How A $819,000 Work Note Brought Down The Economy

The reality of life is that we all get sick from time to time.  Some employers are more understanding than others.  Some companies are not.  We all know a few co-workers that seem to get sick more than the average person.  Sure, some have chronic medical conditions that require frequent medical visits and often flare up leaving the person unable to perform their work duties.
The other side of the coin are those that are always suffering from a variety of conditions that are often minor or simply used as an excuse not to come into work.  This is the issue addressed in this article.

The Issues

It is not uncommon for physicians and nurse practicioners to see higher volumes in the clinic and Urgent Care center on Mondays.  It's just a statistically proven busier day with higher patient volumes.  Patients often request a work note excusing them for missed work, allowing additional days off or simply verification that they did in fact seek medical care.
The frustration lies in those who arrive Monday morning feeling "all better", but ask for a note excusing them for the shifts over the weekend they missed.  This puts providers in a difficult position of deciding whether to trust what the patient is stating or make an alternate decision.  Unless one has an established relationship with the patient, most providers would decline to write a note for an illness or condition that resolved before the patient presented for evaluation at the clinic.

The Real Price

The cost of just a single visit to an Urgent Care center or clinic for a minor illness such as vomiting, diarrhea, strep throat or bronchitis is on average $150.  That includes a copay and office charge from the provider.  If any tests are performed or X-rays ordered, that cost jumps up considerably. 

A Game Of Simple Math

There are always those who are trying to game the system.  Some are quite adept at pulling it off; others are less skilled and easier for health care professionals to spot in the crowd.  Patients often forget that medical staff are a very observant lot of people; it is part of their training.  When a nurse witnesses a patient laughing and carrying on in the waiting area or laughing and having a good time during a cell phone conversation that information is filed away.  When this same patient is checked into an exam room this information will be shared with the health care provider.
After decades of working in health care, it is often this subgroup of patients that are most eager to get a work note for a current illness that is preventing them from going to work.  In talking with my colleagues, it seems there is not a day that doesn't go by without each of us seeing at least one patient such as this.
Adding it up:  $150 x 15 patients / day with the sole goal of getting a work note = $2,250/day ; $15,750/week; $819,000/year.  These figures should make one take a step back and ask what are we doing here?
These numbers are for a single health care setting in a medium sized suburb.  Just multiply this by any factor and one can see the impact on our economy.  Economists are able to tell us the impact of sick days on the economy in terms of lost work and productivity, but what about the cost billed to patients and insurance companies?  Many of these patients are covered under state funded health plans such as medicaid.  These are you tax dollars going out the window.
While it is true that employers often require a work note for medical absence, but there has to be a better alternative than a doctor's office visit or worse yet, an ER visit just to obtain the work excuse note required by most employers. 
Potential options could include the quick care or convienience care clinics found in many grocery stores or malls.  Some larger health groups are offering online medical appoints done through texting, email or video calls.  Often these visits have a fixed price and could defray some of the exorbitant expense described above.
I'd love to hear your thoughts on this issue and some possible solutions.  Please post a comment below this article on