| 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. |