Ontario scrapping sick notes to cut down on doctors' paperwork

Ontario says it will force employers to scrap requirements for sick notes as part of an effort to cut down on paperwork for family physicians.

The change will be part of new legislation tabled by the minister of labour in coming weeks, a government official says. The amendments would eliminate the need for a doctor's note from employees who want to use part or all of their three days of provincially-mandated annual sick leave.

Employers will retain the right to require another form of evidence that an employee is ill, which could include self-attestations or a receipt for over-the-counter medication, the official said.

The change is part of a host of measures announced by Health Minister Sylvia Jones Wednesday intended to help free primary care physicians for more direct patient care.

The province is also expanding a pilot program that will see family doctors use artificial intelligence technology to transcribe and summarize patient visits.

Some 150 primary care clinics will participate in the project, which is being administered and evaluated by OntarioMD, a subsidiary of the Ontario Medical Association (OMA).

Hopes to reduce paperwork

The AI software is called Scribe. It can summarize conversations with patients who consent to its use into electronic medical records, Jones said.

The province says it will also digitize more referral and consultation forms and is working to improve the eForms platform.

"Together these changes put patients before paperwork, allowing clinicians to spend more time with their patients, resulting in a more connected and convenient patient care experience," Jones said.

According to an accompanying news release, research in other jurisdictions suggests AI software can reduce the time doctors spend on after-hours paperwork by up to 50 per cent and allow them to see more patients.

OMA President Dr. Andrew Park said the "burden of unnecessary administration" takes up about 19 hours per week for primary care doctors, preventing them from seeing more patients and achieving a healthy work-life balance.

The OMA estimates roughly four of those total hours are spent on writing sick notes and completing government medical forms.

Checks and balances

Liberal MPP Adil Shamji, who has also worked as an emergency room doctor, told reporters Wednesday that "the devil is in the details and the execution," and AI systems would need to be carefully implemented.

"If this proves to be an avenue that we actually decide to pursue beyond a pilot project, there will need to be a series of checks and balances to make sure that there is accuracy, to make sure that patient confidentiality is preserved," he said.

Roughly 2.3 million Ontarians do not have a family doctor, a figure that is expected to double in the coming two to three years, Park said. 

The OMA warned earlier this week that fewer medical students are choosing to pursue family medicine, partly due to the time primary care physicians spend doing unpaid paperwork.

As part of Wednesday's announcement, the OMA said it is also working with the health ministry to streamline and simplify 12 key government medical forms that are burdensome and time-consuming for family doctors.

Kathleen Wynne's Liberal government actually banned employers from demanding sick notes, effective Jan. 1, 2018. Then, the Doug Ford government repealed that ban shortly after taking office, allowing employers to demand a doctor's note for even minor illnesses, as part of its changes to provincial labour law.