nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, February 23, 2011

Doctors Handing Out Work Excuses To Support Political Protest

A long-standing practice becomes openly political.

Surely many of you have sought a doctor's excuse from work.  Plenty of my patients asked for one.  This has been going on for a long time, and most doctors I know don't really make an assessment of what the patient can and can't do, balance that against the type of work performed, and make a decision about physical capacity for work.

It's usually just an administrative pain in the neck that most docs just pencil-whip whenever asked.   If you've ever tried to argue someone out of needing one, they get mad, and then you just want to go on to the next patient.

So, now we allegedly have accusations of unethical behavior for writing multiple work excuses, sought by those who don't need it, so they can leave work to protest politically...and still get paid  See the Milwaukee Sentinel Journal, Feb 21)

Although there's a lot of hoopla on the airwaves and blogs, it's not clear what's being done.

If someone gets an appointment to see a doctor for a medical problem, and a doctor's work excuse results, I can't second-guess how it came about.   What happens in the examining room is confidential.

If people are just calling to say they want an excuse, or doctors are handing them out without seeing the patient, that's another matter...

I doubt that many doctors are doing it as an act of political protest.   Doctors don't care that much about labor laws.  A career without unions or defined working hours doesn't lend itself to sympathy over union contracts.

To the extent that doctors are pencil-whipping excuses for non-patients, or persons without a medical problem, there is an ethical issue.  Do you really want your doctor to accomodate you for convenience?   It may be to your benefit this time, but what about the next time, when the convenience benefits him/her rather than you?  If they are willing to bend for the former, they will do so for the latter.  Trust is undermined.

The ideal system for work excuses requires a doctor visit and evaluation, and a specification of what the person can't do (sit, stand, jump, lift, or they are dehydrated, etc).  If a person can sit but not lift, and sits at a desk all day, it seems silly to say they can't work.

There's nothing in the Hippocratic Oath about supporting political causes.

Doc D

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