The reported average of 20 days is likely skewed by a small number of long leaves and I suspect* is nowhere near typical for the median worker (it's nearly taking a day off every two weeks).
Longer leave already requires a doctor's approval so the proposal to require that for all leave is unlikely to change much other than drown doctors in more busy work.
*I can't find much for the 'median' amount of leave taken per year.
This article [1] mentions 40% of sick days being from people with long-term (> 6 weeks) illnesses. That's data from one of Germany's large insurers. While I don't know the proportion of those with long-term illnesses, if we assume it's at most 10%, then the average is around 12 days. So much lower.
For clarification, “default” above doesn’t mean “In Berlin you get insured with TK by default”, and rather “Most people in Berlin will recommend choosing TK over a different state-mandated insurer”. TK was also very popular when I was back in university in Frankfurt. It might just still be the one with reasonable prices!
In Germany there’s private insurance which can only be chosen by people of higher salary and good health because the rate depends on their condition when they sign up. So this data would be biased towards sick people, people doing jobs that are more likely to make you sick, and people who are financially less well off.
I wonder if lost productivity from sick leave days is offset by preserved productivity of all coworkers that were not infected by people that felt obliged to show up sick with flu or other communicable disease.
"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.
I had a migraine attack recently; I was able to call my doctor and have him write a sick note for a day over the phone and have it transmitted digitally to my employer. What the fuck would be the point of tormenting myself for half an hour on a noisy public bus in bright daylight in the middle of summer, the waiting in a bright room for half an hour, wait at the bus stop in bright daylight for up to an hour for the next bus back (since I don't know how long I will be at the doctor's office I cannot plan my trip back) and then torture myself for another half hour on the bus back?
It's not like the doctor can do anything but take my word for it when I'm in his office anyway. There is no migraine test you can run. So you might as well cut out all the bullshit and let me rest so I can recover better.
The point is there must be a boot ever-closely infringing on your neck and your reasonable breakdown of the impending absurdity about to play out just doesnt take any of that into account.
> Can't wait to share the sbahn with feverish people or seeing a live diarrhea attack.
The 2 results I see from this change in policy is:
1. People go sick to work and possibly infect other people
2. Doctors give multi day sick notes (when 1 day would have been enough) to not be bothered again the next day, resulting in people being home longer when not needed.
I genuinely don't understand who looked at this policy change and thought "this will probably help with people working more". The only people that will be working more are the "Hausärzte".
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.
It's mostly cultural. In some countries it's normalized that if you're tired or hungover or have a sore throat, you just don't show up at work that day, but in others it's frowned up and your boomer parents and some peers will look at you like you're needlessly weak and avoiding your adult responsibilities by letting a little headache or sniff hold you back from your duties.
Doctors in Germany love to put you off work for longer than necessary. Usually the whole week. I totally see that this will result in average going up instead of down.
Yeah, I have no idea how any of these figures are derived, but... I have a hard time imagining a planet where 1.8 weeks of our Polish employees and 2.7 weeks of our Dutch employees are 'lost due to sick leave' per annum.
Days? Maybe. Weeks? On average? Nah... But, please, do continue your explanations of "see, this is why Europe can't compete"
You're deservedly getting downvoted for this unprompted outburst of racism, but please: describe, in detail, how your colleague, regardless of country of origin, gets away with at least 8 hours of absence every month with a Dutch company, without triggering a remediation program with the bedrijfsarts.
But yes, these are averages between 1 person having 12 weeks and 12 people with 1 week. It's most likely power law distributed, so the average will feel weird.
There are people with cancer, severe car crashes and other horrible but temporary medical conditions in this average.
Oh, yeah, I know. One of our top (young! sad!) people in .nl has been intermittently-working for, like, months now due to that, unfortunately. But... that doesn't count as "sick leave"! Because, it's, like entirely foreseeable!
What is happening is that they, through the medical consultancy working for the employer (i.e. "us"), submit their proposed working schedule a few weeks in advance. This will have several 'non-work' days (around chemo), some 'partial-work' days, and so on, basically with hourly granularity.
"We" then plan and account accordingly: "we" pay for a few hours, insurance for a few, national-level insurance for a lot, but all "we" see is a plan for actual working time.
