A hospital bullies a physician due to her disability

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If this is indeed 100% true and not exaggerated then the PD + Admins should be either investigated and disciplined accordingly or my favorite lightly flogged in a public square. It's one of those cases where it would almost feel justifiable to say "I hope you get a benign meningioma" just so they too have to deal with practicing medicine while experiencing the shear terror of living with brain cancer.
 
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I think by default this would be fairly rare as most disabling conditions are rare in resident-aged people.

Only case I know of personally was a guy in my med school class who was diagnosed with MS our 2nd year. He finished a neurology residency, so I'm guessing it wasn't too bad.
 
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I think by default this would be fairly rare as most disabling conditions are rare in resident-aged people.

Only case I know of personally was a guy in my med school class who was diagnosed with MS our 2nd year. He finished a neurology residency, so I'm guessing it wasn't too bad.

Not as rare as you think, actually. Depends what you mean by disabling condition.
 
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A hospital bullies a physician and threatens termination for her disability

Attendings, Residents, do things like this occur commonly or is this a rare isolated incident?

You will learn the hidden curriculum.

You are joining the culture of shame and silence, which not only requires but even encourages self-neglect.
The highest virtue after work ethic is hiding weakness.

The people who will tell you this is not the case, I can almost guarantee you either didn't have such conditions themselves, were treated fairly, weren't but won't recognize it as such, or just weren't aware their colleagues were going through it.

I was not in a large class. Yet, somehow I became known as the person you could talk to about this stuff. So I know the ugly side of things.

In my career, I have seen this happen with colleagues with cancer, diabetes, arthritis, mental illness, seizures, migraines, asthma, sexual assault, even self-limited things like needing a root canal, just name a few.
 
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Wow

Sadly, that's what can happen when society sees the punishment of residents in training somehow being a necessary evil in the doctor creating process

Terrible how we treat our own
 
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You will learn the hidden curriculum.

You are joining the culture of shame and silence, which not only requires but even encourages self-neglect.
The highest virtue after worth ethic is hiding weakness.

The people who will tell you this is not the case, I can almost guarantee you either didn't have such conditions themselves, were treated fairly, weren't but won't recognize it as such, or just weren't aware their colleagues were going through it.

I was not in a large class. Yet, somehow I became known as the person you could talk to about this stuff. So I know the ugly side of things.

In my career, I have seen this happen with colleagues with cancer, diabetes, arthritis, mental illness, seizures, migraines, asthma, sexual assault, even self-limited things like needing a root canal, just name a few.

You are awesome.
 
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look up the rates in the 25-35 cohort for the conditions I just listed

many of them meet ADA, many of them your colleagues were coping with. maybe we define disability differently
If you think migraines and asthma qualify, we absolutely do.
 
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Look at it this way...

When society debates work hours for doctors, it discusses patient safety. No one talks about resident/physician health outcomes and quality of life. Weird, right? Because medical training doesn't make doctors in some other countries regularly consider killing themselves. Part of the culture here in the US is that doctors are being paid to provide a service and their own needs are immaterial.
 
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If you think migraines and asthma qualify, we absolutely do.

Disability doesn't mean you're missing a limb, that there's some aspect of your health that is always fixed & doesn't wax and wane.
Disability is having a medical condition that impairs your functioning in one or more important areas of functioning. Disabilities can be hidden, they can also be accommodated or coped with, with no one but you or your medical providers any the wiser.

You don't think migraines or asthma can be disabling? I guess you've never seen either condition when it was severe and not well controlled.

I have seen plenty of patients on disability for migraines. Again, I don't think you understand the legal definition of a disability, let alone from a purely medical standpoint.

My friend in medical school was finding their migraines to be disabling. They were fine for most rotations, I can't remember what their triggers were but I remember a few rotations they had to make up time. They were missing part of the day probably once per week, and if you missed 2 whole days of the rotation you had to make the whole thing up. Ultimately they only had to make up 2 weeks of 4.

Another friend, asthma was a new dx for them. I remember the extra "cold" air of the OR was a trigger, and they had exercise-induced. This was an issue on rotations were one really needed to "run" through the halls or take multiple flights of stairs quickly (ob/gyn I remember was a real issue). Ultimately, this is had to be accommodated. The team was made aware and when it wasn't emergent, they walked/stairs at a slower pace. Eventually they were able to get their inhalers figured out that they weren't that worried about rushing to a code during residency, but otherwise they didn't really run in the hospital. They kept their inhaler in their white coat pocket. As you might imagine, needing to use it suddenly would be less of an issue inpt/outpt than scrubbed in to surgery. Another accommodation: the team was aware and they were not given tasks where there wasn't back up for them to quickly and easily step out of the surgery.

Needing to use an inhaler at any moment (so needing quick access to it and to your hands) and having to limit the speed of walking/running (guess what? both were in my technical standards for residency) - these could be seen as impairments in important areas of functioning and what I have described are accommodations.
 
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I'm happy to educate physicians on what the legal definitions of disabilities are and how they are accommodated.

