Pharmacists issuing medical certificates - doorstop with Dr Rosanna Capolingua

DR CAPOLINGUA: The AMA's really concerned for the employee, for the worker, for the person who's sick, who presents to the pharmacist. Pharmacists are very skilled at what they do, but they actually don't have the training and the experience and the knowledge to take a history, certainly not to examine a patient, that would be inappropriate in a pharmacy, and to understand or make a diagnosis about what that sickness may be. Something very serious may be missed.

QUESTION: What could be the complications, I guess, if someone goes in for a headache, but a pharmacist is not able to assess that? It could turn into something a bit more severe and who's going to take the liability.

DR CAPOLINGUA: You know, a worker may indeed have a significant headache and decide they can't go to work that day. They go to the pharmacist, the consultation has its call between the pharmacist and the worker, comes to the conclusion that the person has a headache, certificate is written for 24 or 48 hours, that person may indeed have meningitis and by the time that sick certificate is up, they could be dead.

I don't want that sort of risk to occur to anyone at all. If you are sick and you're needing attention, you need to be seeing a doctor. A medical certificate is a legal document as well as a medical one and doctors have parameters that define how those certificates are written, but more importantly, the examination of the patient and the ability to understand what is wrong and provide advice is essential.

QUESTION: Could it also see the certificates being abused?

DR CAPOLINGUA: Under the WorkChoices legislation, allied health workers across the board could provide a medical certificate and you have to understand, of course, that they have varying skills and experience and expertise in their own particular fields.

I think that employers may be a little concerned or wary when they receive sick certificates from a broad range of other allied registered health professionals, when indeed the understanding about the sickness may not be there.

QUESTION: Do you think it's a positive though that this could perhaps take the pressure off doctors?

DR CAPOLINGUA: If you're thinking about the pressure on doctors, then let's look at the relationships between employers and employees and let's work on building the trust between them, building arrangements around the need or requirement for sick certificates. As doctors, we have a responsibility to look after those who are sick and if you are sick, you need to be seen by a doctor.

QUESTION: But the reality is a lot of employers do require these medical certificates and a lot of the time you're waiting two to three hours to be seen by a doctor when in fact you've just got a headache and a sore throat.

DR CAPOLINGUA: If indeed you have an arrangement between the employer and the employee where maybe for the first day off or two days off, as used to be very much the habit, a sick certificate was not a requirement, then indeed, that negates the need to see a doctor at that point in time.

The safe thing about that is that you haven't been falsely reassured by seeing some other allied health professional who tells you that you're okay, so you may stay home, you may feel unwell and you will determine that you need to see a doctor if that continues or progresses.

The employer may be satisfied with no need for a certificate for a trivial complaint for a day or two. There's got to be some way of working that out.

QUESTION: You mentioned meningitis. What other common things can you think of that could easily be missed in that situation?

DR CAPOLINGUA: Apart from something such as a headache which could turn out to be significantly serious like meningitis, a tummy upset or a gastroenteritis, which is a viral infection, could in fact be something as serious as a bleeding ulcer, the consequences for the worker or the employee are very significant.

QUESTION: But do you agree that this will help ease the workload for doctors?

DR CAPOLINGUA: This is not about easing the workload for doctors. This is about patient safety and making sure that the employee is not trivialised around the need for a medical certificate.

Ends