MANITOULIN—In an effort to decrease the burden on emergency department teams of the Manitoulin Health Centre (MHC), patients will be receiving information indicating that the emergency department is not the appropriate setting for patients to ask for a sick note to return to work, and that changes have been in place since October in the Employment Standards Act surrounding the requirement of sick notes.
“The administrative burden on physicians is unmanageable, and the local shortage of physicians and rising emergency room (ER) visits leaves the physicians vulnerable for burnout,” stated Paula Fields, president and chief executive of the MHC, last week. “We need to protect our local health care resources and reducing unnecessary ED visits is a small way that we can help them.”
“We have always given out sick notes and this will continue when the physician feels it is appropriate,” Ms. Fields told The Expositor. However, “what we are finding is more employers are asking their employees to provide a sick note, even for one day of illness. We understand it is challenging for some patients to see their primary care providers in a timely manner or they do not have a primary care provider, and at times the emergency department is the only place to get a sick note on the Island. The change to the Employment Standards Act requiring sick notes for illnesses up to three days came into effect October 2024. This change was made to reduce the burden on employees and the health care system.”
The MHC will be handing out a letter to patients who come to the emergency department asking for a sick note to return to work.
The letter reads, “To our valued patients: Thank you for visiting the emergency department at Manitoulin Health Centre. We understand that feeling unwell and needing time off from work or school can be a stressful experience. However, we would like to take a moment to share some important information regarding the use of Emergency Department services. 1. the emergency department is for urgent care. Our team is here to provide care for serious and urgent health concerns. If you are here only to obtain a doctor’s note for a mild illness or short-term absence, please know that the emergency department is not the appropriate setting for this purpose. 2. Sick notes for short absences are often not required. According to Ontario’s Employment Standards Act, employers cannot require a doctor’s note for absences due to illness that lasts fewer than three days. We encourage open communication with your employer about this policy. 3. Alternative options for notes: If you do require a note, please consider contacting your primary care provider or accessing virtual care service at virtualcareontario.ca.
“We kindly ask for your support in keeping our emergency department resources focused on those who truly need immediate medical care,” the letter continues. “Your cooperation helps ensure that timely treatment is available to patients with more serious health concerns. If your employer is insisting on a note, please share this letter with them. Thank you for your understanding. Sincerely, the Emergency Department team. Manitoulin Health Centre.”
“They (province) are trying to reduce the burden on physicians and the emergency departments,” said Ms. Fields. “Employers should ensure that they are aware of the legislative changes and implement attendance management programs and policies.”
“Patients become frustrated when they are in the emergency room for three to four hours or longer waiting to get a note,” said Ms. Fields. “These patients are considered the lowest priority ‘level 5’ according to the Canadian Triage and Acuity Scale; therefore, all other triage levels are seen prior to them, regardless of when they arrived. Our volumes are beginning to double as our summer residents return, we are beginning our busiest season of the year with tired reduced workforce.”
“The administrative burden on physicians in Ontario is unmanageable, and this includes taking the time to provide sick notes, it is eating away at the time physicians need to spend with higher acuity patients in the emergency department and primary care. We are hoping through informing employers and the public it will reduce this burden, so physicians have more time to provide direct patient care,” added Ms. Fields.
