The ubiquitous "work note"

[JustPlainBill]

So, had a new patient come in with various complaints -- "had the flu", muscle aches, sore throat ..... Saturday week before and stayed home all week and now wants a work note covering them for that time --- obviously not sick but did my due diligence --- became somewhat miffed when I wrote the note covering for day of visit and return to work next day ---

What's your rule of thumb?

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[smq123]

So, had a new patient come in with various complaints -- "had the flu", muscle aches, sore throat ..... Saturday week before and stayed home all week and now wants a work note covering them for that time --- obviously not sick but did my due diligence --- became somewhat miffed when I wrote the note covering for day of visit and return to work next day ---

What's your rule of thumb?

I usually only write it for the day of visit and return to work the next day, unless it's really obvious that they truly had something, or if they have documentation (like from the ER) that supports the fact that they needed to take time off.

 

[VA Hopeful Dr]

"Patient seen in office on [date]. Patient states that he/she was sick from [date] to [date]."

 

[JustPlainBill]

yeah, had one that badgered me, my MA, my front staff, me again until I finally told them,"No, I've written for 2 days and I'm not writing for any more." -- they still didn't get it so I politely stated that if this continued I'd have to ask them to leave the building.

 

[Apollyon]

I'm not in the office (I'm EM, not FM), but, I've had people badger me. I just tell them I don't know what they were doing the prior days, and that I can only write for today and forward. Otherwise, it is fraud, and I am not going to commit a felony for you. Really, you wait a week to see the doc, instead of calling the first day (at least), and THEN say you were off a week? Yeah, you're fishy. We're not robots that just pour out notes, and, if your job needs one, maybe you should be more sanguine. As @VA Hopeful Dr says, though, "Patient states". Still, I am not comfortable doing that.

 

[deleted87716]

As long as the work absence is reasonable considering the duration and severity of their illness, I'll write the note. No skin off my nose.

My hard and fast rule is that I never write work notes unless I've actually seen the patient.

 

[JustPlainBill]

Ahh, yes --- had more requests for 2 days today -- and, wow, gee whiz Ringo Rangers -- we're off Thursday, Friday, Saturday Sunday because of the holiday ---- so it turns into a 1 day workweek.....likely filled with holiday spreads/parties.....

I need scotch...lots and lots of scotch....and cigars.. H Upmann Amatistas, Ring size 47 or larger....

 

[cabinbuilder]

OH yeah. I had a 20 somtheing guy come into urgent care who lives at the mission. Part of that program is you work during the day. He and a friend decided that if they were "sick" they wouldn't have to work. He came in with some bogus complaint, "can't breathe" with a sat of 100% . Asks for a work release. Tells the MA after I leave the room he didn't want to go to work today. How's that??

My note: "Patient was seen in urgent care today for the common cold. He is cleared to return to work today". HA!!!! Freaking lazy ass.

 

[NurWollen]

OH yeah. I had a 20 somtheing guy come into urgent care who lives at the mission. Part of that program is you work during the day. He and a friend decided that if they were "sick" they wouldn't have to work. He came in with some bogus complaint, "can't breathe" with a sat of 100% . Asks for a work release. Tells the MA after I leave the room he didn't want to go to work today. How's that??

My note: "Patient was seen in urgent care today for the common cold. He is cleared to return to work today". HA!!!! Freaking lazy ass.

He didn't try to tell you someone at the mission stole his xanax while he was as it?

 

[JustPlainBill]

OH yeah. I had a 20 somtheing guy come into urgent care who lives at the mission. Part of that program is you work during the day. He and a friend decided that if they were "sick" they wouldn't have to work. He came in with some bogus complaint, "can't breathe" with a sat of 100% . Asks for a work release. Tells the MA after I leave the room he didn't want to go to work today. How's that??

My note: "Patient was seen in urgent care today for the common cold. He is cleared to return to work today". HA!!!! Freaking lazy ass.

Muwahhahaha.....

on that spin -- I once had a long haul truck driver present to the UC asking for a work note -- his complaint -- I was tired and overslept -- my work wanted me to come in and take another truck out but my body needed sleep and I slept through my alarm. if I don't have a note, they'll fire me;

I had a problem with that -- especially having just graduated from residency and remembering nights of 4-5 hours of sleep at best or long ob stints where we slept in 2 hour increments (if you can call that sleeping) ---

the other physician working at the UC center reasoned that he'd rather have the patient fully rested before getting out on the road and potentially killing someone....

Opinions?

 

[smq123]

Muwahhahaha.....

on that spin -- I once had a long haul truck driver present to the UC asking for a work note -- his complaint -- I was tired and overslept -- my work wanted me to come in and take another truck out but my body needed sleep and I slept through my alarm. if I don't have a note, they'll fire me;

I had a problem with that -- especially having just graduated from residency and remembering nights of 4-5 hours of sleep at best or long ob stints where we slept in 2 hour increments (if you can call that sleeping) ---

the other physician working at the UC center reasoned that he'd rather have the patient fully rested before getting out on the road and potentially killing someone....

Opinions?

I don't get involved in a situation like that. Yes, it is better to have a commercial driver fully rested, but all you have is his side of the story, and not his job's. It's possible that he overslept because he was out drinking the night before. You don't know.

If the driver thinks that his work is enforcing unsafe hours, he can take it up with the Labor Board. But don't get involved, because they could easily pull you in for a deposition or something, if it came down to that.