Tennessee district bans doctor's notes to exempt kids from school to teach them good work ethic
New rules set out by the Lawrence County School System Board of Education state that 'absences are not excused' and only permits them in a number of specific circumstances. Regular illness is not included in the list.
Sanctions for multiple instances of alleged truancy include loss of school event privileges and even referral to juvenile court for truancy.
'If you have the sniffles, that is fine,' Director of Schools Michael Adkins said during a recent meeting. 'You are going to have them when you go to work one day. We have all gone to work sick and hurt and beat up.'
The new attendance policy states that 'absences shall be classified as absent' and 'absences are not excused or unexcused.'
Social media users acted with outrage to the news, with one writing: 'I hope teachers send kids to his office to throw up.'
'Where were the parents when this type of policy was being passed?' questioned another. 'What can be the reasoning behind this?' another person asked 'This is not right nor fair to the children.'
'[If] I was a parent I would pull my kid out of school cause you are putting other students and their parents at risk of potential illness!' added another.
The district's policy adds that exemptions can be made by a school's principal in circumstances including a death in the family, religious observance, court summons, school-endorsed or military activities, or circumstances out of the students' control.
Absence is also permitted in cases of chronic illness 'verified by a licensed medical provider practicing in Tennessee,' according to the policy. That includes pregnancy-related issues and births, according to the policy.
However, there is no option given for doctors to verify a child is absent because they are sick or injured, or if they need to stay home to recover and prevent spreading contagious illnesses.
'Attendance is a key factor in student achievement, and therefore, students are expected to be present each day school is in session,' the attendance policy states. 'The Lawrence County School System believes attendance is vital to one's educational experience and future financial earnings.'
The new policy is also designed to address the issue of 'chronic absenteeism,' which the district defines as missing 10 percent or more time meant to be in class. Such students will also automatically fail the subjects and grades regardless of their academic results.
'We are going to take control of the attendance of our students,' Adkins said. 'You can bring all the doctor's notes you want, but it is still unexcused.'
The policies follow a notable increase in diseases affecting children. According to the Centers for Disease Control and Prevention, 216 children died during this past flu season — a higher number than any time since the 2009 U.S. swine flu pandemic.
2025 also saw an outbreak of measles explode into a total of 1,319 confirmed cases as of Wednesday, according to the CDC. Cases have been recorded in 40 states stretching across the country, while vaccination rates dropped in 78 percent of American counties, with an average decline of 2.67 percent to below the 95 percent herd immunity threshold to predict or limit the spread of measles.
In addition, a new study in the medical journal JAMA found that the health of America's children has significantly worsened across several key indicators since 2007.
A U.S. child is 15 to 20 percent more likely to have a chronic condition in 2023 than a child in 2011 with the prevalence of conditions such of depression, anxiety, sleep apnea and obesity all increasing.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Medscape
a minute ago
- Medscape
Pediatric Pickleball Injuries Surge in 2024
TOPLINE: A recent study showed that pediatric pickleball injuries increased sharply in 2024, with facial injuries being the most common. Younger children faced higher risks for lacerations, whereas older players experienced more joint injuries. METHODOLOGY: Researchers analyzed pickleball-related injuries in pediatric patients (average age, 12.7 years; 61.4% boys) presenting to emergency departments during 2014-2024, representing an estimated 3011 injuries nationally during this period. Researchers conducted narrative searches to identify cases and categorize injury mechanisms. Of 66 patients with information on race, 78.8% were White, 13.6% were Black or African American, and 7.6% were Asian. Injuries were defined as nontraumatic if they resulted from a medical or environmental cause without an external force (eg, sunburn). Traumatic injuries were further subclassified based on the type of external force, including falls, being hit with a paddle, being hit with a ball, noncontact trauma, or unknown causes. TAKEAWAY: Most injuries occurred in teenagers (57.4%) and only 4% of the injuries resulted in hospitalizations; 58.4% of the cases were reported in 2024. Lacerations were the most common injury (23.8%), followed by fractures (13.9%), sprains (12.9%), and abrasions/contusions (10.9%). Facial lacerations (18.8%), sprained ankles (8.9%), and concussions/closed-head injuries (6.9%) were the most frequent specific injuries. Older patients had an increased risk for dislocation (odds ratio [OR], 1.63; P = .03) but were less likely to have lacerations (OR, 0.84; P = .03) or concussions (OR, 0.75; P = .02) than younger patients. The most common injury mechanism was collision with a paddle (34.4%), followed by falls (27.8%). The odds of noncontact trauma increased with age (OR, 1.33; P = .01). IN PRACTICE: Age-related differences in injuries call for "specific prevention strategies" including "lighter paddles and optional headgear for younger children to potentially reduce head trauma, and strength training or technique-focused interventions for older children to help mitigate joint injuries," the study authors wrote. They added "prospective studies are needed to evaluate the effectiveness of these strategies and to monitor evolving injury patterns as participation continues to grow across pediatric age groups." SOURCE: The study was led by Michaelangelo Coppa, BS, Mayo Clinic Alix School of Medicine, Rochester, Minnesota. It was published online on July 25, 2025, in the American Journal of Emergency Medicine. LIMITATIONS: Reliance on narrative text due to the absence of a dedicated National Electronic Injury Surveillance System code may have led to underreporting or missed cases. Exclusion of non-ED encounters potentially biased the sample toward more severe injuries. Additionally, the limited clinical details, small sample size, and absence of interventions or long-term outcomes restricted the generalizability of the study findings. DISCLOSURES: The study did not receive any funding, and the authors reported no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
a minute ago
- Medscape
Age Is Just a Number: Blood Cancer Care in Older Patients
