Refusal | Requesting Sick-note for Whiplash

Casebank Counselling
1

Who you are:
You are FY2 in the GP clinic.

Who the patient is:
Susan Wood, a 35-year-old lady presented with some concerns.

Other information
She had RTA 2 weeks ago during which the police and an ambulance were called ,she was brought to hospital and all examinations were normal.

What you must do:
Talk to the patient and address her concerns

Patient’s information (Station flow):

  • Doctor I want sick note.
  • You had an accident about 2 weeks ago.You went out with friends on Friday evening ,accident happened that day ,hit a tree.
  • You drank 3 glasses of wine before accident .
  • The police checked your breathe for alcohol content and found out to be too high to be driving.
  • You work as medical representative and you need to drive to help with your job.Your employer has told you that you cannot drive so you cannot do this job ,so you are afraid to lose your job.
  • You want your doctor to write sick note stating that you got a whiplash injury.you know that you don’t have whiplash injury ,because you were examined 2 weeks ago.
  • You have 2 children and struggle with finances.

Data Gathering

  • GRIPS
  • History of incident.( before ,during ,after)
  • Headache ,confusion,LOC,vomiting,seizures.
  • Head injury.
  • neck stiffness/pain
  • Any other passengers on vehicle.
  • Symptoms with bleeding

History of concerns.

  • why do you need us to write?
  • Will that help you in any way?
  • Will you get any benefits?
  • Can’t the employer find you any other job?

PMAFTOSA

Examination

  • I would like to examine your neck to see how are you doing.
  • Inspection of neck
  • Palpation of the neck for spinal processes and para spinal muscles tenderness.
  • Neurological examination (power ,sensations,reflexes,nerves,neck movements)

Management

  • Apologise that unfortunately you cannot help.
  • I cannot write something that you don’t have
  • As a doctor I have to be honest and maintain my integrity.If at the moment you don’t have a whiplash injury,I am not allowed to do so .I do not feel right about it.
  • We are regulated by GMC and we all have to abide by the same professional obligations and those obligations are bound with honesty so unfortunately even seniors could not help.
  • Offer Advice
    • Can you try to talk to your employer,they may understand.
    • Can you try and find another job or do different duties within the same company?
    • Citizens advisory beareu.