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My PCP hated these sorts of policies, so if you needed a 'doctors note' from him, he would put down whatever you wanted. No work for a week and then no heavy lifting for a month after? Sure. Need to sleep in and start work no earlier than 11am? Sure! He'd write these out as a prescription too, which was helpful in shutting up HR after.

I’ve seen the same. That’s the way to do it, IMO. Employer doesn’t trust employees to use sick leave appropriately, they should pay the price.

Or we could just legislate some sanity. 10 days sick and 15 days holiday minimum nationally. But that would make too much sense.

Sick days shouldn't be countable except in extreme cases. If someone is unfortunate enough to get something that requires extended time off work, losing income shouldn't be a worry.

What is needed is a national insurance scheme that pays your salary when sick beyond some minimum that your employer has to cover.

Totally agree. I was just thinking baby steps towards something reasonable.

How could it possibly be reasonable?

How could codified leave be reasonable? I’m not sure what you’re asking?

I think if you are out 2 weeks, requiring some official documentation is reasonable.

I think in most circumstances, 2 weeks illness would qualify as some level of 'extreme' -- that's rarely something not serious. So you and the parent are probably in agreement.

"The Crud", which is a southern US ailment that lasts weeks, it makes you cough and snotty, and generally lethargic. It isn't awful, but when you feel it coming on you're in for at least 2-3 weeks. It isn't serious, at all. It's just similar to or a cold that generally presents in the warm months.

Some jobs coughing and whatnot is frowned upon.

I live in the northern part of the US and it’s not uncommon for people to refer to common viral infections as crud or “feeling cruddy” regardless of what time of year it occurs. But, it’s not taken to mean anything more than another way of saying you have a cold. Though I kind of understand because the combination of hot weather and cold symptoms just makes it feel worse.

Lived in the south my whole life and never heard of this once

I've been informed that it's possible it's a Louisiana (or thereabouts) thing. And it may be the common cold (whatever that means), but the cough lasts multiple weeks, and there's no medicine for it except guaifenesin and dextromethorphan. I've lived in the PNW, i was raised in LA County, CA, and i've spent a decade and a half in the US South.

I bet there's things you've heard of in the south that i've never heard of, too.

Totally fair, I've mostly lived in one part of the south so it's likely regional.

Two weeks is extreme? Maybe if you're a healthy 30 year old without any chronic illness - and even then bone breaks can take more than a month before you can get the cast off.

I'd guess for an average person aged 40 to 60, two consecutive weeks off would be a one in maybe five years kind of event. Any minor surgery, mental health, cancer treatment, heart issue or significant infection like shingles, pneumonia, mono, hep could easily lead to two weeks off.

Two weeks definitely isn't an every year thing for most people but it's certainly not extreme.

2 weeks straight? Sure.

2 weeks total over a year? Doesn’t seem unreasonable to me. I’ve never actually used that much sick leave myself, but I have it if I need it. Doesn’t seem crazy to me that everybody have the same benefit (or, we could just be reasonable and not actually have sick leave and just let people stay home).

In France, the social security pays a part of your salary during the leave only if it is more than 3 days

Doesn’t FMLA come into play during those circumstances?

I had an extended leave and there was no issue once my manager worked with me to do the FMLA documentation.

FMLA isn't required to be paid. That depends on what state you live in.

Private insurance for that is relatively cheap.

(Devil's advocate) And employers will be happy to cover it for their employees, especially since they'll be paying them 10-20% less to account for their increased costs :)

If they could get away with paying 10-20% less, don't you think they'd do it now in a heartbeat?

I have seen companies, that when confronted by this, that will send the employee to a physician vetted by the company to confirm the need for accommodation.

In the end it isn’t about the loss of money, it’s the loss of power. An agreeable doctor giving you reasonable time off to mend feels like letting employees claw back power. It’s the same with work from home policies, they’re not interested in performance, it’s control.

It’s really not. It’s money. A lost employee that you still have to pay for is a huge expense.

Most companies costs are dominated by labor costs so anything that could be gamed there that would drive up that cost is scrutinized significantly.

So? Aren't these companies "good at business"? They should be able to plan around it - if they are in fact good at business.

Many of these fast food places have executives whos monthly compensation exceeds the YEARLY compensation of these front-line employees. Its for sure not a money problem - it's an allocation problem.

Being good at business means that they know where they can easily push and get away with it to get more money in the long run. Making it unreasonable hard to take time off will end up in fewer time off over time, and it only takes a couple words from management.

Being good at business means ensuring you’re not being ripped off on labor costs. We’ve come full circle.

There are like thousands of times as many front line employees as executives. Whether or not it’s right for executives to make so much, it’s easy to see why a business would be much more worried about cost increases for a role with much higher scale.

