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Employers requiring people back in office


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My most recent outrage, the latest thing that got me all fired up and tearing through the work, was a patient today who has a few cardiac issues plus prediabetes plus asthma, your basic combo plate of mid-60s chronic stuff plus a few ambulance rides in the last couple years.

BUT, the thing is, her job is one she can do from home, and she has been, and it’s been so much better for her. Not dealing with the commute, or the daily stairs, or the weather setting things off. Being able to rest if she needs to, being able to take daytime meds on time. So of course, her employer is trying to get her back in the office. Why? No reason. She’s missed fewer work hours since WFH has been a thing. The quality of her work has remained great. Her boss supports it, boss’ boss doesn’t care, but the HR manager is digging in their heels. I really do think it’s just a tiny HR tyrant control thing. 

So today my patient brings me this letter from HR Grumpystuff, asking me to comment on the question of is there any medical condition that makes it so this person can’t do their job in the office?

Off the record my patient explains this is a smallish company that didn’t require or even really mention masks until the Governor made it a mandate, and even then they have grumbled. They don’t inform the staff when there’s a positive. But anyway, the HR creature has already made noise about how “this better not be about covid risk” because my patient is vaccinated. 

So, my inclination is to write a letter and surgically furnish this HR person a new poop-chute. I’ve done Occ Med work, so I flexed in one paragraph about how “restrictions” or “limitations” are specific terms with specific applications, and I don’t believe we are filing a FMLA claim or requesting disability, we’re just having a nice chat. So, I continue, instead of me answering that dumb question, how about you tell me why the patient can’t just continue to WFH? It’s a work modification. Not a restriction, and not a benefit. 

I will need to edit a ton and have my SP look at it Monday, and I won’t ever send documents while angry, but I’m wondering: have any of you had to write a “hey D***bag, please don’t be a d***bag” letter like this? How did it turn out? 

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I have learned to not get sucked into other peoples drama.  

One. It is unwise 

Two it is not medicine (where we are the experts)

Three I can pretty much guarantee you that you are not getting the whole story

 

 

comment on the medicine and leave the rest alone.  Better for you.  Better for patient.  Better for company.   

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Oh, I definitely see the wisdom of that. But still — focusing on just the medicine, there are risks to this person’s health that come with being forced to work on-site. Meanwhile, she’s been doing the same work from home for a year. I think they should provide a reason why it needs to be done in-person, but of course I don’t get to decide that. My medical opinion is, it’s healthier to leave it as-is and just let her work.

Obviously it’s not my role or my place to comment too much on how they run their business. But I kind of take offense at their being able to frame it as “is the person capable of working in the office?” because that’s not the salient question, I think. They’re setting it up like we need to choose between her health and her job, when we just proved we can take good care of both.

You want a healthy employee? This is what I think helps, this is what I think probably hurts. I feel like there’s a line, and I’m not sure which side of it I’m on, but my role as PCP is to advocate for this person’s health. If it’s okay for me to tell someone to smoke or drink or eat less, what’s the problem with me agreeing their job seems to come with health risks that should be avoidable? 

I’m also contemplating an opportunity that’s come up in Occ Med again, so it’s kind of interesting to think that if things go a certain way, I might be in a position to help direct policy a little, in how we relate to employers and approach these questions. I get fired up thinking it may be possible to advocate for people and reduce harms. I’m probably being too blue-sky about it, but it’s a nice diversion anyway.

And I really do feel there are gonna be lawsuits, when employees/ patients get the Delta because some chucklehead at the workplace lied about being vaccinated, or the employer insisted everything was fine when they knew it was not. 

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7 hours ago, Febrifuge said:

Have any of you had to write a “hey D***bag, please don’t be a d***bag” letter like this? How did it turn out? 

I love writing those letters, and you're going about it the right way:

1) Get mad
2) Get over it
3) Then write the letter
4) Then sleep on it
5) Then edit the following day to add more sarcasm and condescension if possible.

The madder you are about the situation, the more polite you need to be.

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8 hours ago, rev ronin said:

I love writing those letters, and you're going about it the right way:

1) Get mad
2) Get over it
3) Then write the letter
4) Then sleep on it
5) Then edit the following day to add more sarcasm and condescension if possible.

The madder you are about the situation, the more polite you need to be.


This right here feels like wisdom.

And it’s true, I probably enjoy a little too much being able to bust out my liberal-arts writing skillz at these times. As the saying (attributed to Churchill, but never sourced or confirmed) goes, “diplomacy is the art of telling someone to go to hell in such a way as to have them look forward to the trip.” 

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  • 2 weeks later...

An update: I focused on the medicine, and I was specific, but I did say that this patient’s chronic medical conditions, as evidenced by the little changes and the big exacerbations in the last 6-12 months, compared to how things have settled down more recently, are clearly influenced by environmental factors.
 

I said she’s not UNable to work from the office, but if she were able to continue working from home I would expect fewer complications and a better overall situation. I didn’t come right out and say anything provocative, but I tossed in enough Occ Med verbiage that it should be clear I know what I’m talking about. 
 

I heard today that the HR person was satisfied, which I take to mean they backed off. I see this as an appropriate level of advocating for the well-being of my patient, and removing unnecessary threats to her long-term prognosis.

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