Andrew Artz, MD, MS After years spent caring for older patients with leukemias and other hematologic diseases, Andrew Artz, MD, MS, takes pride in his role of moving the field away from one-size-fits-all approaches. Too many times, he's seen older adults kept away from the most effective treatments based solely on their age, without thoughtful consideration of their fitness or personal treatment goals. The director of the Aging and Blood Cancers Program at City of Hope Cancer Center in Duarte, California, Artz said that his ultimate goal is to develop guidelines that embed multiple assessment measures to make it easier for older patients to successfully complete grueling treatments like allogeneic stem cell transplantation and chimeric antigen receptor (CAR) T-cell therapy, even as they provide clinicians with more direction on how to customize the care of individual patients. Simply put, older age has been one of the largest barriers to referral for allogeneic transplantation, he said. 'Historically, we only had the 'eyeball test' [in which the physician bases fitness decisions on visual assessment only] and then the patient basically had to argue with the physician to get what they wanted,' Artz told Medscape Medical News . 'Patients don't want to be dismissed with some imprecise tool, and they don't want to be told they're too old for treatment. Over time, there's been more alignment with what the patients want and what we try to achieve.' Artz is the senior author of a recent paper that shows how far this area of health services research has come. He and coauthors developed and validated a first-of-its-kind composite health assessment risk model for allogeneic transplant recipients older than 60 years. The goal was to test the model's prognostic abilities with non-relapse mortality (NRM) and survival following transplant. The authors studied the prognostic impact of 13 health variables, eventually settling on seven: age, hematopoietic cell transplantation-specific comorbidity index, albumin, C reactive protein, weight loss, patient-rated Karnofsky performance status, and cognition by the Montreal cognitive assessment (MoCA)—to make up the primary model. They noted that all but MoCA are readily available in the clinic and that cancer guidelines already call for cognitive impairment screening in older adults. 'It is encouraging that the primary-CHARM score was the only prognostic factor for overall survival in a multivariate analysis along with disease risk assessed by the refined Disease Risk Index,' the authors wrote. 'This met our study framework to quantify patient vulnerability to gauge NRM separate from disease risk tools.' Artz recently sat down with Medscape Medical News . The following interview has been edited for clarity. What drew you to focus on improving care for older adults with blood cancers? Even very early in training, I noticed that many of our clinical trials inappropriately exclude older adults. And we can't necessarily infer effects on older adults to the younger adults in the trials. I grew up in West Virginia, where people's health was generally less robust than elsewhere. My grandfather was an immigrant who lived a very healthy lifestyle, exercising and generally staying active. He did all the things that now are formalized in studies about keeping the mind and body active. That made me wonder about what makes some older adults healthier than others. Why did you decide to focus on health services research vs clinical research? During premedical training, I worked in nursing homes as a nurse's aide and saw older people who were frail and deconditioned and that really stuck with me. I struggled with how to wed my interest in the biology of cancer and hematology with caring for older adults. Eventually I settled on looking at aggressive malignancies and transplant curative-intent approaches for people who historically might be given palliative therapy or no therapy. I began to realize we could pursue curative approaches for some of these patients. I am very appreciative of my translational and basic science colleagues. I view myself as someone who takes the baton from them and moves into studying these discoveries with pragmatic clinical trials to understand real-world outcomes. How has the concept of fitness for treatment evolved in older patients? Patients will change over time, of course, but we can potentially intervene to change their fitness or resilience. Some limitations or vulnerabilities can be improved, and we can also use people's strengths to help them prepare for and tolerate treatment. Risk stratification is one step, but it's really using that information to then make decisions to ensure people recover faster. To me, tailoring our approaches to both treatment and the optimization of their health and fitness is the best because that's how we expand eligibility and access for our patients. How do you get older patients ready for CAR T or transplant? On an individual level, we'll ask patients what they would like to recover to and use that as a motivator. But in the research setting, we use a set of patient-reported tools and simple objective measures that are reproducible. There won't be a single easy tool, but most of the tools are complementary and overlapping. Comorbid conditions are essential to optimize, whether by adding or adjusting medications or doing something else to limit further damage. We are very active and targeted in optimizing patients and then using a shared decision-making model to motivate patients. We'll explain that, if you lose weight, you won't have enough muscle mass for treatment. And we might also need to change some medication that's making you orthostatic and keeping you from staying active to keep up your muscle mass. Most of the time it's not as simple as just sending someone to physical therapy because it's not fair to ask a physical therapist to try to make someone stronger in 4 weeks without considering other factors. What is the most important element of care optimization in older adults? It's realizing that because each patient has different limitations and each treatment is different, it's up to you to offer treatment options based on both the disease and the specific patient and their goals, above and beyond the standard considerations that apply to all patients. It's like saying airbags should be available for everyone in the car, but how each person adjusts their seat for the ride depends on how tall they are. That requires a little bit more effort to tailor the solution. Also, social support is critical, including making sure caregivers are available and can advocate for the patient. We universally recommend that and then broaden and deepen social support as needed to help with common geriatric syndromes like weight loss, functional decline, and polypharmacy. We also work with patients to develop both short- and long-term goals for their recovery because that tends to keep them and their families motivated. Artz reported an advisory role for AstraZeneca and Magenta Therapeutics and provided consulting to AbbVie.
Bloomberg
2 minutes ago
- Bloomberg
Whoop Refuses to Remove Blood Pressure Tool Despite FDA Warning
Whoop Inc., the maker of screen-less fitness bands, said it will not disable its blood-pressure tracking tool despite a request from the US Food and Drug Administration. The FDA last month sent a warning letter to Whoop stating that the company's Blood Pressure Insights feature, which both measures blood pressure and provides related feedback, means that the Whoop is operating as a medical device.
