If the patient does agree to be examined, then the doctor should ascertain whether it is a victimisation case. This is often clear from the history, previous pattern of sick leave, and whether the underlying issues appear to have been addressed. At all times, the patient's interests should be paramount, and there should be no communications with the employer that the patient has not agreed to. Even a statement of fitness or unfitness for work can be problematic. In what may be a finely balanced situation, a report from a psychiatrist saying that the employee is unfit for work because of anxiety and depression caused by the stress, can be misused by the employer to claim the employee's concerns are irrational and justify the victimisation that has in fact caused their illness.
Certificates have to be carefully worded to prevent such misuse.
The doctor can be of considerable help in putting pressure on the employer to remedy the underlying situation, by pointing out that the problem appears to be primarily managerial rather than medical. If the doctor considers the health problem is in fact caused by stress at work, this should be clearly stated. Dr Jean Lennane is a psychiatrist in private practice and a member of the NSW Branch Council. This page was converted to html by a member of Whistleblowers Australia.