MC culture and the burden of proof: An outdated concept in a tech-driven world

As featured in The Straits Times

Just as employers adjusted to remote working during the pandemic, they should trust staff when they say they are unwell instead of demanding proof.

Winthrop Wong

Patients at a clinic
Most employees here are required to consult a doctor and obtain a medical certificate before they are granted sick leave and entitled time off to recover. STPHOTO: KUA CHEE SIONG

Medical certificates (MC) as proof of illness are commonplace across the world, and unusually demanded in Singapore.

Most employees here are required to consult a doctor and obtain an MC before they are granted sick leave and entitled to time off to recover.

While for some this may seem a reasonable step to ensure that the sick leave being granted is legitimate, for others it imposes an unnecessary burden of proof – an administrative step that sucks up time, money and resources.

In this day and age, with modern work-from-home cultures in place and telehealth in easy reach, has the time come to question the merits of our somewhat outdated “MC culture”?

Singaporeans are entitled to 14 days of paid sick leave under the Employment Act. In many cases, when all that an unwell employee needs for recovery is a spell of rest, having to head to the doctor just to secure an MC seems excessive. Worse, requiring MC paper proof before medical expenses are reimbursed and medical leave is granted suggests bean-counting and poor trust.

Yet in Singapore, this is the norm, despite government advisories issued during the pandemic indicating that employers should not demand a doctor’s letter to excuse workers who have Covid-19 from work.

Elsewhere in the world, things look somewhat different. In Britain, for example, employees can self-certify and take time off work if they are unwell, without needing proof of their illness.

This relies on a two-way system of trust and integrity between supervisors and staff, whereby employees are expected to tend to their health needs and return to work when they are fi t to do so without needlessly burdening co-workers, who have to pick up the slack, by taking too much time off work.

This all-or-nothing approach to sick leave in Singapore is, for many, an antiquated practice demanding review. Just as the pandemic has upended stuffy old corporate notes and introduced new, progressive working practices, a culture that demands an MC should also be scrapped.

How companies managed flexible work arrangements may be instructive. Before the pandemic hit, remote working was rare. Employers shunned it, fearing employees might skive when not under the watchful eyes of middle managers in office.

But working remotely has now become the norm at many workplaces. It is convenient for employees, it is productive – people don’t have to always spend time and money shuttling between home and work – and the rise of digital tools has facilitated communications amid asynchronous work.

The same factors – convenience, productivity, trust and technology – are in play when it comes to looking at junking the MC culture.

Patients at a clinic
This all-or-nothing approach to sick leave in Singapore is, for many, an antiquated practice demanding review. PHOTO: ST FILE

Technology has created greater efficiencies and afforded us more convenience. E-pharmacies in the Singapore market today can provide healthcare consultation on common ailments like the common flu, diarrhoea and eczema. Teleconsultation services involving doctors can be arranged for those who have more complicated, severe symptoms.

These tech-enabled services allow individuals to bridge physical distances, bringing access to healthcare services to our fingertips like never before. We can get same-day doorstep deliveries of important prescription medication without leaving our homes.

The combination of technology, teleconsultation and doorstop delivery is a great enabler of self-care, particularly for time-poor, working professionals.

We were also reminded during the Covid-19 crisis that we needed to harness our healthcare resources. With Singapore’s pharmacies dispensing over 60 million medication items annually, the Ministry of Health aims to use technology to manage orders from multiple sources for delivery to households nationwide. This eases pressure on the system.

Similarly, when workers halt the practice of visiting the polyclinic or the general practitioner to get an MC, primary healthcare professionals can spend more time with patients who really need their expertise.

Calls to abolish the need for an MC are often accompanied by concerns of abuse, absenteeism and moral hazards. Yet, just as skiving while working from home can easily be dealt with when it is in everyone’s interests to make the system work, similarly here the bad apples will soon get found out and pay a price.

That is why we should do away with the MC and paper proof of illness and focus more on addressing the immediate healthcare needs of those who are unwell. It starts with trust, it’s simply more productive, it is enabled by technology and can be possible, if only we change our old mindsets.

Winthrop Wong is a founder of e-pharmacy Glovida-Rx.

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