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20 Jun 2017

Transcript: AMA Vice President Dr Tony Bartone, 3AW, Tuesday 20 June 2017

Subject: Medical Certificates


ROSS STEVENSON:  Tony Bartone, Vice President of the Australian Medical Association. Doctor, good morning to you.

TONY BARTONE:  Morning, Ross.

ROSS STEVENSON:  Is it satisfactory to write a medical certificate exempting someone from work or from community-based orders by simply saying, quote, medical condition, close quote?

TONY BARTONE:  When we issue a certificate, the more commonplace situation is obviously for the purposes of work and there is a - it's a legal document, but it's also a document based on the trust and confidentiality that underpins the medical consultation between a patient and their doctor.

ROSS STEVENSON:  Yeah.

TONY BARTONE:  So if the patient - without the patient's permission, we would never really want to offer the conditions or the issues behind the conditions on which we're basing the medical certificate on ...

ROSS STEVENSON:  I can see that.

TONY BARTONE: ... but if the employer then wants more information – and obviously with the patient's permission – we can then give the basis on which we made the decision to issue the medical certificate. In terms of the court that you're - issuing the court order, that would be obviously if the judge wanted more information, we would obviously be obliged to supply that.

ROSS STEVENSON:  Okay. Interesting. My question from earlier this morning: has a doctor ever refused to give a medical certificate to a patient?

TONY BARTONE:  Look, Ross, you may find this surprising but, yes, unfortunately there are situations and there are occurrences where patients ask - especially, the most common request where we have to turn it down is where they want a back-dated certificate and they couldn't get in on the day. And, unfortunately, unless we've got an ongoing history of a condition that we're aware of and we've been managing along the way, or at least some sort of other knowledge to verify that, we can never back-date a certificate. And that's because basically it's a legal document ...

ROSS STEVENSON:  [Talks over] What about if my back pain is so bad I can't get out of bed to come and see you to get my certificate?

TONY BARTONE:  Okay, so, Ross, you're my patient – well you're not, but let's assume you are my patient – and we've been treating you for your back, and I know that, and you've phoned the clinic on the day, you've spoken to me, you've given me symptoms over the phone. There is a certain amount of trust that underpins the history that I obtain from the patient and it's a two-way trust; just as they've got trust in me when I'm performing the consultation and the examination, I have to rely on the patient that the patient is giving me the right information.

Obviously, when they're in the clinic I'm examining them and I'm making independent observations and assessments as to the nature of their illness and that gives me, obviously, a lot more comfort. But where there is no relationship between patient and doctor, really that's much more problematic and that's unfortunately one of the issues that has seen a number of other alternatives spring up in terms of not being able to get a certificate in a timely manner sometimes for patients.

ROSS STEVENSON:  Tony, thank you very much.


20 June 2017

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Published: 20 Jun 2017