Conflating any of that with "oh, you can just stay home whenever you want" is sick and wrong, like so much of the discussion here around "Europe." I mean, you get eviscerated for wrongly naming a Chicago suburb, but blanket statements about an entire continent are de rigeur
In the OECD data averaged here, I reckon this chemo therapy is counted as sick leave. On a first search, the metric seemed to be defined as "(compensated) absenteeism from work due to illness, days per employee per year"
In .nl and even .pl, once someone gets into "chemo" territory, they're no longer a full-time employee for at least part of the year. I have no idea how this is reflected in OECD data, but I would not be entirely unsurprised if this is a reprise of the "women in .nl don't work" trope, whereas in-actual-fact it's sort-of the opposite, except not full-time.
To put this into perspective, young children have an average amount of 16 colds per year (there's even a cool repo for incidence data, I suspect you could get more precise [1]). With an increasing number of parents both being in the labor market, and with childcare facilities increasingly (and rightfully IMO) refusing to take in sick kids, this means that parents need to take their own sick days to care for them.
It's difficult to do a back of the napkin calculation, but you can easily see how 16 colds x 3 days / 2 parents leads to 24 excess sick days for parents per kid (discounting for some overlap when multiple kids are sick) over the first few years.
> But, please, do continue your explanations of "see, this is why Europe can't compete"
Okay, let's consider what laws like this (the existing one) do.
In the US most employers don't care if you take a normal number of sick days, don't require a doctor's note, regardless of whether the law allows them to. Sick days are like vacation days, it's your own business how you use them. This is fine. And if you want to make a major long-term disability claim then you'll be expected to prove it, but that seems overall pretty reasonable?
That's the common case. No major incentive for employers to cause friction with workers who are mostly acting in good faith. Then there are employers who are, let's say, less selective about their employees, will hire anyone willing to do the job, but correspondingly then see a high rate of fraud. These employers want to be able to demand evidence all the time because the sort of people they're willing to hire would be taking three months of paid vacation a year as sick days if they could get away with it.
Since the law applies to everyone, what does a law like that do? In the common case it does nothing because the employer doesn't do it regardless. In the high fraud cause it prevents something good and increases actual fraud.
So the only time it does something good is the uncommon edge case on the other side where the employer requires that even though their employees mostly weren't faking sick days. And because most employers for that type of work don't do that and employees don't like it, the ones who do are at a competitive disadvantage, so it stays uncommon.
Which means the main effect of the law is to cause problems for the employers willing to do "second chance" hiring of people who might screw them over, which harms not only the employer but also those workers when employers stop being willing to hire them because the law requires them to take the hit if they do.
> In the US most employers don't care if you take a normal number of sick days, don't require a doctor's note
In .nl (and .pl also, although I'm less familiar with actual practices there, just because we haven't had anyone sick there in the last decade or so) there is no "normal number of sick days", and a "doctor's note" is also entirely unheard of.
If you cannot work for medical reasons, you report this to your employer, which will then (in most cases) hand off things entirely to a medical consultancy working for them. Obviously, this will not be done for 4-to-8-hour absences (again, in most cases), but definitely for anything beyond that, and if an employee tries to game the system, there are safeguards for the company there as well.
The medical consultancy will establish a plan for working hours for the next month or so (depending on the severity of the condition) and submit that to the employer: they don't get any details beyond that (in fact, that would be highly illegal). Depending on the duration of employee absence, there are various levels of insurance that (may) kick in, but the main focus is to provide a (literally) workable schedule.
Oh, and if an employee gets sick while on holiday, the same scheme applies. I found that one really gets everyone nonfamiliar with "European" working culture going...
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 these changes is insane. Many people in the food business don't have paid sick leave, and as such lose pay when they don't come to work. And those people should absolutely have the ability to stay home without putting their finances in jeopardy. It should be a sign out front: we have paid sick leave for our people so they don't feel forced to come to work sick.
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, increasing my stress levels which are already high due to my body fighting an infection, and risk infecting others or worse, catch something else myself for being made to cohabit space with other sick individuals
* I work even though I'm sick. If I do that from the office, I risk contaminating colleagues - and other people I interact with
> 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 this for extra vacation.
