Evening star. [volume] (Washington, D.C.) 1854-1972, 1886-11-17
SICK LEAVES AND THE DOCTORS.
Ine Snn1eet Discussed BY The Medical
society Last Evening Secretary La.
mars Letter.

special meeting of the Medical Society of
the District of Columbia was held last evening
to consider the action of the commissioner of
pensions in requiring that physicians, in their
certificates for sick leaves given to the EN-.
pioyes of that Office, should state the nature of
the sickness. There was large attendance,
ana Dr. Garnett stated briefly the facts in his
correspondence on this subject with the Pension
office, which were published some time ago in
The STAR. He said that he deemed it unpro-
1essonai TO state the nature Of the sickness, and
that therefore he mad declined to do SO. The
secretary then read the correspondence which
had taken place between DR.. Bayne, Commits
sl0ner Black and the letter of Secretary Lamar,
10 WHOM the matter had been referred.
DIR. BAYNE's LETTER.
The letter of Dr. ]. w. Bayne, under date of
October 18th, addressed to the commissioner of
pensions, is as follows: 4" Your favor OF the 10th
ultimo, inclosiEg my certificate In the case of
Mr.. - Tor correction, has been received, and
IN accordance with that request hereby in-
close 1t corrected in order that no unjust sus-
plclon may rest on this individual case. But
beg leave to respectfully submit to your con-
sheraton certain reasons why this order should
not be eniorced-the justice Of which I think
should be paid to the honor of the physician,
who would not render a certificate unless he
thought they deserved 1t. But If the physician
is SO lost TO truth as to give one without proper
GROUNDS SUCH man would not hesitate to rem
der a false diagnosis. But to members of the
IneOIcttl profession the chlef reason Is that they
consider such course "a violation OF profes-
sionai secrecy, making them, in fact,
iniormers upon those whom they have
every reason to be considerate to. In the
second place, many of the clerks in the depart
ments are ladies, some of whom are suffering
from the effects of uterine and other diseases of
q delicate nature. While not by any means
dishonorable to them-yet their native mod
esty would shrink from the idea OF such dis
though they were treated with the .strictest
confidence. No good purpose can be subserved
by this course, for Ii, as mentioned before the
physician was unprincipled enough to give q
false certificate he would not scruple at giving
false diagnosis and if such a case should occur
mat the disease is OF q aquestionable character
you are forcing the patients physician into the
p lace of II spy. The Medical Society OF the Dis
trict OF Columbia, which composes all of the
most respectable practitioners in the District,
adopted several years ago resolutions similar to
the ideas have sought to call to your atten-
ton. Beileving, sir, that if the matter was
brought before your attention that you would
give IL due considerations
1nls letter was referred to Secretary Lamar
by Commissioners Black, and in a letter to DR..
Bayne transmitting the Secretary's letter. the
commissioner dlsclalniS any Intention OF inter-
lering IN the confidential relations existing be-
tween physician and patient, but at the same
time refers to the impositions from which the
department has suffered by members of the
medical fraternity in this city, both in and out
OF the medical society.
SECRETARY LAMAR's LETTER.
The following is the letter of Secretary Lamar
to Commissioner Black:
81 have received your letter of the 18th in.
slant, accom- panied by a letter from DIR. Bayne,
of this city, in which you ask my consideration
OF the views presented by him upon the subject
leave or absence, on account OF sickness. In
structiOns were issued ON this subject on the
1Sih of October, 1884, as follows:
VIII. Applications for leave on account of
sickness must be accompanied by a physicians
certificate, which shall state specifically that
the disability Is such as to prevent the person
In whose favor 1t is given from attending TO his
or her Office duties. Otherwise the certificate
will not be considered.
Will not be granted for a longer period in ad-
vance than thirty days at a time, the necessity
for which sick leave, and in explanation there
Of must be established by medical evidence,
and to the satisfaction OF the officers OF the de-
partment.
