Canadian Doctor Criticizes Employer-Mandated Medical Notes

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The NJBIA’s point about documentation raises the question of who should pay for proof that a patient is sick. But is writing a sick note for someone who is calling out with a cold really a good use of a doctor’s time, and medical resources? Last year a Canadian physician, Dr. Ethel Cooper-Rosen of Nova Scotia, gained worldwide attention for a letter that she sends back with employees who request a sick note:

Dear Employer:

An employee of your company visited my office/emergency room for the purpose of obtaining a medical note to satisfy your company’s absenteeism policy. This request is a non-insured service, not funded by Medical Services Insurance.

As a business operator in Nova Scotia, I am asking for your support in helping to alleviate unnecessary pressure on the health-care system. I am hoping you will consider revisiting your current absenteeism policy and remove the requirement for your employees to obtain a medical note for missed time from work.

This policy creates an unnecessary burden on the healthcare system and also exposes seriously ill patients in my office to viruses that could cause detrimental consequences to their health. In most cases, the best remedy for a patient with an isolated illness (i.e., gastrointestinal virus or common cold) is to stay home, rest, and drink fluids. Coming to a doctor’s office or an emergency room for a medical note does not complement their recovery.

If, for whatever reason, your business decided to continue to require a physician to authorize their employees’ absenteeism, I will require your employee to bring with them a written request from the organization for the medical note. Upon providing the service I will invoice your company $30 per medical note. This is a standard practice when providing non-medical necessary services for third-party organizations.

As Canadians we are lucky to have our healthcare system, but the ability to access its services in a timely fashion is a growing problem. Healthcare providers, business operators, governments, and individuals all have a role to play to ensure its sustainability. I hope your business will consider changing your current absenteeism policy and therefore contribute to reducing the unnecessary burden on our health-care system and improve access for other Nova Scotians.

CE – US1

US1 | Issue 10/21/2026

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