If we just let everyone self diagnose themselves all the time, the graveyards will be full.
Forcing sick people to see a doctor after X days feels like the best for both worlds.
I mean, people are sick what, 3 times per year? Those with kids probably around 7.
So for simplicity, let's say people self diagnose 4 times per year and they are right 4 times because they are not dead and back to work.
You can then grab statistics for deaths and overlay that, but the enormous amount of false negatives you would get by doing what you are suggesting is staggering, I don't consider that a good idea.
How about not? If you think your employee is lying too much about being sick, perhaps have a conversation? Establish trust? If it doesn't work out, require a doctor's note, and eventually fire them.
If the problem is one of trust, work on that. Forcing a sick person to leave the house and expose themselves and everyone else along their way to new pathogens just because you don't trust them is hardly a net positive for anyone.
That's ... exactly what I was saying. How long is your context window that you missed that?
If you're sick longer than X days, go see a doctor, for your own safety, not for the note.
>Establish trust?
How? Trust goes both way. If you trust someone and they don't reciprocate and abuse it for personal gain, then there's nothing left to establish, you just got robbed plain and simple, there's no trust there anymore. Trust is very hard to earn and very easily to lose.
>If the problem is one of trust, work on that.
Why should you be working on trust when you're the one being scammed? That's like telling the stroe who got robbed they should work on trust.
> How long is your context window that you missed that?
256K tokens. I suspect yours is about 20 tokens, because you forgot the bit right before the one you quoted: "_If it doesn't work out_, require a doctor's note."
> If you trust someone and they don't reciprocate and abuse it for personal gain, then there's nothing left to establish
Correct. Terminate them in this case. Or have a process to give them a second chance and then terminate them. Whatever works for you.
> Why should you be working on trust when you're the one being scammed?
Probably don't. Don't hire scammers. Hired one by mistake? Fire them.
> No, you're right, they should just get to sit at home as long as they want with no medical oversight until it gets worse, or they end up at the ER
I get sick between 0 and 5 times a year. I can't remember the last time I went to the doctor for any of those, but I can say it has been many years. Some times I have really bad allergies to the point that I can barely get out of bed for maybe 2 or 3 days. I don't need to see the doctor, I just need to find the right anti-histaminics that work for me for whatever pollen is causing it.
Here you have a person who you supposedly trust with things a lot more valuable than whatever a day or a week's worth of missed work amount to, and you need to make them get out of the house, maybe queue up for hours in the hospital or whatever, because you don't trust them when they tell you they're sick? I'm sorry, but I know who I find sicker in this scenario and it's not the person missing work.
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.
What pisses me off about all this is that the there is the underlying assumption that the working class is with the lazy working class. No, the problem is efficiency and incompetence at the top levels, not at the bottom. Running faster in the wrong direction won't get us any closes to the goal.
Let me make a proposal and you tell me what you think of it. I'd say the fundamental problem is career culture, the idea that mobility is valued over reliability. What I mean by that the culture of collecting good-boy points by starting projects, building PowerPoint slides and giving the appearance of getting work done, all in order to get a promotion and jump ship to the next higher position before your sloppiness catches up with you. Someone else is left holding the bag. If people had to actually own what they shit out in the long-term things would be much different. You either fall or rise with whatever projects you start. You might be able to bullshit your way through the corporate structures for a year or two, but ten years? No, if your project is to last for ten years you better put actual effort into it, not just the bare minimum to produce Potemkin slides.
Look at Stuttgart 21[1]. The reason it has been moved to 2031 (at the very least) is not because of the grunt worker being too slow. It is systemic failure at the top. Is it incompetence or malice? I don't know, you pick which option is worse. What I do know is that it cannot be the common worker on the ground who has to pay the price for it.
Fehmarnbelttunnel is the better example because you can see the difference in legislation between Denmark and Germany. Denmark passes laws for projects of such importance while in Germany the project has to hop over every existing legislative hurdle that are great for preventing smaller projects going bad, but do cost extra time and money on a larger scale.
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 days. If you can't trust me on sick days, how can you trust me to do my job?
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.
