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Sick leave: Germany rising but not the worst in Europe

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Re: Sick leave: Germany rising but not the worst in Europe

#71
post #9

"As part of Merz's proposals, from January next year, workers will no longer be able to get a sick note over the phone. They must visit a doctor in person and on the first day of illness." Can't wait to share the sbahn with feverish people or seeing a live diarrhea attack.

Maybe this could be addressed by partially bringing back the house call?

Before around the 1960s in many countries if you were sick you called your doctor and they came to your house. The net is telling me that the reasons that this largely stopped are that advances in medical technology led to more reliance on equipment that you really couldn't all around with you to patient homes, that doctors became more specialized, and that as the population spread out more due to the boom in cars doctors couldn't see enough patients a day.

If everyone who wants to take sick time needs a note on day 1 maybe that would be sufficient to have some doctors who just make house calls.

I'd expect that most illnesses that prompt a worker to want a sick day are simple enough that you do not need to fancy diagnostic equipment available at doctor's offices, so that gets rid of one of the main reasons house calls became infeasible.

There is still the problem of people being spread out, but I'd expect the visits should be pretty quick so maybe it would be possible to do enough per day to handle to load. I think the visits would be quick because the doctor should just need to verify that you have something that justifies taking a day off work. For most cases that's going to be some kind of cold or flu or some chronic condition acting up, which should to quick to check. E.e., the patient has a fever and a cough...you don't have to figure out exactly what they have to know they shouldn't be going into work. Approve the note and collect a blood sample to drop off at the end of the day to get more information tomorrow.

If this is still too much for doctors to handle maybe introduce a new type of practitioner. In the US we have Nurse Practitioners (NPs) and Physician Assistants (PAs).

NPs are licensed registered nurses who get additional training and certification. NPs can diagnose and treat acute and chronic conditions, write prescriptions, order and interpret lab work and imaging, and counsel patients. What they cannot do is perform surgery (although they can assist) and manage complex cases. In some states they cannot prescribe certain drugs like opioids without oversight from a doctor, and in some states they have to work under the supervision of a doctor. NPs do not have to go through a residency, and require about an order of magnitude less clinical training than doctors.

PAs are roughly similar from a patient point of view, but they always work with a doctor. Their training requirements are more doctor-like. Their focus is also more doctor-like, focusing on biological aspects of disease, whereas NPs are more holistic. PAs are also better as generalists, whereas NPs must choose during their schooling a specialty like family car or geontology or pediatrics.

The net is telling me Germany does have non-doctors that can do some of the things doctors do but says none of them are like NPs and PAs who can independently diagnose and treat, so would probably not be able to substitute for a doctor in seeing patients to produce a sick note. It also is telling me Germany has a doctor shortage, so maybe something like NPs or PAs that can take much of the routine load of dealing with routine issues would be a good idea even without the new sick note requirements.

Re: Sick leave: Germany rising but not the worst in Europe

#72

Earlier quoted context omitted.

In the USA the most untrustworthy among us who in your words are "destroying society for the rest of us" are employers, as wage theft by employers is the largest form of theft in the country. If workspaces are as much a community as anywhere else, the fact that the rot starts at the top should be the most major concern. People taking sick days seems like it falls way down the list of concerns in trying to get the Ame…

>In the USA the most untrustworthy [...] are employers [...]tyranny of the untrustworthy (employers) Have you ever been an employer? Like if being a trustworthy employer is so easy why aren't you and many other people doing it to set an example? How come all employers are tyrannical? IMHO your blame is misplaced. A lot of the issues you point out are not due to employers, but due to government regulations or lack the…

Why are you defending/waiving away wage theft? Not stealing from people and following the law is the absolute minimum an employer can do. It is not the governments fault when you break the law. Should it be ok for an employee to steal because someone else stole from work? Because society is complex and hard and has rules and laws but can't police everything 24/7?

I've been an employer. I've been a manager. My family owned factories. None of us were forced to steal wages. If you are in that situation you are a zombie business that can't actually afford to function properly.

Here's OPs tone that I simply echoed back but directed at the actual identified largest thieves in our nation.

https://news.ycombinator.com/item?id=48788134

And they are the largest thieves without even going into abusing 1099. Hiring undocumented workers under the table. And all kinds of other 'acceptable to civil society' society undermining behaviors.