\. 1t is not the intention of the law, or the
regulations OF the department., that leave of
absence shall be granted, except in cases of
absolute inability to perform duty, and employees
Iouno attempting TO evade Or take advantage OF
such law or regulations will be summariy dealt
with.
These rules have been in force more than two
years, and are binding upon the commissioner
OF pensions as well as ali neads Of bureaus and
oHcefs OF the department.. They are based
upon the provisions OF the act of March 3D.
1883, which directs that all absence from the
department. on the part OF said clerks or other
employees, In excess OF such leave OF absence as
may be granted by the heads thereof which
shall not exceed thirty days in one year, ex-
The investigation of cases coming under this
law must rest chiefly with the heads of bureaus.
who IN the nrst instance consider the evidence
and submit the sane TO the department with
their recommendation
ain satisfied LHat the purport and spirit of
your letter to Lr. Bayne and other ply sicians
nave been misconcelved. 1t was not, as uu-
derstand, intended to be in any sense manda-
tory, nor designed to elicit the disclosures of
professional condolences. regard it in the light
OF Il request made TO the physician tor addi-
tlonal Information in behalf OF the applicant
in his effort to obtain a leave of abscence II
was iaoeeu not at all necessary that the letter
should have been written, and in view OF the
action OF the Medical society of WASHINGTON
referred to in DIR. Bayne's letter, and in defer
clans In this city, deem il advisable that
hereafter, in all cases where additional evil
dence us 10 the precise character OF the disabil-
ity certined to is needed, the applicant, instead
OF the attending physician, should be notified
thereon. In no q sick leave of
atsenee ;iSsa,a De granted except upon the GER
sented entities the application to the favor
able consideration OF the commissioner.
But ii Is unquestionably the right and duty OF
that officer 70 weigh the evidence submitted,
and to determine the character OF the testimony
required whenever facts are brought to his
attention which will put him upon inquiry
The delicate and confidential relations which
generally do and should always exist between
me physician and his patient and the absolute
discretion of the former to withhold any
Information in reference to causes OF sickness,
and the minutiH OF diagnosis, are fully recog-
nlZeO anu respected Dy this department.. On
the other hand, the bureau officer Is charged
with the duty of seeking whatever additional
information he thinks may be needed to form q
correct conclusion Us TO whether he will recon-
mend the leave OF absence or not In the per-
of this duty the exercise OF this
authority under the rule should not be so mex
OraDle as TO prevent favorable action in cases of
apparent merit, even though the certificate OF
the physician be insufficient TO afford the
specific information desired.
1n conclusion it Is due to you to say that your
enforcement OF the regulation of the depart
lnent on this subject has added greatly to the
efnclent, stcadiast, honest working force of the
bureau under your charge
ACTION OF THE SOCIETY.
Some discussion followed the reading of the
letters, and the opinion was expressed that the
position of the department was entirely satis-
factory, and that in order to avoid any further
complications the word of the empOye should
De taken with The physicians certificate cor
foborative evidence. With this conclusion it
was 1T first thought best to drop the subject,
but owing to the statements made that some Oi
Tue physicians had abused the confidence inn
posed upon them, 1t was cOnc.udeu 10 appoint
u committee 10 have an interview with Secre-
tary Lamar and Commissioner Black on this
subject: This committee, consisting Of Drs
Toner, Lovejoy and Busey was appointed and
the meeting adjourned.
formed to-day that during the past year appli-
cations ior leave On account OF alleged sickness
hao been closely Scrutinized, anu in cOnse-
qucnce u saving OF over $500 days had been
sick leave OF the previous year. The imposition
upon the department. was SO fragrant that it had
almost become o matter OF public scandal.
THE FIRST CERTIFICATES OF THE 5OrH Con-
GREss.-Ihe certificates OF the election to the
5Oth Congress of Maryland's six representatives
nave been received and filed by the clerk OF the
Rouse OF representatives. A certificate of the