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)
> 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)
This is not true, it is possible to fire people in these cases.
You have the option in Germany to require a doctor's note on day 1. If an employee is sick too much, their health insurance reimburses you for their salary.
I don’t understand Merz’s obsession with this sick leave topic, like this is going solve the economic crisis in Germany and calling people lazy will score points with voters?
Fun fact: research shows it’s probably not better or worse than before, just more rigorously reported through a new digital system since couple years (before that people needed to send paper slip notes to their employers and insurance, which some just wouldn’t do so the data was incomplete).
On the other hand, they explained that they want to go back to the rules like they were before Covid. Effectively, this means that sick leave notes can be fixed contractually between employers and employees and a lot of companies and contracts have more flexible rules as also most HR departments don’t feel like dealing with the bureaucracy.
Nobody understands it. Merz never worked. The last time he worked was when he did his service in the Bundeswehr. His Politics can be described as Anti-Merkel: Immigrants are the Evil and the woking class must work for the lowest pay possible and preferably die before they can enjoy retirement; and lastly nobody is right of the CDU.
It is very ordinary conservative neoliberal politics, isn't it? People with these politics are always complaining that people aren't working hard enough.
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.
I can relate to the attitude, but I also suspect it's a lot easier to live like this in one of the two richest countries in the world with the least stressful labor markets (going by the experience of my friends who emigrated there).
What’s the insurance setup like in norway? In germany at least, your insurance pays for (at least part) of this time, and since its mandatory to pay it and hundreds of euros a month, I’m not in any way inclined to give up my precious family time (holidays) to save my insurer money. I have a hard time understanding how one would feel otherwise.
Also, generally, I can’t think of a time i had off work where something ultimately failed to be delivered because of it, I’ll typically put in some extra time etc when i’m back if a deadline is looming.
Should you not then take responsibility for the additional sick leave taken by your colleagues as a result of you exposing them to your infectious diseases?
It's quite possible that the total sick leave you've caused is substantially higher than it would have been had you simply stayed home when ill.
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 level of abuse.
Either that or companies will drastically lower the amount of paid sick leave they give, maybe to zero like in the US. I think that would be even worse.
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…
Since the late 80s, Sweden has a system where on the first day when you're off work due to illness, you're not paid ("karensdag").
I started working just before this system was put in place, and there was so much sick leave claimed that people were seriously wondering why Swedish workplaces were so unhealthy. A year after the reform, the numbers fell precipitously.
[Weekendmodus:] First the thing seem to be, that there were a depressive pilot, some years ago, who made an "extended-suicide". The people across Germany were told, "It was, cos the company hasn't known, that a doctor issued a 'sick note' (In Terms of: When he was unable to work - he should't fly a plane with more than 100 people on board.')."
There was a need for a soulution, so my bet was on the workers side: "If the doctors send the "sick-note" directly to the employer (via "Fax" or email), you'll save a Stamp at minimum, or doesn't have to visit your workplace, ill." Everybody who went sick one time, knows that it is not easy every time, to visit someone when you're ill, not?
That is one of the Mistakes somebody would take granted, by those what the media seem to hide for -you know "generating hype and clicks about".
And for the 2nd, (verry distracting by now): If doctors now have to inform employers within day one, that'll fit it perfect.
So no "hysteria", no "hype". People seem to forget fast -in not my words: "Just a school class who died by that extended suicide" but in memory of that... by remembering it...
If you need such laws to be enforced in order to keep your workforce on leash... you are either a very uninspiring employer or you are the current german chancellor. Good bye german economy with such an uninspiring leadership.
Of course sick leave has increased in Germany, but the main reason is reporting. Since 2022 in Germany there is a new electronic sick note and doctors report every certificate directly to insurers. Before that short illnesses very often went uncounted.
I find it quite concerning and clickbaity that this reason is also included but comes relative late in the article:
One major reason for the rise in sick leave is better reporting, IGES wrote in its report published in January.
People on HN don't understand what Germany's like these days. I know people who have been off work for over a year still getting paid quite handsomely, even though they're perfectly fit to work. There's been a lady in Berlin recently who has been on sick leave for two years but still tried to run for some office and was defended for it by the usual suspects. It's really out of control. Doctors are handing out sick notes like candy. Germany has developed a really unhealthy relationship to work ethics after years of being coddled with benefits and victim ideology.