The executives are good at business so they virtually exclusively license franchises to independent owner-operators who are on the hook to meet franchise standards, pay licensing fees, pay the actual employees, and still turn a profit.

My former place required (and i heard still requires) notes from day one. Guess what? All the time, people went on sick leave at least for a week - gotta pay off the effort to get a note, right? (This was before telemed though. Loved when it became available: Just answer a few questions via forms, submit - get the PDF one hour later. Beats having to take public transport to your GP who is located 30-40min away, while feeling miserable and unfit for driving yourself)

Current place wears their reasonable pants, and this is basically standard procedure: just give a quick info if you can't work today and maybe tomorrow; notes required from day three.

Remember what is discussed in this thread. I would assume that food poisoning incidents are on another level from a few lost work hours.

But in a sense I'm sure you're right. What they fear is that if they lose control employees will go berserk with their newfound power and cost them a fortune in labour costs. It's just not a rational trade-off calculation, because then things like food poisoning and contagion would weigh much heavier than they do. Rather it's a game consideration that we mustn't appear weak here. They fear things that could be gamed because it's that sort of game to them already.

That often opens up a lot of other cans of worms for the company to deal with. I've seen and heard of it happening for some cases of workers comp or extended illnesses, but those were cases where the company was potentially on the hook for a lot of money. The pragmatic companies will usually just quietly settle the smaller claims because it's cheaper than fighting them.

My dad went through this shit at the end of his working life. Physician in the plant, guy had been kicked out of his family practice (his father started the place!) because he was a liability. His go to answer to these guys on the factory floor was, "You're not getting any younger!" He misdiagnosed his wife's breath cancer. All sorts of horrific stuff, considering he was a GP for 40+ years.

> Now a doctor's note seems to be a reasonable ask, but have you ever tried to get one?

Yes. Just needed one, and got it via a telemedicine visit (also got advised to take more time off than I would have if I didn’t have to get a doctor's note for how long I had already been off.) Whether this is an option depends, of course, on whether either your insurance or your primary care medical group offers telemedicine visits.

> Don't even think about a telemed alternative. They'll render their letter worthless with disclaimers, because the HCP didn't meet or examine you in any meaningful way.

I literally just did this (as described above), the note doesn’t have any disclaimers at all except that the return to work was contingent on both the specified time elapsing and symptoms being gone.

I deeply love that doctors, tired with this bullshit wasting their time and exposing them to all manner of unnecessary pathogens, have arrived at the solution of making it well known that they will demand excessive time off if you require your employees to get notes.

I always get a lot of enjoyment out of people finding creative ways of weaponizing corporate fear of liability in order to make them behave.

A doctor's note is not a reasonable ask, actually. It is actually unreasonable that work has so few days off available and that you need to take further of your own time to see a medical professional to give you permission to stay at home while you are ill.

Also getting a doctors note while sick is hard if you’re feeling really unwell plus a doctors visit will cost you money if you don’t have insurance, and it will cost time too. For serios illness that requires a visit to the doctor is okay, probably not hard to obtain if already seeing a doctor.

Not to mention that often, the illness is something where just some bed rest and relaxation for a day or two is all that's needed, so not much the doctor can really do, but by coming in you've potentially exposed a lot of other people to your disease.

Furthermore, what's a doctor going to do for my cold or flu? I'd rather take the opportunity to drop by the pharmacy for some cough drops, fruit juice, and replace the battery in my thermometer.

Lest we forget, though, Mary Mallon was an asymptomatic carrier who didn't feel sick, needed to work, and wasn't about to call in sick. In fact she defied forcible and controversial quarantine measures.

So what's an asymptomatic carrier to do in 2023? Wear a mask?

> Now a doctor's note seems to be a reasonable ask

Trust is a reasonable ask. Shocked me at first when my employer in the US, coming from France where doctor's notes are mandatory, didn't give a fuck because they trusted me.

I guess the difference is that in the US you can just fire someone if you suspect them of breaking your trust, whereas in France you would need a long process and paper trail with medium confidence of actually being able to go through.

This complaint is so strange. I guess an HCP is some terrible American insurance thing I haven't heard of yet? (I believe you, I just haven't encountered this.)

Out here in California, I can't set foot near a doctor's office or conclude a telemedicine without being offered a machine-generated note. Worst case, I could probably just print out the follow up emails from my provider's web page documenting the visit, and my employer would accept that.

I loathed these visits when I had to do primary care. I understand the patient's position and don't hold that against them but can we just decide as a society to let people take occasional sick days and stop wasting everyone's time with short-term sick notes, especially as these requirements disproportionately affect low SES individuals.

I'm sure someone's studied it but I would confidently bet this song and dance costs society more than the supposed malingering it is preventing.

