Published February 22, 2011
The University of Wisconsin School of Medicine is investigating the disturbing and disgraceful writing of fake sick notes by some of its doctors to excuse teachers who decided to bail from their jobs. It is the right call. But an investigation is not enough. The state Medical Examining Board of the Department of Regulation and Licensing needs to reprimand these doctors and, in some cases, consider handing down suspension.
I take my professional license seriously. I am bound by ethics as well as HIPAA to conduct a secret exchange with my patient. This exchange takes place in my office or in the hospital behind closed doors. It does not take place on the street with a stranger. When I interact with a patient, I am not allowed to provide the information I learn to anyone without permission. The HIPAA law is there for a good reason: it elevates the exchange between a patient and her doctor. This week's fake doctor notes in Wisconsin make a mockery of this process and undermines the sanctity of the entire profession.
A doctor's signature on a sick form is in the same category as his signature to a prescription. In the case of the fake note, he is prescribing rest or several days off to someone he doesn't know as a form of political protest. Using our medical powers in this way is a distortion that dilutes the essential meaning of these powers.
In order to maintain my professionalism, I need to know where to draw the line. Patients ask doctors for notes all the time, but doctors can only comply if they know the patient. I am often asked for a letter to excuse a patient from a jury or a plane flight, but I will only provide this letter if the medical complaint is legitimate. I would never consider supplying a note for a patient I've never met.
There is certainly a role for altruism in medicine. Many of the young doctors involved are idealistic residents in training. I understand their instinct to throw their voice and weight into the political process. Unfortunately, those who have been standing outside the Wisconsin Capitol building in Madison and offering their notes are violating the basic Hippocratic oath of "do no harm."
These young doctors might be better advised to volunteer their time to Medicaid clinics, especially at a time when Obamacare is in the process of adding hundreds of thousands more Medicaid patients to the state coffers.
We doctors are prevented by federal anti-trust legislation from collective bargaining, work stoppages or strikes. This law is in the best interest of our patients, since many of our sickest patients cannot do without our help for even a day. Maybe the doctors who risked their licenses by writing fake notes in Wisconsin should have considered this; the teachers they are helping to stay home with fake illnesses are leaving their students without necessary guidance. Should this greedy act really gain a physician's sympathy?
Unfortunately, in service professions like medicine or teaching, once you cross the uncrossable line and use fraud for self promotion, you send a message to the public of no confidence. I wouldn't trust one of these striking teachers with a real student any more than I would trust one of these doctors with a real patient.
And it's not just a question of licensure; it's also a question of basic ethics and integrity.
Marc Siegel MD is an associate professor of medicine and Medical Director of Doctor Radio at NYU Langone Medical Center and a Fox News Medical Contributor.