If this is actually enforced it'll probably change healthcare in Germany quite a lot.
Imagine that people infected with something from Caliciviridae, as parents tend to be every or every other year when the kids are small, has to enter medical facilities to get sick leave from work. Highly contagious, shits and/or vomiting, not uncommonly together with fever.
As a medical practitioner you'll quickly find a way to work around this and make yourself able to hand out notes without bringing the infected remotely close to your actual care facilities.
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[ 4.8 ms ] story [ 44.5 ms ] threaddropping phone-in sick calls will sure as hell end those /s
this whole package is driven by populist disinformation.
Longer leave already requires a doctor's approval so the proposal to require that for all leave is unlikely to change much other than drown doctors in more busy work.
*I can't find much for the 'median' amount of leave taken per year.
This article [1] mentions 40% of sick days being from people with long-term (> 6 weeks) illnesses. That's data from one of Germany's large insurers. While I don't know the proportion of those with long-term illnesses, if we assume it's at most 10%, then the average is around 12 days. So much lower.
[1] https://www.deutschlandfunk.de/sind-die-deutschen-wirklich-h...
Is this voluntary insurance? It changes meaning to the statistic to % from those that made an insurance.
TK service via email, phone, etc is amazing, even if your German is not very good, as it was the case for me the first year.
Can't wait to share the sbahn with feverish people or seeing a live diarrhea attack.
It's not like the doctor can do anything but take my word for it when I'm in his office anyway. There is no migraine test you can run. So you might as well cut out all the bullshit and let me rest so I can recover better.
The 2 results I see from this change in policy is:
1. People go sick to work and possibly infect other people
2. Doctors give multi day sick notes (when 1 day would have been enough) to not be bothered again the next day, resulting in people being home longer when not needed.
I genuinely don't understand who looked at this policy change and thought "this will probably help with people working more". The only people that will be working more are the "Hausärzte".
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.
Days? Maybe. Weeks? On average? Nah... But, please, do continue your explanations of "see, this is why Europe can't compete"
But yes, these are averages between 1 person having 12 weeks and 12 people with 1 week. It's most likely power law distributed, so the average will feel weird.
There are people with cancer, severe car crashes and other horrible but temporary medical conditions in this average.
Oh, yeah, I know. One of our top (young! sad!) people in .nl has been intermittently-working for, like, months now due to that, unfortunately. But... that doesn't count as "sick leave"! Because, it's, like entirely foreseeable!
What is happening is that they, through the medical consultancy working for the employer (i.e. "us"), submit their proposed working schedule a few weeks in advance. This will have several 'non-work' days (around chemo), some 'partial-work' days, and so on, basically with hourly granularity.
"We" then plan and account accordingly: "we" pay for a few hours, insurance for a few, national-level insurance for a lot, but all "we" see is a plan for actual working time.
Conflating any of that with "oh, you can just stay home whenever you want" is sick and wrong, like so much of the discussion here around "Europe." I mean, you get eviscerated for wrongly naming a Chicago suburb, but blanket statements about an entire continent are de rigeur
It's difficult to do a back of the napkin calculation, but you can easily see how 16 colds x 3 days / 2 parents leads to 24 excess sick days for parents per kid (discounting for some overlap when multiple kids are sick) over the first few years.
[1] https://github.com/robert-koch-institut/GrippeWeb_Daten_des_...
Okay, let's consider what laws like this (the existing one) do.
In the US most employers don't care if you take a normal number of sick days, don't require a doctor's note, regardless of whether the law allows them to. Sick days are like vacation days, it's your own business how you use them. This is fine. And if you want to make a major long-term disability claim then you'll be expected to prove it, but that seems overall pretty reasonable?
That's the common case. No major incentive for employers to cause friction with workers who are mostly acting in good faith. Then there are employers who are, let's say, less selective about their employees, will hire anyone willing to do the job, but correspondingly then see a high rate of fraud. These employers want to be able to demand evidence all the time because the sort of people they're willing to hire would be taking three months of paid vacation a year as sick days if they could get away with it.
