New guidelines on sickness certificates

By Dr Peter Ford

The AMA recently updated its Guidelines for Medical Practitioners on Certificates Certifying Illness 2011. These clarify the responsibilities of doctors, patients, and relevant third parties regarding certificates certifying illness (sickness certificates) within the context of the doctor-patient relationship.

While the update is not a major shift, the new guidelines expand on the responsibilities of doctors and recognise the greater variety of contexts in which sickness certificates may be required. For example, sickness certificates may be required for employment, school, daycare, sporting activities, and other activities. The guidelines also include new sections on when a sickness certificate should not be provided and certificates for carers’ leave.

Although applicable to doctors, these particular guidelines serve as a valuable source of information for patients and relevant third parties alike. Here at the AMA, we receive numerous queries from the public, particularly from employers, questioning the stated period of illness or the lack of diagnosis on a certificate.

In order to inform the public regarding the role and responsibility of the doctor in relation to sickness certificates, we have prepared the guidelines in a manner that is clear, comprehensive, unambiguous, and reflective of good medical practice.

The guidelines state up front that trust and confidentiality for the basis of the doctor-patient relationship. Patients trust doctors regarding their medical care and rightly expect confidentiality. Doctors are not the agents of employers, private industry, or governments.

The guidelines make it clear that sickness certificates are legal documents and doctors who deliberately issue a false, misleading or inaccurate certificate could face disciplinary action. For example, a sickness certificate should not be provided where a doctor does not believe the patient was sick or otherwise disabled. Further, certificates cannot be backdated (although there may be medical conditions which enable the doctor to certify that a period of illness occurred prior to the date of examination). 

In addition, the guidelines stress that doctors have a duty to protect the confidentiality of their patient’s health information. Third parties should generally not expect to see a diagnosis on the certificate and should accept the doctor’s certification of an individual’s unfitness for work as sufficient.

By clarifying the legal nature of sickness certificates, and the doctor’s related ethical and legal duties, the guidelines may assist in resolving an issue of contention before it gets out of hand.

The guidelines can be found on the AMA’s website at http://ama.com.au/node/6505