asking doctors to back date certificates. You have to bear in mind that most doctors are employers as well, so we certainly understand the implications for a business of people who are employees in that business not turning up for work. But you also have to understand that, particularly in the case of infectious disease, like colds and 'flu, that it's unfair to other workers for people to turn up to work.

CATTERNS: Doctor Phelps, one of our listeners suggested that it was at rather large kind of medical centres where somebody could just show up and see any doctor, not necessarily one who's familiar with their ongoing state of their health, and almost get one over the counter.

PHELPS: I think doctors do try and do the right thing no matter where they're working, and try and put the interests of their patients first and have to make a judgement call. You can't give a medical certificate without having seen the patient. We do have to put the interests of the patient first. But I would say that the Australian Medical Association would be more than willing to work with employer groups if they are perceiving that there is a problem to see if we can do something to assess and to address their concerns.

EPSTEIN: Is it a misconception, or how big do you think the problem is, because everyone seems to think that it's easy to get a certificate? Do you think it's actually going on to any large degree?

PHELPS: I don't think it's going on to a large degree, but once again it's an anecdotal point of view from both sides really. I think we don't really have any scientific evidence one way or the other that there is an over issuing of medical certificates or indeed under issuing. One of the concerns that the Hotels' Association expressed is that there is no information about the patient's illness on the medical certificate. Now that is because the doctor/patient relationship is based on confidentiality and based on trust, and if the doctor is going to maintain that level of trust with the patient then you can't put the patient's diagnosis on the certificate. I think the medical profession would strongly resist any moves by anybody to enforce a breaching of that confidentiality.

CATTERNS: Which is why many medical certificates simply say, "Angela has a medical condition and won't be at work today."

PHELPS: That's exactly right, because it's really none of the employer's business why that patient is off sick. I mean you can imagine the range of highly personal information that could possibly be put on a certificate if doctors had to put the diagnosis there and, quite honestly, doctors would simply refuse to do that.

EPSTEIN: Just finally, Kerryn, the idea that there could be some guidelines or that there could be some way that doctors have to check off a list of conditions that people have to be suffering from before they issue a certificate, is that sort of idea worth considering because that's something the Hotels' Association is talking about?

PHELPS: I don't think that shows a particularly good understanding of medical practice, to be honest. I think you can't really have a cookbook certificate where you say - well, you know, check off this list. If a patient is too unwell to go to work, for whatever reason, then that's really up to the judgement of the doctor and not up to the judgement of the employer. Frustrating though that may be for an employer, that's the situation. There are certificate requirements - you need to make sure that the patient is appropriately identified, the date has to be on it, the date the patient was unfit for work, any sort of supplementary information for the employer if there is any discrepancies for the period that the patient is not there.

Diagnosis is not required, as I said. I think it's important that people understand that that information, unless the patient specifically requests that the diagnosis be on there, then the doctor is required to maintain confidentiality. So there are a certain number of requirements for a certificate already, but not a medical checklist if you like. It's really the doctor's judgement as to whether that patient is well enough to go to work or not.

CATTERNS: All right, thank you for joining us this morning.

PHELPS: You're welcome.

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