Since the law applies to everyone, what does a law like that do? In the common case it does nothing because the employer doesn't do it regardless. In the high fraud cause it prevents something good and increases actual fraud.
So the only time it does something good is the uncommon edge case on the other side where the employer requires that even though their employees mostly weren't faking sick days. And because most employers for that type of work don't do that and employees don't like it, the ones who do are at a competitive disadvantage, so it stays uncommon.
Which means the main effect of the law is to cause problems for the employers willing to do "second chance" hiring of people who might screw them over, which harms not only the employer but also those workers when employers stop being willing to hire them because the law requires them to take the hit if they do.
In .nl (and .pl also, although I'm less familiar with actual practices there, just because we haven't had anyone sick there in the last decade or so) there is no "normal number of sick days", and a "doctor's note" is also entirely unheard of.
If you cannot work for medical reasons, you report this to your employer, which will then (in most cases) hand off things entirely to a medical consultancy working for them. Obviously, this will not be done for 4-to-8-hour absences (again, in most cases), but definitely for anything beyond that, and if an employee tries to game the system, there are safeguards for the company there as well.
The medical consultancy will establish a plan for working hours for the next month or so (depending on the severity of the condition) and submit that to the employer: they don't get any details beyond that (in fact, that would be highly illegal). Depending on the duration of employee absence, there are various levels of insurance that (may) kick in, but the main focus is to provide a (literally) workable schedule.
Oh, and if an employee gets sick while on holiday, the same scheme applies. I found that one really gets everyone nonfamiliar with "European" working culture going...
I am not; the same amount of work gets done. Probably more because I’m not half-sick on the job for 3 days instead.
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 these changes is insane. Many people in the food business don't have paid sick leave, and as such lose pay when they don't come to work. And those people should absolutely have the ability to stay home without putting their finances in jeopardy. It should be a sign out front: we have paid sick leave for our people so they don't feel forced to come to work sick.
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, increasing my stress levels which are already high due to my body fighting an infection, and risk infecting others or worse, catch something else myself for being made to cohabit space with other sick individuals
* I work even though I'm sick. If I do that from the office, I risk contaminating colleagues - and other people I interact with
There's no winning.
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 this for extra vacation.
If we just let everyone self diagnose themselves all the time, the graveyards will be full.
Forcing sick people to see a doctor after X days feels like the best for both worlds.
No. Who do you think you are.
So for simplicity, let's say people self diagnose 4 times per year and they are right 4 times because they are not dead and back to work.
You can then grab statistics for deaths and overlay that, but the enormous amount of false negatives you would get by doing what you are suggesting is staggering, I don't consider that a good idea.
If the problem is one of trust, work on that. Forcing a sick person to leave the house and expose themselves and everyone else along their way to new pathogens just because you don't trust them is hardly a net positive for anyone.
That's ... exactly what I was saying. How long is your context window that you missed that?
If you're sick longer than X days, go see a doctor, for your own safety, not for the note.
>Establish trust?
How? Trust goes both way. If you trust someone and they don't reciprocate and abuse it for personal gain, then there's nothing left to establish, you just got robbed plain and simple, there's no trust there anymore. Trust is very hard to earn and very easily to lose.
>If the problem is one of trust, work on that.
Why should you be working on trust when you're the one being scammed? That's like telling the stroe who got robbed they should work on trust.
256K tokens. I suspect yours is about 20 tokens, because you forgot the bit right before the one you quoted: "_If it doesn't work out_, require a doctor's note."
> If you trust someone and they don't reciprocate and abuse it for personal gain, then there's nothing left to establish
Correct. Terminate them in this case. Or have a process to give them a second chance and then terminate them. Whatever works for you.
> Why should you be working on trust when you're the one being scammed?
Probably don't. Don't hire scammers. Hired one by mistake? Fire them.
> No, you're right, they should just get to sit at home as long as they want with no medical oversight until it gets worse, or they end up at the ER
I get sick between 0 and 5 times a year. I can't remember the last time I went to the doctor for any of those, but I can say it has been many years. Some times I have really bad allergies to the point that I can barely get out of bed for maybe 2 or 3 days. I don't need to see the doctor, I just need to find the right anti-histaminics that work for me for whatever pollen is causing it.
