Why do employers still need MCs as proof of illness? | Deep Dive podcast

all right hello everyone welcome back to another episode of Deep dive with me Steven CH and chrispina Robert uh so so this week we're talking about you know getting that medical certificate and and teley medicine is one of the common ways we do it nowadays in Singapore we call it MC right which is a medical certificate actually it's medical leave essentially and the medical certificate is the proof okay how many days MC oh I've been a great employee I didn't take any medical leave last year no way yeah I'm just so fit and healthy no way that's no way hard to believe no no no to be fair I did take time off work there were a few days but I just told the guys hey I'm not feeling well today I can't come in and we just worked around it I actually went into my HR System to check and like you I only had two days like I took only days like me I didn't take at all yeah no okay so well close to you okay so maybe let me explain for media C uh we have 14 days I think a lot of people do um and 2 days out of that 14 days is for well-being leave I don't need to say that I'm sick I can just say I want to take the leave which makes me wonder you know generally it's it's the work that we do right because I'm quite fortunate I'm in a team where if I say hey guys I'm kind of feeling under the weather can you cover for me so does it mean that we weren't sick Steve the whole year cannot be just different kind of sickness right no as in we were sick but we didn't have to take leave yes that's right so that's where the complication arises that is that is so sickening very funny okay this issue of um medical certificates has come under scrutiny CNA did a story in 2023 about teley health providers who issue MC's without so much as a chat like in under one minute you can get an MC and then in February M said it was investigating a clinic for advertising ing that an MC will cost $5.99 no video no audio consult just fill in a couple of questions I was thinking my God that's such a good deal from students trying to skip a class so that's what we we're going to be talking about to yeah how can we you know police this should we regulate it more what can we do to sort of make it such that it's used [Music] properly Dr Verma maybe you start with because you see patients both in person and also via T Health which means they virtually just call in if I were in your clinic and I tell you I have a tummy egg I have a headache I mean you can't really verify it because you can't see or you know and you'll probably give me an MC if I ask it right in general yes we've actually had a few different um scenarios related to this so when patients do give symptoms like that like tummy ache or headache it is difficult to verify especially when you're doing a tele Health Service with tell Health right you see even less of the person exactly so you try to make your best clinical judgment usually when somebody says they have a headache and they cannot work doctors do tend to of course uh comply but what we can see of course is all the medical records and see how frequently patients have been requesting MC's and if there's any area of concern those guys who go to you you can see right yes correct but if if hop yeah if I'm Doctor hopping you can't see my other records right correct we cannot yeah and this brings the question is this the only solution that we can have because really what we're trying to solve is the question of people abusing or malingering right and using MC when they're not really sick but but from a doctor's point of view what is the stand you take when you're unsure would you rather give an MC or not give we try to use our clinical judgment if it's like a one day MC we do usually give it that being said right we have also faced uh in situations where say we do suspect potential minging and we don't readily uh choose to give a MC in those cases we've also faced issues where patients first thing go to like your Google review or App Store and put a one star review so this is what's happening now when is it that that the doctor is being unethical I think that that's the line that moh wants to draw right I mean it's okay to make a judgment the guy says he's not feeling well yeah sure but in what in in which cases where it becomes gray where the doctor is being you know unethical uh unethical would be if a doctor knowingly suspects malingering and then still proceeds to issue an MC right I would say that would border on the line of uh unethical but if a doctor is using his best clinical judgment and if a patient comes in with symptoms that are you know fairly reasonable yeah it's uh difficult for us to usually discern and not give a MC but minimally you have to see somebody right uh tella Health it's a video consultation so you do have to see the person in front of you that is a strict uh regulatory requirement that it cannot be without a video consultation think the doctor would if I were the doctor I would rather give it than not give it just in case something happens the next day he collapses or whatever I don't want to get sued for you know and the doctor can always justify and say I I noticed there were certain symptoms that uh gave me concern and therefore I gave him the the time off to rest so I think it's very hard to when you say mingering to Define maybe Christine you can you can come in here because they were saying a lot ofoh Ministry of Health they was getting a lot of feedback from employers about the the excessive issuance of MC's and uh some people online were saying in fact MC's are a waste of time why do we even need them you know adults don't need a doctor's note to know when they can and cannot work so from a company point of view is it possible to really just get rid of these medical certificates well I think in a matter of time we should be do away with this but the S itself is served as a verification okay to confirm that someone is sick but so for documentations that they go to the proper way of getting the MC people are already abusing it in a way but I must say it's only a handful of them I we don't penalize what do you think would be the ideal system currently we try to go on an unrecorded leave okay uh some companies give it about highest four days and then like the wellness uh leave and things like that but this is um mainly just for like for example I wake up this morning I feel a little headache but I do not need to uh go and see a doctor yeah I do not need to because I might have some leftover medication and I take that and arrest and also to help the organization uh not you know it may be contagious that you pass it to other people in your office that is one and second thing is that um to because I'm not going to work today and I need to produce an MC it might cost more to the organization by going to the doctors and then you probably need to pay the the current uh the medical fee so a day of not working and plus the