Academic policies that require medical excuses are based on mistrust of students and conflict with institutional honor codes. Such policies undermine the philosophical and educational foundations of higher education; namely, to model and nurture honesty, integrity, and citizenship in emerging adults. Instead, they encourage hypocrisy and exaggeration by requiring students to prove they are sick enough to produce temporary disability. More pragmatically, the "game" also consumes valuable clinician time. The authors describe their experiences with medical excuse policies at their respective institutions and offer suggestions for other colleges and universities.