Re: Sick leave: Germany rising but not the worst in Europe

#73

Stupid idea. Doctors are incentivised to just give out a sick note to anyone that asks. There's no downside for them if they do that, and if they don't, they get complaints from the public. It seems likely to me that we will end up with private companies being paid by employers to evaluate your health and determine if you can go off sick. Not the nicest solution but I don't see what other option there is given the le…

more than 80% of workers in the US have paid sick leave without doctors notes required. varies by state. not sure where you’re getting your information…

Re: Sick leave: Germany rising but not the worst in Europe

#74
post #39

Disclaimer: I'm a US Citizen / Worker, white collar. My first job had: Unlimited sick time. Take it when you need it. No doctor's note. I think you may have needed one at the week mark. Never hit at that employer. Most employers have been limited sick, with a note at a week. I can't imagine note on day 1. That's just... nuts. The lack of trust shown there is massive. I'm making calls on stuff far larger than my sick…

Don't know about other places, but in places I have worked that required sick note on day 1, you could get one via a phone/video doctor's appointment.

You could argue that this is accountability theatre, though frankly for something like a cold - what will a doctor see face to face that they won't on the phone?

It's still a positive amount of faff but pretty tiny.

Re: Sick leave: Germany rising but not the worst in Europe

#75

Earlier quoted context omitted.

Even more than a day is terrible. If I have a cold or the flu, the last thing I want to do is to go to the doctor. I'd rather just rest up, it goes away in 3-5 days and I can be back at work. The need for a doctor's notes means one of: * I explain to my employer, probably don't get paid for those days, and might face disciplinary action or eventually get fired * I go to the doctor, making my recovery less likely, inc…

> it goes away in 3-5 days and I can be back at work. Sitting 5 days at home without a doctor seeing you on the basis of "trust me bro it's just a flue it will pass soon" also seems dangerous since plenty of people suck at self diagnosing themselves and end up more sick or even dead by ignoring major issues thinking it's something small that will pass. And that's besides the trust part where people are gonna exploit…

[deleted]

Re: Sick leave: Germany rising but not the worst in Europe

#77

I'm Norwegian. I have not taken a single day of sick leave (M51). I believe that if I get sick, it is my fault and responsibility, and I should not burden the employer or public sector with that. In 2009 i fell off a bike and hurt a knee. My fault. So I took 5 days of my vacation to stay home.

So you go to work sick ?

I work even if I have a cold. Luckily I never had symptoms of flue.

I was down with Epstein-Barr/mononucleosis for 12-14 days in 2004, and then I stayed home (home from PhD studies).

Re: Sick leave: Germany rising but not the worst in Europe

#78

Belgium law allows employers to enforce a sick note starting day 1. I joined an employer that didn't require this, and it was such a breath of fresh air. At our local doctor, the first 5 hours of his workday were comprised solely of writing notes for people to stay home. It is a waste of (recovery) time to enforce everybody to get a note starting day one. And describing the situation in the US on this to validate the…

I am all for it, but if a business is one of the few offering this, I guarantee you that their new hires will tend to have significantly more health issues than at other businesses not offering this.

It’s a bit of a chicken and egg issue.

Re: Sick leave: Germany rising but not the worst in Europe

#79
post #39

Disclaimer: I'm a US Citizen / Worker, white collar. My first job had: Unlimited sick time. Take it when you need it. No doctor's note. I think you may have needed one at the week mark. Never hit at that employer. Most employers have been limited sick, with a note at a week. I can't imagine note on day 1. That's just... nuts. The lack of trust shown there is massive. I'm making calls on stuff far larger than my sick…

Employers still have the option to not require it on day one if they choose? It’s just that they have the option now if they feel specific employees are abusing it. Considering that you can’t fire people in Germany for taking an excessive number of sick days (even if you have good reason to believe they are faking it that doesn’t seem unreasonable)

Re: Sick leave: Germany rising but not the worst in Europe

#80
post #52

Earlier quoted context omitted.

>The lack of trust shown there is massive. All systems based on trust eventually get abused. Not by everyone of course, but catching a few with their hands in the cookie jar is enough to trigger a rethink on the whole trust-based thing. Most corporate German workers I knew were taking a few extra vacation days a year as sick leave, or using fake sick leave(often weeks or months!) as revenge if their employer didn't g…

There will always be abusers. The issue I see is day 1 asks. Not day N. If I'm out a week asking why is reasonable. If I'm out a day, it's more annoying for everyone. And I'm not advocating for no limits with no responsibility to the employer. That'd be stupid. Clearly there's a "more sane" middle ground. Even on a menial job, they are dealing with more value than they make daily, by definition. A middle road exists,…

Your employer doesn’t have to ask it on day 1 if they “trust” you, though. They just have the option now. Of course unfortunately it will still affect a lot of people who aren’t cheating neg.

> A middle road exists, and it is solid, why it isn't being taken, I don't know.

That’s what Germany has now, though? i.e. companies are only allowed to require it from day 3

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