04 February 2008

Bogus Medical Certificates

I believe any doctor (especially Filipino doctors) has had these problems, and today, I would like to write about them. Here are sample true-to-life cases:

  1. CASE I - THE DEVIOUS EMPLOYEE - a government employee or private corporation employee plans to take a long vacation ('long' here means many weeks or several months) with his family either on some local tropical island or on some famous destination abroad. The reasons range from any of the following: (1) his employer demands a valid reason for taking such a long vacation, (2) only a chronic medical illness can justify taking that long break, and (3) he does not want anyone from his office know he is vacationing because he fears he cannot buy pasalubongs or gifts given to all people when he comes back. Solution? Ask a friend doctor to issue a fake medical certificate.

  2. CASE II - THE MORE DEVIOUS EMPLOYEE - knowing that there are some medical procedures done which their employers are willing to shoulder and give full refunds as part of their health-related benefits, this sly person asks for a fake medical certification so he can collect the said monetary amount. It might be real, meaning, he might really have undergone some surgical procedure but this time, he asks his friend doctor to exaggerate a little to bloat the medical expenses so he can collect more. The worst version of this case is when a fake medical certificate is issued when, in fact, no medical or surgical procedure really happened.

  3. CASE III - THE SHREWD STUDENT - the reasons he will probably give can be any of these: (1) there's a limited number of class absences allowed before getting booted out of the class, and (2) the student is running for high honors and only a medical illness is the allowed excuse for not blemishing his stellar(?) class records. Solution? The student or in most cases, the student's parents ask a friend or relative doctor to issue a fake medical certificate.

  4. CASE IV - MISCELLANEOUS CASES - here, the reasons are varied: (1) missing a flight, (2) the other friend doctor refuses, or is unavailable, (3) being unable to attend a required Senate/Congress hearing, (4) being unable to attend a court hearing, and (5) any other WILD reason you can possibly think of. Solution? Ask a friend or relative doctor to issue a fake medical certificate.

If you notice, the common denominator among ALL the cases is having a friend or relative doctor. In the Philippines, I think issuing medical certificates is one of the most abused privileges. Because the prevailing culture here is very personal --- everyone is a Tito or Tita or an extended family --- occurrences like these come as no surprise. In fact, a relative or friend doctor who refuses to write a fake medical certificate for any of the reasons cited above is labeled as walang pakikisama or not a true friend at all. It is silly, if you ask me. A true friend will not put his friend doctor in such an awkward position.

Often, a conscientious doctor is put into unnecessary social pressure, and is forced to give the fake medical certificate. I think this is unfair for doctors who have been taught to help those in need and not those who are faking it for selfish purposes. Also, it corrupts. One fake medical certificate issued leads to one more, two more, and soon, the corrupted physician has become a mill for medical certificates. In fact, there are some disreputable physicians around who issue fake medical certificates for a fee. Incredible, but true.

In the past, I must admit that I was also pressured to acquiesce to such unthinkable requests. I was a fresh graduate and did not know any better. But that was a long time ago. These days, I no longer issue bogus medical certificates, and when I look back and remember my iniquities back then, I feel ashamed of myself.

How about you? What's your stand in this? Have you encountered these cases? Were you the pressured doctor or were you the one pressuring your friend doctor to issue you one?

11 reactions:

ipanema said...

Oh my, glad to read it coming from a physician. Yes, I have heard stories of people coercing a doctor friend to issue a med cert for their own twisted reason.

I consider absences white lie. However, to ask for a med cert for claims is pretty way beyond one's dignity. I pity the doctor who has no choice -requested at gunpoint? :)

When we claim for medical reimbursement, we have to attach supporting documents - laboratory results, x-ray, scans, etc. other than a mere medical certificate. One will be asked to produce these.

If it's only to support an excuse letter a med cert is enough. When there's money involved, they need the above.

I hope will stop doing this. It is hard to the doctor-friend. Professionally demeaning.

Thanks for covering this.