Here you have a person who you supposedly trust with things a lot more valuable than whatever a day or a week's worth of missed work amount to, and you need to make them get out of the house, maybe queue up for hours in the hospital or whatever, because you don't trust them when they tell you they're sick? I'm sorry, but I know who I find sicker in this scenario and it's not the person missing work.
It’s a bit of a chicken and egg issue.
Let me make a proposal and you tell me what you think of it. I'd say the fundamental problem is career culture, the idea that mobility is valued over reliability. What I mean by that the culture of collecting good-boy points by starting projects, building PowerPoint slides and giving the appearance of getting work done, all in order to get a promotion and jump ship to the next higher position before your sloppiness catches up with you. Someone else is left holding the bag. If people had to actually own what they shit out in the long-term things would be much different. You either fall or rise with whatever projects you start. You might be able to bullshit your way through the corporate structures for a year or two, but ten years? No, if your project is to last for ten years you better put actual effort into it, not just the bare minimum to produce Potemkin slides.
Look at Stuttgart 21[1]. The reason it has been moved to 2031 (at the very least) is not because of the grunt worker being too slow. It is systemic failure at the top. Is it incompetence or malice? I don't know, you pick which option is worse. What I do know is that it cannot be the common worker on the ground who has to pay the price for it.
[1]: https://en.wikipedia.org/wiki/Stuttgart_21
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 days. If you can't trust me on sick days, how can you trust me to do my job?
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.
This is not true, it is possible to fire people in these cases.
Fun fact: research shows it’s probably not better or worse than before, just more rigorously reported through a new digital system since couple years (before that people needed to send paper slip notes to their employers and insurance, which some just wouldn’t do so the data was incomplete).
On the other hand, they explained that they want to go back to the rules like they were before Covid. Effectively, this means that sick leave notes can be fixed contractually between employers and employees and a lot of companies and contracts have more flexible rules as also most HR departments don’t feel like dealing with the bureaucracy.
In 2009 i fell off a bike and hurt a knee. My fault. So I took 5 days of my vacation to stay home.
Also, generally, I can’t think of a time i had off work where something ultimately failed to be delivered because of it, I’ll typically put in some extra time etc when i’m back if a deadline is looming.
So who really loses?
I was down with Epstein-Barr/mononucleosis for 12-14 days in 2004, and then I stayed home (home from PhD studies).
It's quite possible that the total sick leave you've caused is substantially higher than it would have been had you simply stayed home when ill.
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 level of abuse.
Either that or companies will drastically lower the amount of paid sick leave they give, maybe to zero like in the US. I think that would be even worse.
I started working just before this system was put in place, and there was so much sick leave claimed that people were seriously wondering why Swedish workplaces were so unhealthy. A year after the reform, the numbers fell precipitously.
There was a need for a soulution, so my bet was on the workers side: "If the doctors send the "sick-note" directly to the employer (via "Fax" or email), you'll save a Stamp at minimum, or doesn't have to visit your workplace, ill." Everybody who went sick one time, knows that it is not easy every time, to visit someone when you're ill, not?
That is one of the Mistakes somebody would take granted, by those what the media seem to hide for -you know "generating hype and clicks about".
And for the 2nd, (verry distracting by now): If doctors now have to inform employers within day one, that'll fit it perfect.
So no "hysteria", no "hype". People seem to forget fast -in not my words: "Just a school class who died by that extended suicide" but in memory of that... by remembering it...
regards (-:
I find it quite concerning and clickbaity that this reason is also included but comes relative late in the article:
One major reason for the rise in sick leave is better reporting, IGES wrote in its report published in January.
https://x.com/posta_octavian/status/2072672993126334709?s=20
Imagine that people infected with something from Caliciviridae, as parents tend to be every or every other year when the kids are small, has to enter medical facilities to get sick leave from work. Highly contagious, shits and/or vomiting, not uncommonly together with fever.
As a medical practitioner you'll quickly find a way to work around this and make yourself able to hand out notes without bringing the infected remotely close to your actual care facilities.