Disagreement with an occupational health report
Dissatisfaction with health report
Part 1 - When a patient disagrees with information going into an occupational health report
Background
Mrs Sullivan has been signed off work by her GP for six weeks with anxiety and depression.
Dr Jackman is an occupational health doctor. He has been asked to assess and advise on when Mrs Sullivan may be able to return to work and what appropriate adjustments should be made.
Dr Jackman carries out the assessment and emails Mrs Sullivan a copy of his report.
Scenario
Mrs Sullivan telephones to say she’s unhappy with the report because it mentions that she is menopausal and receiving treatment for an underactive thyroid.
Both conditions were discussed briefly during the assessment, but she doesn’t think they’re relevant to her anxiety and depression which she feels were caused by conditions at work. She fears that her employers will use the report to dismiss her as ‘a hormonal woman’ and gloss over a hostile work environment. She asks Dr Jackman to remove the references to her menopause and underactive thyroid from the report.
However Dr Jackman, thinks that these hormonal issues, though not the main cause, may be a contributory factor and are also affecting Mrs Sullivan’s ability to cope.
What should the doctor do?
- Agree to amend the report?
- Refuse to amend the report and explain his duty to Mrs Sullivan’s employer?
- Explain the purpose of asking Mrs Sullivan to review the report and the limited circumstances in which he can amend it?
Withdrawing consent for report to be disclosed
Part 2 - When a patient refuses to give consent for the occupation health report to be sent to the employer
Background
Dr Jackman makes changes the emphasis of the Occupational Health Report in response to her concerns that her employers may use the information to gloss over a hostile work environment. He shares the amended Occupational Health report with Mrs Sullivan ahead of sending it to her employer.
Mrs Sullivan becomes distressed and tells him that, if he won’t leave out the information about her underactive thyroid and menopause, she doesn’t want the report to be sent to her employer at all.
Dr Jackman still has Mrs Sullivan’s earlier written consent.
What should the doctor do?
- Send the amended version of the report to her employer?
- Agree not to send the amended the version of the report to her employer but explain the potential consequences of preventing the report being sent?
- Let Mrs Sullivan reword the sections of the report that she is unhappy with?
Failure to submit report to employer
Part 3 - When there is no occupational report because a patient has disagreed and the employer is asking for details.
Background
Dr Jackman carried out an Occupation Health assessment with Mrs Sullivan.
Mrs Sullivan withdrew her consent for the report to go to her employer.
Dr Jackman tells Mr Iles, the HR manager that he will not be submitting a report because Mrs Sullivan has withdrawn her consent.
Scenario
Mr Iles points out that Dr Jackman has been paid to provide a report and Mrs Sullivan agreed to the assessment.
Mr Iles says that without the report it will be very difficult to plan for Mrs Sullivan’s absence or manage any potential return to work. He presses Dr Jackman for further information.
What should the doctor do?
- Only disclose the reason why Mrs Sullivan has withdrawn her consent?
- Disclose the whole report, Mr Iles has made some fair points?
- Not share anything. To share anything further without Mrs Sullivan’s consent would be a breach of confidentiality?
