Who really knows whether a Pt is able to go to work?
Ummmm...
The Patient, The Adult, The Responsible Person.
Most of the time
Unless there is some power-knowledge-control thing going on, where Doctors
are the only people who can be "responsible"
Of course, sometimes adults lie.
And sometimes doctors are incompetent or venal.
Anyone know the Type 1 / Type 2 errors on this?
How about everyone - even medical professionals - is allowed to sign their
own certification?
(Of course they may need advice from Doctors on physical symptoms /
diagnosis / prognosis, which they can choose to request.)
Which is not the same question as "Am I able to go to work?"
S
-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Mary Hawking
Sent: 11 February 2007 20:06
To: [log in to unmask]
Subject: Re: How should sickness certification work?
I'm getting confused.
Issue 1 - should qualified nurse practitioners (and nurse specialists in
secondary care) be recognised as being competent to judge whether a
patient needs to have x weeks off work? Answer, I should think, a
resounding "yes" (any training issues (and as a GP I have never received
any training in this) could be formalised and addressed.)
Issue 2. Do you need to see the patient to issue a Med 3?. I think this
is clear. Yes. It's what it says on the can.
Issue 3. Do GPs need to see every patient treated in secondary care who
is not given an appropriate certificate from secondary care?
Probably not: I sign a Med 5 quoting the consultant involved if I have
received documentation.
Issue 4. should hospitals be providing certificates?
Answer Yes: they have the best knowledge of how long they would expect a
patient to be off work for surgical procedures. I am not sure that their
understanding of the occupational requirements is better (or worse) than
the average GP's
I think we need a standard letter that does not need any input and keep
sending it cc to CEO with every failure to provide appropriate
certification. CEO is obliged to answer complaints and investigate .. so
hammering on sometimes does produce results!
Issue 5. Does the whole system need reforming?
Probably - but in the meantime we need to work with the system in place
.. and campaign for change if seriously concerned.
For me, life's too short to risk ulcers. Annoying - but can mostly be
worked around.
Mary H
PS does anyone else Code SC1 advised with a note "may need Med 5 for x
weeks"?
In message <[log in to unmask]>, Adrian Midgley
<[log in to unmask]> writes
>Julian Bradley wrote:
>> Leaving aside the nurse practitioner issue, if anyone wants to
>> challenge the essence of the current policy, they've not yet really
>> explained why.
>>
>The nurse practitioner issue was where it came in, and deserves action,
>since the DWP certification system has failed to keep up with the
>DoH/RCN/RCGP/GPC/professional system for providing the care upon which
>certification is based.
>
>I agree that widening the discussion to every tedious bit of paperwork
>is not conducive to a solution to any part of it, nor necessarily to our
>interests being furthered in any way.
>
--
Mary Hawking
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