Online medicine- an easy way to chuck a sickie?

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Back in the 1800s the French called it “malingering”. These days Aussies refer to it as “chucking a sickie”. (In the UK, interestingly, you “pull a sickie”, rather than “chuck” it!) In any case, whether you lived in France in the 1800s or in modern day Australia, the meaning is much the same- it’s taking time off work when you’re only a little bit sick, or actually not sick at all.

The fact the French had a word for it for 200 years ago tells us it’s nothing new. It’s human nature to need a quick break from life now and then. But of course, there are those who make too regular a habit of it.

When Dr Sicknote first started out, there was a lot of heated debate- here was a service providing online medical certificates! Wouldn’t it be abused by malingerers? Wouldn’t it give the sickie-chuckers a helping hand? Well, the honest answer to this question is, yes, to a point it might. Because it’s a fact of life- there will always be a small minority of people waiting to abuse any system that is based on trust. As a GP, I see dozens of patients, in person, in my surgery every day. Do they tell me the truth 100% of the time? Of course they don’t! But the vast majority of people are honest. It’s hard to be a good doctor if you start out from a position of mistrust. In fact, I’d argue it’s impossible. And for that reason I refuse to allow my trust in patients be undermined by the tall tales of a few. I therefore choose to welcome every patient I see, in good faith- and with this approach I must accept that sometimes, inevitably, I will end up signing medical certificates for made-up ailments. The bottom line is that the majority of patients benefit from seeing a doctor who trusts them- and this has to be my aim- to serve the honest majority.

And so, on a larger scale, do we deny this honest majority access to helpful online medical services simply because a handful of people will abuse the system? That would clearly make no sense! Especially since such services can reduce Medicare spending and thus the cost to other taxpayers. At present, if a patient chooses to use an online service, they pay a private fee, and are not being bulk-billed or receiving a Medicare rebate. Also, every time a person goes online for a medical certificate or for a minor ailment, they automatically free up a consultation in a GP surgery that can be used for a more unwell person.

Malingerers, sickie-chuckers and sickie-pullers- they’ve always been with us, and they always will be.

But we must not let this prevent us innovating for the greater good!

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