HR MANAGERS often fail to appreciate that a company doctor has a patient duty to the employee and may be obliged to keep patient confidences, writes Gerald Flynn.
The interface of medical practice and work has become an increasingly problem area for people managers, with some human resources managers running the risk of becoming "amateur physicians".
One of the first cases I came across of a personnel manager entering the health area was some years ago when a rather arrogant young executive in the company where I worked picked on an old guy of about 70 who was trying to eke out a living, not having any decent pension provision.
We all looked on as this genial, if somewhat stooped and breathless, gent came in for a few hours' work and silently hoped that we would not end up in a similar position. The poor fellow suffered from emphysema and, after some months, he just disappeared - no farewell, no round of drinks and no office collection, although he could have done with a few bob.
Some weeks later inquiries were met with a response from the HR department that this old lad was a liability. Some bright spark had decided that, in the event of a fire or a bomb-scare, with the lifts out of action, he would be a health and safety risk because he would take too much time to get down the eight flights of stairs from the fourth floor.
I was thinking of this man a few weeks ago when I spent some time in a small ward in a large hospital. I was quite taken with the willingness of the nursing and medical staff to be up-front and detailed with patients about their ailments and recovery prospects.
Given that only curtains separated us, we each got to know one another's medical conditions, recommended medication and test results rather well.
What really struck me were the pre-discharge conversations when the issue of returning to work arose. Nobody wanted to let their employer know why they had been in hospital even though most were fairly routine and certainly lacked the "blood and bandages" drama associated with TV medical programmes.
One guy had a very raw-looking leg with, what looked to me, at a distance, like blisters or burns. It was diagnosed as a bad case of skin infection having begun as athlete's foot and exacerbated by eczema and skin irritation.
It was decided that he could be treated by a community nursing team under a "hospital in the home" system of community care. He was keen to get back to work but, as there is yet no "hospital in the workplace" initiative, he was advised to stay at home.
He knew he would eventually be returning to work and so closely questioned the physician about his ailment and how much his employer would be told.
Within a few sentences it was obvious that "athlete's foot" was not to be mentioned, perhaps fearing that he would be seen as a latter-day Typhoid Mary by his colleagues. The sensible doctor asked him if he had ever skied, and was delighted when he said that he had, although not recently.
"Well, we'll put it down as an infection probably contracted on a skiing trip from rented equipment," suggested the doc.
Another patient was crippled with acute gout but felt that this was not suitable for an employment sick cert with connotations of high-living and consumption of large amounts of pheasant, partridge and port. His doctor assured him that teetotal nuns could experience gout but then relented and said that acute arthritis would describe his condition just as well.
A third man, in his late 20s, was worried that any reference to his chest pains would jeopardise his work chances. He was a casual outdoor worker and did not want to share a diagnosis of a heart murmur with his employers. Perhaps he knew former Dublin airport ramp supervisor Vincent Kavanagh or was just a keen student of recent labour law.
Last year Mr Kavanagh was awarded an impressive €65,000 for his discriminatory dismissal by his employers, Aviance UK Ltd, a baggage and ground services firm as well as an additional €60,000 in compensation for the stress he suffered in relation to his dismissal.
The unfortunate Mr Kavanagh injured his elbow at work and subsequently, in conversation with the company's doctor, he mentioned earlier cardiac treatments. When Aviance management found that he had a reasonably common heart complaint - and following various correspondence with medical practitioners - it was decided to dismiss him from his €33,000 a year supervisory job early in 2005.
The Equality Tribunal heard evidence from his cardiac specialist that Mr Kavanagh was capable of undertaking general active duties. The company was found to have discriminated against him by failing to provide reasonable accommodation in his role overseeing loading and unloading of baggage.
The case is being appealed by Aviance, which took over the British Midland ground services work at Dublin airport in 2001.
Medical assessments are a tricky area for HR managers to get involved with and many fail to appreciate that a company doctor, now often called an occupational health physician, has a patient duty to the employee and may be obliged to keep patient confidences.
Another aspect is that the employee is usually entitled, under the Data Protection Act, to be provided with a copy of any assessments of their health either by a medical practitioner or any "medical observations" recorded by supervisory or management staff.
Disputes over medical certification can often escalate. A recent medical cert from an employee on long-term absence, written by a consultant psychiatrist, noted that she was suffering acute anxiety and panic attacks as a direct result of the stress endured in "the toxic work environment" where she experienced persistent bullying and harassment.
You can just see the psychiatrist being invited by senior counsel to read it out slowly from the witness box of the High Court as the senior management wonder why nobody took it too seriously and just left it on her file. HR people need to have a healthy respect for medical certs.
Gerald Flynn is an employment specialist with Align Management Solutions in Dublin.
gflynn@alignmanagement.net
