Sick of sick notes

Opinion

It is time to retire sick notes in Manitoba. They are a relic of another era — a paper slip that pretends to verify illness, yet does very little to support attendance management, public health or a strained care system.

In a province managing an acute physician shortage, every minute spent writing a workplace verification note for a routine cold or a short bout of stomach flu is a minute not spent diagnosing, treating or following up with patients who truly need care. That trade-off is no longer defensible and leading employers in health care are already showing a better way.

The data is clear. Doctors Manitoba estimates eliminating sick notes used only to verify a short-term absence could free up more than 300,000 appointments each year. At current workloads, that would be the equivalent of adding more than 50 physicians worth of appointment time back into the system.

There is also a direct financial cost, with unnecessary note appointments pegged at roughly $8 million annually — money that would be better directed to diagnostics, specialist consults or community care.

Just as importantly, traditional sick notes do not do what many employers hope they will do: confirm whether someone was truly too sick to work. By the time a worker secures a medical appointment, the acute symptoms have often passed and there is nothing for a clinician to observe.

The note becomes a proxy for attendance management rather than a useful tool. That proxy distorts incentives in dangerous ways. People will drag themselves to a waiting room while contagious because a policy says a paper note is required, which increases transmission risk at work and in clinics, and it punishes the conscientious employee trying to keep their germs away from others while they rest and recover.

Doctors Manitoba’s guidance reflects this reality and recommends replacing verification notes with better practices that protect both patient access and workplace health.

Public and employer sentiment is already ahead of policy in many cases.

In March, new research released in Manitoba found overwhelming support for eliminating or sharply limiting sick notes, with 96 per cent of respondents in favour, and similarly strong support among business owners and managers. The message is consistent: people want physicians to focus on care, not paperwork, and they want workplaces that treat adults with trust while still holding clear expectations about attendance and performance.

If you want proof that change is workable in real organizations, look at the health system’s own employers.

The Interlake-Eastern Regional Health Authority updated its policy in January. Its managers do not require notes for staff who are out sick for up to two weeks, after which the employee meets with human resources to determine whether any medical documentation is warranted based on the situation.

The Winnipeg Regional Health Authority followed suit May 1, confirming staff are not required to provide a note for absences shorter than two weeks and any request beyond that threshold must involve consultation with HR.

Both organizations cite easing pressure on health-care providers and reducing infection risks as key goals, with the added benefit of allowing clinicians to prioritize patients who need medical assessment rather than paperwork.

These are practical models that any employer can adapt.

Moving away from sick notes does not mean abandoning good attendance management.

It means shifting from paper verification to trust-based, data-informed and wellness-focused practices that actually work.

Start by being clear that short-term illness does not require proof beyond the employee’s word. Pair that with straightforward self-attestation form for record keeping, which gives managers a documented basis to spot patterns and have timely coaching conversations when they are warranted.

Build in flexibility for minor illnesses and family health needs so employees stay home when they are infectious and return when they are fit to do the job safely.

Reserve requests for medical information for the right scenarios, such as accommodations, return to work planning or longer duration absences where clinical guidance is needed to support a safe and sustainable plan. These are precisely the kinds of practices recommended by Doctors Manitoba in its guidance and mirror what progressive employers are already doing.

There is also a broader systems argument. Manitoba needs to recruit and retain physicians, nurse practitioners and other providers — and one of the fastest ways to improve day-to-day workloads is to cut low-value administrative tasks.

Doctors Manitoba has launched a province-wide campaign (with HR resources for employers) to eliminate sick notes for short-term verification. The campaign underscores Manitoba is one of the few jurisdictions without legislative limits on sick notes and it calls for action that aligns employer policies with what is already evidence-based and patient-centred.

The more employers that make the change now, the more appointment time becomes available and the safer Manitoba waiting rooms and workplaces become during peak cold and flu seasons.

Employers sometimes worry getting rid of notes will lead to higher absenteeism. The experience from early adopters suggests the opposite.

When people are trusted to use sick time appropriately and when managers are trained to intervene early on patterns and offer support or performance feedback, absenteeism stabilizes or even improves.

The reason is simple: employees do not face the perverse incentive to show up while sick, which reduces outbreaks, and they do not waste energy navigating an appointment bottleneck for a slip of paper that says nothing useful. Without the distraction of chasing notes, managers can focus on patterns, supports and accountability.

That is the real work.

For organizations ready to modernize, there is practical help available. Doctors Manitoba has published concise guidance for employers on eliminating sick notes for short-term absence verification, including clear explanations of when medical information is still appropriate.

The document explains alternatives (such as self-attestation forms), outlines how to update policies, contracts and handbooks, and it stresses the importance of communicating changes while tracking outcomes. A comprehensive toolkit with sample policies, self-attestation templates and manager guides is forthcoming.

Employers can use these resources to make evidence-based changes quickly and confidently, with support from a broad coalition of physicians, business leaders, labour and HR experts who contributed to the recommendations.

The path forward is straightforward. Treat adults like adults for short-term illness. Use self-attestation and simple records to keep attendance management on track. Ask for medical information only when it truly supports accommodation, return to work or longer-term planning.

Follow the lead of health authorities by adopting a two-week threshold before considering documentation, with any request beyond that made thoughtfully and in consultation with human resources. Measure results and share what you learn with peers, so policy change does not depend on legislation alone.

Retiring sick notes for short-term absences is not only a compassionate move for workers, it is a smart systems decision for Manitoba.

It reduces administrative burden in clinics, keeps infections out of workplaces and waiting rooms, and gives managers better tools to support attendance and performance. It aligns with public opinion and with the lived experience of employees and physicians.

Most importantly, it potentially gives hundreds of thousands of appointment hours back to patients who need them.

Tory McNally, CPHR, BSc., vice-president,

professional services, is a human resource consultant, radio personality and problem solver.

She can be reached at tory@legacybowes.com