Quebec workers can now take up to 3 sick days without a doctor's note

In Quebec, a new law allows employees to take up to three days of sick leave without providing a doctor's note.

Partially in effect since the start of the year, the legislation forces employers to eliminate such requirements. It aims to streamline doctors' workloads by reducing paperwork and unnecessary clinical visits.

Dr. Laura Sang, a family physician from the Montreal area, said the new law can allow her to focus on clients who need more attention.

"There's not usually much that I'm going to do for someone and those appointment spots can be much better used for someone who's a lot sicker or has more urgent issues," Sang said.

This change is something Quebec doctors have long called for. About two months ago, the Canadian Medical Association (CMA) urged employers to stop requiring sick notes, calling them a burden on the health-care system and more of a human resources issue than a medical one.

The CMA cited a poll showing that 82 per cent of employed Canadians would likely go to work ill rather than obtain a sick note from a health-care provider. This behaviour, the association argued, increases the risk of spreading infections to co-workers.

Sick notes also add strain to already overburdened health-care providers, reducing access to care and potentially leading to longer wait times for appointments, the CMA said.

In a position paper published in October, the CMA estimated that eliminating the requirement could prevent as many as 12.5 million unnecessary medical visits annually.

Half a day each week on paperwork

In Quebec, Dr. Simon-Pierre Landry, a family physician practising in Mont-Tremblant, estimates he spends about half a day each week on paperwork.

"Seeing an average of 25 to 30 patients per day, the time saved by cutting certain administrative tasks could be significant," he told Radio-Canada.

"The health-care system is currently bogged down, and we won't get through this unless we improve the system's efficiency by reducing waste."

Landry said any measure that improves access to care is a step in the right direction.

"Meanwhile, I'll be seeing patients who really need me — those with depression or possibly cancer. I'd much rather do that than fill out forms, no question," he said.

An Institut national d'excellence en santé et en services sociaux (INESSS) report published in the fall found that 2.1 million Quebecers were not registered with a family doctor in 2022-23, representing 23 per cent of the population. Quebec's target is 15 per cent. Of those 2.1 million, 500,000 are ill.

The provincial government has estimated that the new law would free up 600,000 appointment slots annually.

However, during parliamentary committee hearings, the province's general practitioners' federation said the measures would not significantly increase the number of available appointments.

Instead, the measures would primarily help reduce doctors' workloads and allow better use of appointment slots, the Fédération des médecins omnipraticiens du Québec (FMOQ) said.

The new law also stipulates that doctors will decide how often to see a patient on disability leave, rather than insurers. However, no date has been set for this measure to take effect.

The FMOQ notes on its website that implementation of this measure will not occur before April 9.

The same timeline applies to ending requirements for medical documents from insurers for reimbursing health-care services, such as psychologists, physiotherapists and massage therapists, as well as accessories like canes, crutches and orthotics.

While acknowledging that some paperwork is intended to prevent abuse, Landry does not believe it is a doctor's role to act as a gatekeeper for human resources or insurers. Insurers will need to find other ways to prevent abuse, he said.