Great post as always! :)

Lester Cavestany said...

For better or worse, fake medical certificates and diplomas are easy to get in the Philippines. Your post reminded me of the recent reports about the diploma scandal in South Korea. Apparently, the fake diplomas, used by 13 South Korean army officers, were made here in the Philippines.

For those of you who want to have a laugh, read the full article here: http://globalnation.inquirer.net/news/news/view_article.php?article_id=98386

Mec said...

in a way i feel superstitious about faking illnesses and wouldn't be comfortable at all asking for a fake medical certificate... because it'd be like tempting fate

i dunno..

rolly said...

Sayang! Papagawa pa naman sana ako ng medical certificate. Hehehehe

I will have to qualify my answer to your question. If it is plain shrewdness, then it is definitely wrong. Immoral even. But if it is for a white lie, like it would make things easier for an employee, rather not having to resort to huge trouble, why not? The world is not made up of black and white. There are many gray areas in between.

Dr. Emer said...

IPANEMA - Thanks. As I said, there's no problem with me as long as it is true.

LESTER - The news item brings a collective and mistaken impression that we are a country of fakers.

MECSY - Good for you!

TITO ROLLY - For me, it is those gray areas which cause bigger troubles later on.

Mari said...

happens a lot in my previous work, too. in my experience, i think nobody checks the veracity of the medical certificates submitted by the employees because HR people trust the doctors who issued them.

bing said...

a sad issue in the Philippines. personally, i dont want to ask the doctor to feign sickness by issuing me a med cert. these actions have consequences. and i think all actions do have consequences.

in a manufacturing set up, this is very common. as mari said, nobody checks the veracity of the med certs. this is not only because they trust the doctors but also because there are companies that are lax and lack the initiative to create rigid or stricter policies regarding sick leaves. i heard though that SSS are doing their part of investigating especially if the leaves indicate lengthy periods.

Anonymous said...

I have just discovered your medical blog and I find it very interesting.

I have not really had problems issuing med certs. Usually, they are really sick. But there was one patient for whom I did surgery 3 months ago, and still claims to have pain. There is no physical evidence or inflammation. She certainly does not look like she is in pain. She requests me extend her sick leave and SSS, because she claims she can't work well with the pain,which makes me uncomfortable already. This is such a hard situation!

How do you turn down requests for med certs? Any tips?

Lester Cavestany said...

Hi Doc,

I know the fake diplomas issue puts us in a bad light. It's not right for people to use the good name of our universities in their fake diplomas. It's not fair to those who really have degrees. And I wish Mayor Lim can take action on the illegal trade in Recto.

Having said that, I have some friends who have been able to get jobs because they used a home-made diploma. I know it's not right but what if they just didn't have the money to go to university.

As always, poverty is the enemy.


rea_md said...

hi doc
i can relate to your story
i'm also a physician and there were times that i am asked by my friends to issue a medical certificate for them as an excuse for their absences at work. If they have been really ill, it reflects from their physical clinical findings. I have to find out through examining them. Telling them to have lab test done. But if not, I refuse because i feel that their were abusing our identity as doctors. Issuing a fake medical certificate damages the sense of professionalism within us physicians and destroys our moral.

Anonymous said...

I am in dire need of a medical certificate, thus, i came across this website in my google search. I have CTS which requires operation but I want the operation to be performed on March 2011. However, I need a certificate NOW so I can submit it to my husband's employer so he can go home in time for my operation. (Husband works abroad and has "conditional approval" provided he can present the medical certificate, however it takes a long time to process actual approval memo). My own doctor doesn't want to issue a certificate, says he will issue a certificate two weeks before the operation. However, there is time constraint on my part. We wouldn't be able to get approval from his employer if we submit the certificate two weeks prior to the operation. I really want my husband to be here albeit it's only a minor operation. I understand your position about your integrity as a doctor by issuing a medical certificate for bogus reasons. But what if the reason is valid but there is a time concern? Will you issue a certificate or not?