Outdated or necessary? Observers weigh in on the practice of employers requiring MCs as proof of illness

SINGAPORE: Some health conditions such as stomach aches and headaches can be difficult to verify, said Dr Shravan Verma, co-founder and CEO of telemedicine platform Speedoc.

This is even more so in an online setting when doctors see patients through a small screen and diagnose them largely based on their self-reported symptoms, he said. 

Telemedicine platforms have come under scrutiny for the seeming ease in which MCs can be obtained by patients as Singapore looks to tighten rules over the “excessive issuance” of MCs.

“From a doctor’s point of view, it is hard to discern 100 per cent of the time,” he told CNA’s Deep Dive podcast.

“We try to ask more questions and use our best clinical judgement. Usually, if it's a one-day MC we do give it. But if their answers really don’t check out or sound reasonable, and we suspect potential malingering, then we do withhold MCs.”

He suggested that telehealth doctors advise patients to go to a clinic for a more thorough examination if they request for too many days of medical leave.

Dr Verma said he has rejected about 10 per cent of requests for MCs among his patients but has faced retaliation in the form of bad reviews on Google and the App Store.

MC PRACTICE OUTDATED?

The Ministry of Health's intention to make rules surrounding MCs stricter has prompted a discussion on whether there is still a need for such proof of illness when workers take sick leave, or if this practice is outdated and in need of a review.

Employees have argued that conditions, such as a headache, period pains, a stuffy nose, a sore throat, or generally feeling under the weather do not always require a trip to the doctor.

Many say they have a store of basic medication at home, and these are ailments that good rest, plenty of water and some vitamins could potentially fix.

At times, a slight discomfort is just not worth the hassle of going to the clinic and waiting in line for an MC, workers said. Yet, turning up to the office could spread viruses to colleagues.

Another issue is that the culture of approaching medical professionals for MCs just because of a requirement by employers takes up precious resources in an already stretched healthcare system, said Dr Verma.

NOT A LONG-TERM SOLUTION

“Doctors are seeing many patients, people who are actually sick, those with chronic conditions. Then suddenly comes a patient who is just asking for an MC,” Dr Verma said.

“Our healthcare system is strained, and this MC culture and behaviour add to the burden on resources.”

He said employers should take more proactive initiatives and manage their sick leave policies better.

“Is MC the only way to keep a record? Can’t employers have their own portals where people can report sick without having to see a doctor?” he asked.

He added that such portals can also reveal trends or patterns, such as when a staff regularly takes sick leave right before or after a long weekend.

Another challenge the current arrangement presents is that once a doctor authorises sick leave for an employee, it is difficult for employers to question if the staff is genuinely unfit to work, even if the worker decides to head out instead of resting at home.

“People actually feel they're cleared, and that getting an MC means I cannot be questioned, I can take leave,” said Dr Verma.

He added that companies defining what it means to take sick leave, instead of blanket requiring a doctor-issued MC, could lead to better engagement and understanding between employers and employees.  

“(In time) we should do away with (formal MCs). But the cert serves as a verification, to confirm that someone is sick, but also for documentation (to see patterns),” said Ms Christine Chan, a human resources expert who was also on the show.

SOME BUSINESSES MAKE GRADUAL CHANGES

Ms Chan, who is chief human resource officer at deep tech startup Nudgyt, said companies have been refreshing their handling of sick leave as industry standards shift.

One such change is allowing some unrecorded leave, which includes wellness leave or leave without MCs.

By allowing employees to go on such leave, firms potentially save on medical costs as well, she said.

“It might cost more to an organisation for an employee to visit the doctor,” she explained. “Some companies have (up to) four days of such leave… and indirectly the company has saved the four days in terms of cost.”

She said that some workplaces now require employees who take a sick leave to update their managers the day after on their recovery process, as a way to engage staff and deter playing truant.

“This (initiative) shows employers do care for staff, but at the same time staff know bosses have an eye on them,” she said.

Dr Verma, whose firm hires a pool of medical professionals, said his team practises such check-ins with staff, and it helps build rapport.

“If we notice somebody takes multiple MCs, HR steps in for a conversation. We're never against it if somebody's actually sick – we would never hold them back from taking leave. But at least try and find out rather than just taking (the MC) at face value,” he said.

Ms Chan said that at the end of the day, communication is key – employers need to show empathy and engage in employee retention, while workers need to understand why policies are in place and not game the system.

“We want to build trust and make sure that employees are healthy enough to handle their jobs. And to make sure that they will not feel like we are penalising them because they're taking MC, but that we're concerned,” she said.