Benefits intended to assist workers with an injury or illness is often abused. In 25 years of working as a hospital physician, I have taken three days off for acute injuries and for my mother’s funeral. My residents are predisposed to calling in sick on days that bookend their free weekend or a stretch of days rostered off work. The department’s secretary leaves early on a Friday or puts in a no-show. I regularly get a last minute phone call from residents who call in sick, which means that the doctors who are present are required to work an extra shift. Some get sent home from a day shift and are asked to return for night duty that cannot be filled in otherwise. It is common knowlege that a substantial proportion of sick leave in my clinical area is used for recreation. I have had to work marathon shifts for absent colleagues while fatigued and sleep-deprived. This has incurred errors in the care of the seriously ill. On one ocassion I have fallen asleep at the wheel on the way home and run through a red light. Dishonest sick leave takers are abusing an altruistic safety net and imposing risks to others who have to shoulder additional clinical work. Is it worth considering sick leave be paid at half to three quarters full pay, and the difference paid to a locum that can turn up for work at short notice, in the hope that patient care isn’t compromised?