medical fee I think that is can be a quite a costly Affair so you're saying that actually more companies should have you know no need for proof yes MC days correct one of the company that I know the first day your MC is not been recorded only the second day is that better for a company better for a company in terms of for their operations for their costs is it overall a benefit to the company to have unpaid medical lease so to speak versus the the paid medical leave where they have to pay the insurance company for it definitely the the cost is already sunk it it will have to be taken away I mean because you will be expecting this someone not reporting to work uh sick or not sick 14 days will be not reporting Dr Verma you run a company you have employees how do you look at which would you prefer and honestly we have faced such issues right so uh where PE our own employees would use MC's often and then you do question but then what we realized what had worked for us a bit better right if we notice somebody has multiple MC's right three or four MC's that is when the HR does step in and have a conversation with the employee we're never against if somebody's actually sick we would never hold them back from taking the but you at least try and find out rather than just taking it for face value that somebody's taking MC's every day okay even on the telea health side right usually we just give maybe one day MC if they mention such symptoms we do mention Sometimes they come back and ask for another MC we said then it is better that they see a doctor in person so that we can do our full examination out of every 10 patients that may come to you how often do you reject giving an MC yeah I would say roughly happens about 10% and we do try and uh ask more questions about why they need a MC what are they working on which aspect do they feel they're unfit to work on yeah and if it really doesn't sort of check out or sound reasonable then we do actually withhold MC's let's come back to this um you know cold regulation idea moh has said that MC's must be given in the context of an existing patient doctor relationship um um to me it feels like that sounds good in principle we come from a generation where yeah you would see a family doctor young people nowadays they don't have this relationship corre because of Telly Health if this doctor doesn't give me the MC I'm just going to go to the next guy so the premise already is you know bit shaky right correct in fact just earlier another person shared a story of how he called into Telly Health wanted an MC that first doctor said no so guess what he just called back again got another doctor same company and this time he got his MC this is tough right it is I feel sometimes it is a bit unfair for doctors is because we're actually seeing a whole um range of conditions for patients right all the way from actually medically ill chronic conditions patients who need refill they're actually sick and you need to send antibiotics and then suddenly you'll have a patient like this who's just asking for MC so from a doctor's point of view it can become a bit challenging to discern 100% of the time which is why the question may be is whether this is a long-term sustainable solution or rather should there be maybe a more proactive discussion and engagement with the employer beforehand on how to handle such sick leaves and not always have patients go to see a doctor for MC just to get just to get some proof that they on the healthare system the company at the same time if they don't fully trust their employees they say I need you to prove to me that you are sick so is trust part of the issue here if you have a small company there only 10 of you and you trust everyone you'll be like I know when you're faking it to just bring back to the point just now whether MC is it still necessary actually from Hop point of view allows us to see the pattern like the 10 of them that in a small company you see that always after certain long weekends you know payday you know they have people go away so this is something that we can see the pattern so that is where the trust we trying to build you know we want we are concerned we wanted to make sure that you are healthy enough to handle the job so I think that will be the trust piece of the things that we wanted to drive and then to make sure that they will not feel that we are penalizing because they're taking MC but we are concerned yeah I I wanted to talk about tech so one of the things that Mo was worried about is that that that seemed to be the same kind of folks who were you know getting sick all the time getting sick all the time I'm assuming that you guys have records right especially for health is it possible to link up so immediately when somebody calls and says oh uh hi dog I'm sick today you then you can see how many is a Black List exactly so the same shared Black List so the employer has a black list you guys have a blacklist to sounds like a which is why my question would be is MC the only way to keep a record like can the employer just not have a system portal their HR portal where people can just report and sick without having to see a doctor our Health Care system is strained This MC culture and MC seing Behavior does add to that strain on resources so could an employer not have their own little portal sh portal where people can just report and sick and any trends that you need to see you can see it there itself okay so you still report sick but you don't actually need to see a doctor exactly and you can still tell that this guy is been reporting sick like every month on Friday the trend the trend I think even without the you know the Computing I you can tell right Subs always so Mondays and Fridays are very popular for example to be fair I mean when we talk about a company this is a small percentage of people right yeah you don't penalize the majority for the minority yeah you really can see that few of them and then you just need to address those people and then you know find the concern you know what happened to you is there anything that we can help you from the company point of view from the medical side of things yeah this should be the boss should basically be having a chat with this employee and saying hey you know are you really sick I mean not in that sense but are you yeah can can we help you that's yeah so we do have case like that you know that we actually offer the health medical check you know to make sure and I also have little uh things like my department you know for example Steve you're sick and then the next day you will need to say hello to your boss and then to share whether are you okay to resume your work you know it's just I'm letting you know that I'm aware doesn't see his boss is the Box yeah you can use this for his own te no no but I I know you're saying so in a way it's it's concern both ways you you do care for your staff and you really want to help them if they really are the situation but at the