Do you really need a sick note?

I have been faced with an issue that all GPs are likely to experience on a frequent basis, and it makes me uncomfortable. Doctors in general practice are responsible for issuing sick notes to say that patients are not able to work. By doing so, we have a huge responsibility, ultimately to the country’s economy. Most of the time patients genuinely need a doctors note – they really are ill. However, recently, there have been several occasions where I have had a request for a sick note, and I really didn’t feel one was appropriate. One patient I’ve seen regularly comes up with physical problems as ‘excuses’ that he is not able to work. I say this not because I am harsh, but because a lot of health professionals have seen this person, and no one can find any reason why this patient cannot work. I have recently seen a heroin addict who wanted a month off to ‘get clean’ without any help from professionals, and got quite nasty when I said no. Doctors are put into a difficult position at times with where to draw the line, and I’m really not happy with having my integrity compromised