Medical certificates are legal documents. Writing one can be challenging as doctors have a dual role — primarily to their patients, but also to third parties such as employers and insurers. Because a doctor’s views can influence the patient’s trajectory, doctors have to balance between objectively assessing a patient’s condition and advocating for their best outcome. However, what to say on the medical certificate or whether to even issue one raises dilemmas particularly when there are reservations about the patient’s claim, or where the request for a medical certificate is outside a doctor’s scope of practice. Other challenges include time constraints during a consultation, acquiescing to a medical certificate to avoid confrontation, and maintaining patient confidentiality in the face of external queries.
This presentation will highlight key aspects from the Medical Council of New Zealand’s statement on Medical certification. It will outline a doctor’s professional obligations when issuing medical certificates such as the need to be truthful and accurate, and to distinguish what the patient says from the doctor’s own clinical observations. It will discuss commonly asked questions such as whether a diagnosis should be disclosed, the appropriateness of backdating a medical certificate, and what information doctors can provide when third parties query a medical certificate. Ultimately, our statement is intended to help doctors navigate the challenges and ethical dilemmas that arise with writing medical certificates so that doctors act in their patients’ best interests while fulfilling their wider responsibilities to third parties.