University of Colorado faculty, staff look to reduce practice of students seeking doctor‘s notes

Amid an uptick in students seeking medical and mental health care, University of Colorado providers and professors are taking on a relic many say does not help, and in fact can hurt, student health: the doctor‘s note.

Students seek the notes to excuse their absences from classes, but CU‘s health care providers said the practice can cause students to take appointments they might not need and expose themselves or others to illnesses.

At CU‘s Wardenburg Health Center, the note takes the form of an embossed, half-page sheet that confirms a student had an appointment but provides no information about their illness. It‘s known as an “appointment verification form.” Some students come in days or even weeks after they‘ve missed a class to get a note to excuse the absence. And even if students schedule an appointment while in the throes of an illness, the note does not provide information about their symptoms.

Thomas Kunstman, the health center‘s medical director, said a student once booked three successive appointments seeking more detailed notes to provide to a professor, appointments the student otherwise might not have needed.

Kunstman, others at Wardenburg and the Boulder Faculty Assembly are working to encourage faculty to give students a certain number of absences per semester — no excuse needed — and encourage students to seek medical care when it‘s needed.

Last spring, the faculty assembly passed a resolution encouraging faculty to revise their syllabi and practices. Kunstman and Mary McQueen, medical clinic manager and nurse practitioner, also last week attended the assembly‘s first meeting of the year to answer faculty questions and refresh them about the resolution as the semester begins.

The reception by faculty has been overwhelmingly positive, Kuntsman and McQueen said, and many already were not requiring notes. The pair also wants to educate students that they might have needed a note in high school, but that practice doesn‘t necessarily extend to college classes.

“Any time a patient‘s main goal in coming here is to get medical care, that is absolutely appropriate,” McQueen said. “It‘s not that we‘re trying to get them to not come in when they have the flu. It‘s that we want them to come in to get care for their flu and not just to get a note. If they would otherwise stay home but they need a note, that‘s what we‘re aiming to reduce.”

That way, she and Kunstman said, health care providers aren‘t caught in the middle between professors and students, and they can focus on students who truly need care. The topic has been on their radar for years, and they‘re happy to see progress being made. It‘s been a hot topic among college health care providers across the country, who are largely seeing an increase in patients across the board.

“I think we‘re all struggling with cost of health care, cost of provision of health care, growing populations of students and growing demand for medical services,” McQueen said. “We‘re busier than we‘ve ever been, and I think that‘s common across the country. During high flu season, for example, you really feel it when you have a two- to three-hour wait in your waiting room and a certain percentage are there just because they need notes for their classes, and there are some really sick kids who are taking longer to get the attention they need because we have to sift through and see everybody.”

The policy gives students the choice of how to spend their allowed absences. Whether they choose to spend their days recovering from an illness, de-stressing from a busy week or hitting the slopes is up to them.

It gives them a way to take the days they need without having to justify a physical illness, said Catherine Kunce, chair of faculty assembly student affairs committee, which was the committee responsible for writing the resolution. Requiring a note doesn‘t help students make adult decisions or prepare for the “real world,” she said.

“You‘re not inviting students to exercise their own volition and their own choices, and helping them grow into responsible citizens and preparing them for the real world,” Kunce said.

She added, though, that an important piece of the resolution acknowledges that students with extended illnesses or serious injuries should be referred to Student Support and Case Management so that organization can help them receive documentation for missing more classes.

McQueen gave examples that a student with a protracted recovery from mononucleosis or a severe concussion might require a different understanding from faculty, and Wardenburg officials would be happy to help accommodate them.

Overall, Kunce said, she is happy with the resolution and democratic process that allowed faculty to discuss and address their concerns and get their questions answered.

“Our well-being is contingent upon the interaction and cooperation of all parts of the university,” she said.