What's the definition of "selling MCs"?

What's the definition of selling MCs?

To me, that means people come to the clinic, the doctor doesn't even bother to see them, they pay a fee and they walk of with an MC for days off work. That's selling MC.

Now some people have told me (especially so in the SAF), that selling MC means giving MC to patients who are "not really sick".

Now here's where it gets very silly. How do doctors make a diagnosis? History and physical examination, and if needed investigations to confirm the diagnosis. But most of the diagnosis is made from the history taking.

Whena patient decides to lie about certain symptoms eg say they have bodyaches, had fever before taking Panadol, runny nose, cough...... is there any way for the doctor to objectively prove that they are faking it in a standard consultation? Well the answer is definitely no.

That's not how doctors should be practising. We cannot be second guessing and questioning the reliability of the patient's complaints. That's not the way it goes. In fact the more unusual the presentation, the more serious the symptoms sound compared to what we find on clinical examination, the more likely the doctor would want to perform investigations to exclude certain conditions or confirm them.

So the truth is, if a patient complains of headaches, muscle aches, eye aches, joint aches, runny nose, cough and sore throat and ask for a day's rest, most private GPs would give the patient that rest. It is part of the treatment. In fact it's the BEST treatment. Incidentally, in the MOH distributed circular for "Criteria for Suspect Dengue", this was what was written :

A suspect case of dengue fever (DF) is defined as an acute febrile illness with two or more of the following features:

Headache
Eye pain
Myalgia (muscle aches)
Arthralgia (joint aches)
Rash
Hemorrhagic manifestations (bleeding)
Leukopenia (a drop in white blood cells on blood test)

So as you can see, if you told the doctor you have headache, muscle aches and joint aches with an acute onset of fever, you would be a suspected dengue fever case already!

So if a patient who is sick requests for a day off, I usually give it to them. Unless of course they are really chronic regular MC seekers. Even then this is hard to prove and there are a lot of sensitivities involved.

Anyway, there was no course in medical school called "How to diagnose a malingerer in General Practice 101"