same time it also lets them know that you have an eye on them yeah in a way that you know I'm concerned and also knowing that you are not well I feel that it's well and good to get people to think about this and have more trust Etc the reality is many companies just revert doing what they've always done in fact as as far back as 2018 and nmp Irene key raised this in a speech she actually asked Mom to mandate non mc6 days she suggested three days right um so it's not left to companies MH M mandates this and says okay everybody now must have three non sick uh like you can take an MC without proof and recorded um of course you know the natural reaction would be I don't know let's find out what would the the yeah from the HR point of view is this good or like oh my gosh this it's a honor based system but mandating is different from saying it's a good idea why don't you try so in a way by saying 14 plus 3 it sounds like it's you're classifying it almost as annually for you you have I thought it was the three embedded in the 14 so of the 14 days or three of them three uh not recorded not recorded indirectly the company have saved the four days that I suggested I mean uh that we had yeah so yeah in terms of cost yes and then do you think they should be mandated like they should say okay everybody has to do this now to in order to change this whole MC seeking culture yeah I I would share right like I think what the whole uh premise does need to be is a bit more communication with the employer and the employee one of the challenges that we've also seen as facing a company is right when employees present MC's the employers cannot question it as well right like it's very difficult to say oh this is a incorrect MC or you know we don't believe you're MC because the doctor has given it but rather right uh so people actually feel they're cleared that I get a MC that means I cannot be questioned I can take a leave so if we do move to that where you are not really issuing a MC and you're taking a sick leave it can lead to a better engagement and discussion between them employ employee they're absolutely we're absolutely been okay to take sick leave but if somebody like you said has these Trends and is continuously taking MC's then it can lead to a better engagement and discussion and then the employer can decide whether they want to take any action or see a certain ironically I imagine if I were an employee he wanted to minger who get away with the free days I would still go take the MC because it's easier to just take an MC than rather than to have to speak to my boss and say hey boss right would say no I mean bus we don't mandate these kinds of things you know it's up to businesses because if you're running an FNB for example I mean maybe you want it to be a little bit stricter at the end of the day a company trying to build trust within its team right you have to trust first in order for them to trust back right so I mean I I I like to say that I think I'm very privileged in that sense that here in media cop in a way we work in a way where there's a lot of trust and because of our line of work it's very hard to Define exact working hour yeah which is is also allows for a bit of that that flexibility but if I have to be behind a bar or behind a counter selling tickets then it makes it a lot more challenging right and shift based uh systems right where where somebody's working from say 8 to 8 and then they suddenly take a MC it's a big uh challenge for the employer to then suddenly find last minute cover to those uh slots yeah which is why it does become important if somebody's continuously missing the shift rostered shifts that there needs to be a discussion between the employer and employee perhaps the issue really is a question of employers and communicating with their employees right um apart from communicating I think um the policy have to put be very clear and um everyone understands why the policies in place communicate clearly and also to build the the trust of uh we are are worried of your health instead of why are you doing away with the free days yeah I think that is important you're mentioning how scheduling and shifts can be thrown out of whack when the last minute uh you know MC is taken maybe companies need to also anticipate that in other words whenever you plan a roster I know like with uh flight attendance there's always somebody on standby because they know at the last minute somebody could get sick and you can activate another person right away so it doesn't throw everything out of w yeah yeah and if right with that kind of mindset does it not help that is a ideal but because of the current Manpower crunch it can be already on the main shift is already um Max Max you don't have enough nurs and also to be fair uh why people are taking MC is also the just tired just tired yeah and it's to overwhelm on the day exactly so maybe the problem is with the company right with the work maybe it's not engaged maybe there's some something else it's more than just MC it will have you know a lot of other uh little things that to do to to make them feel excited to come to work every day and I see examples that you know when giving flexibility like what stage just mention the flexibility actually allows um uh employee more um the retention is much more better there is no clear answer to this and I think from our discussion it sounds like it really does take two to 10 Bango in terms of the management the company and the staff as well to not abuse the system and if you can find that sweet spot that balance then actually regulation doesn't need to come in and I think when regulation comes in it's a bit unfortunate because when you have to force people to act a certain way yeah you know yeah say something yeah I agree completely agree I I just feel like teley medon has been a long time in coming T Health I mean come on the the savings on cost on time uh and of course resources right so if I have a garden variety flu I should not have to go to see the doctor mix with all these other sick people just to get an MC right so I I love that that's moved in that direction and I think there's no going back it's just that there are Bad actors on both sides you know so if you just need medication you can just buy it from the pharmacy or you can take the ones you had from your previous visit although okay if you're wondering check for expiring yeah you can watch a a talking point episode about expired medicine it will tell you whether you should or should not be taking it okay thank you both for joining us and also thanks of course to our podcast team team behind this podcast are tiffany an Jun Johari Joan Chan sawin sound mixing by Ken delbridge and of course if you're joining us on YouTube or any other platform do subscribe and just click on the link below see you next week

Channel: CNA

Views: 3,416

Keywords: CNA, Channel NewsAsia

Id: U2_fRwYHWJo

Length: 22min 22sec (1342 seconds)

Published: Sat Jun 01 2024