> Now a doctor's note seems to be a reasonable ask, but have you ever tried to get one? Start with limited transportation and insurance, then get into the doctor's office and ask. I think I've made 3-4 requests and at least two, I was refused any excuse.

Is this common? I perform procedures sometimes and most of the things I do require no time off / limitations so I don't get asked a lot but I've been noticing patients seem increasingly awkward when asking for a sick note and go into a long story trying to justify the request. Haven't been sure why as I sure as shit wouldn't want to work the day after I had a biopsy but your experience provides some context.

Personally, I have an extremely low threshold to write a 2-3 day note if someone wants one which is how I was taught in medical school, I assumed this was how most physicians practiced.

Unless someone is a frequent flier asking for sick notes every week (without an appropriate reason) I wonder where the physician hesitancy is coming from, it's incredibly easy to medicolegally justify a short leave < 7 days.

Edit: Checked Cochrane out of curiosity and was surprised to see they had a review on this topic with (unsurprisingly) "very low certainty" evidence.

For self-certification < 3 days 2 studies reported an increase in work time lost of 0.54 and 1.38 days/person-year. On the other hand increasing self-certification to 50 days or 1 year had decreased impact on time off (granted it seems they only counted days off due to longer absences).

Even if these numbers are accurate for < 3 days (ignoring all the methodological flaws pointed out in the Cochrane review) this is already such a minuscule effect before factoring in the increased spread of illness, economic impact and burden on the system it's barely worth discussing.

Honestly, even assuming the worst that this is malingering for 1 day/year I feel like we're better off as a society just calling it a "wellness day" and moving on.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

>can we just decide as a society to let people take occasional sick days and stop wasting everyone's time with short-term sick notes,

I see it as the few arseholes ruining the system for everyone.

That is to say, there's that arsehole who takes leave by lying about having a flu or typhoid or dysentery or whatever else and he ends up costing the company too much in wasted time and pay. So now everyone has to get a note from someone who will insure their reason for taking leave.

Which is to say, don't blame the doctors nor the honest patients and workers. Blame the few arseholes that ruin everything for the rest of us.

If it’s one person, then it’s going to be discussed and addressed individually. Most of the time I’ve seen someone like that, they have good reasons that you are simply not privy to.

I agree that assholes are to blame, but I disagree with your hypothesis on which assholes and why.

> costing the company too much in wasted time and pay

If this happens it's not occasional and would be better addressed on a case by case basis.

> Blame the few arseholes that ruin everything for the rest of us.

In light of the added ~1 day/person-year of absence from a permissive self-certification process suggested by the Cochrane review I added in the edit, I would say we just call this the marginal cost of doing business instead of ruining it for everyone.

Especially considering the people impacted by such draconian policies tend to be low-wage hourly workers, the added cost would be a rounding error but as a consumer I'd also happily pay the extra ~0.3% so people can take sick days.

I would also wager that the improved wellness and morale from being treated with a modicum of respect and decency would result in productivity benefits and savings that outweigh the 0-2 extra missed days a year.

>>>> I would say we just call this the marginal cost of doing business instead of ruining it for everyone.

No.

That arsehole is causing a major cost on 1 employer. Its certainly not the cost of doing business or a rounding error..

1 day a year of a low-wage employee, unknown % of which is malingering vs illness, is a major cost on an employer?

Depending on the size of the employer and what the employee is supposed to do, among other contexts, yes.

....you can fire people if they're being an asshole (at least in the US).

Humans are, generally speaking, fucking stupid. When they're in an organizational setting, especially when they don't want to be bothered with organizing, and have power, it's really common for people to just make "rules" about whatever minor inconvenience they perceive. You see it on workers rights subreddits a lot, one person pissed off the boss so they knee-jerk created whatever blanket rule to bludgeon everyone back into line, then everyone gets upset and it ultimately costs them more that it would have to just ignore the problem.

This is such a prominent phenomenon that it's the entire basis of running a goddamn insurgency.

> I've been noticing patients seem increasingly awkward when asking for a sick note and go into a long story trying to justify the request.

Anecdotally, that reminds me of how back in grade school, a lot of teachers required you to ask their permission to go to the bathroom.

This is the part where you SHOULD see a company nurse (or even HR) in-person to bypass the doctor's note, given the extreme transportation usage.

This way, you made due diligence and cannot be legally fired.

I had a friend who ran into this from time to time. I was able to help him because I own a printer.

If work ever asked me for a doctors note I’d just risk calling their bluff. Not worth it. Schools do it too, never a consequence for anyone I’ve known that just simply didn’t get one, students and workers alike.

Belgium still has policies in place. Now, you do get paid for sick days, but still, my PCP in Belgium did one thing from 9am to 2pm. Write doctor's notes for overzealous employers.