I remember the diversity and disability inclusion coordinator, who said they had worked in various industries, including the private sector in high-powered long-hour fields like business, finance, etc, for over a decade, told me about my institution (a large academic medical school and trauma 1 center)

"I have never worked with a group not only so ignorant of the laws, but also this recalcitrant to following them." They were speaking of physicians. They were absolutely floored at how resistant to accommodating any disability or illness they are as a group. It honestly made them angry.

Such a coordinator would talk to a patient/employee/student, to their medical providers, look over technical requirements, talk to a boss, and would come up with a list of reasonable accommodations. This would be given to the supervisor or whoever was in charge.

"But do we really have to follow these??"
"Um, yes you really have to follow them!! Disability accommodations aren't exactly optional; it's the law!"

This coordinator was of the opinion that other fields didn't see themselves as "exceptions to the rules regarding health" and "above the law" as physicians did.

It sort of makes sense, so much of the medical documentation created by physicians is just for show and we all know it. Couple that with the lack of respect we have for our personal health, the low lying contempt for disability in general, and you see why the attitude is "we're not giving you the accommodations on your form!"

Contrast this with the business sector: presented with a legal document pertaining to health, not their expertise, you can see why they may have been more likely to fall in line as was this coordinator's experience.
 
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20,000+ residents per year. Even if 100 people air said grievances, that's a pretty low percentage.

170121181022-sean-spicer-donald-trump-inauguration-crowd-bts-00002515-large-169.jpg

"WingedOx's post was meant to be taken seriously, but not literally."

Sorry, I have to take a lot of what's posted on KevinMD with a massive grain of salt most of the time. Most of what people share on facebook from there may as well be SDN posts but with fewer grammatical errors. Hell, this case probably WAS an SDN post at one point.
 
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"WingedOx's post was meant to be taken seriously, but not literally."

Sorry, I have to take a lot of what's posted on KevinMD with a massive grain of salt most of the time. Most of what people share on facebook from there may as well be SDN posts but with fewer grammatical errors. Hell, this case probably WAS an SDN post at one point.
great to see you back!
wounds.gif

Kinda sucks when peeps like you and @Crayola227 disappear for a while.
 
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Wow

Sadly, that's what can happen when society sees the punishment of residents in training somehow being a necessary evil in the doctor creating process

Terrible how we treat our own
I don't think society gives a crap about doctor culture.
 
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I don't think society gives a crap about doctor culture.

I'm frequently surprised/unsurprised how interested people on the outside actually are when you tell them about it

mostly I think because it's a touch bizarre and counter-intuitive

like any profession that deals with topics of human interest (military, clergy, education, police, social work, firefighting) the work itself is of interest, as well as the "culture" behind it - even high school teachers, one always wonders a little "what's it like in the teachers' lounge"?

studies have shown as well laymen have very pronounced feelings about our training and culture
 
Disability doesn't mean you're missing a limb, that there's some aspect of your health that is always fixed & doesn't wax and wane.
Disability is having a medical condition that impairs your functioning in one or more important areas of functioning. Disabilities can be hidden, they can also be accommodated or coped with, with no one but you or your medical providers any the wiser.

You don't think migraines or asthma can be disabling? I guess you've never seen either condition when it was severe and not well controlled.

I have seen plenty of patients on disability for migraines. Again, I don't think you understand the legal definition of a disability, let alone from a purely medical standpoint.

My friend in medical school was finding their migraines to be disabling. They were fine for most rotations, I can't remember what their triggers were but I remember a few rotations they had to make up time. They were missing part of the day probably once per week, and if you missed 2 whole days of the rotation you had to make the whole thing up. Ultimately they only had to make up 2 weeks of 4.

Another friend, asthma was a new dx for them. I remember the extra "cold" air of the OR was a trigger, and they had exercise-induced. This was an issue on rotations were one really needed to "run" through the halls or take multiple flights of stairs quickly (ob/gyn I remember was a real issue). Ultimately, this is had to be accommodated. The team was made aware and when it wasn't emergent, they walked/stairs at a slower pace. Eventually they were able to get their inhalers figured out that they weren't that worried about rushing to a code during residency, but otherwise they didn't really run in the hospital. They kept their inhaler in their white coat pocket. As you might imagine, needing to use it suddenly would be less of an issue inpt/outpt than scrubbed in to surgery. Another accommodation: the team was aware and they were not given tasks where there wasn't back up for them to quickly and easily step out of the surgery.

Needing to use an inhaler at any moment (so needing quick access to it and to your hands) and having to limit the speed of walking/running (guess what? both were in my technical standards for residency) - these could be seen as impairments in important areas of functioning and what I have described are accommodations.
I used to do disability exams for the state, so I'm quite aware of the legal definition. Nice try there. There are also lots of bull**** conditions people are on disability for, doesn't actually mean they are disabled. I have a cousin on disability for his back pain. 3 years ago he built a fence for his backyard. NPR even did a neat piece on this a year or so back: http://apps.npr.org/unfit-for-work/

Of course uncontrolled problems can screw with your job - residency isn't special in that regard. If its bad enough that you can't do your job, you take a medical leave of absence (allowed), get it under control, and go back to work.

The vast majority of medical problems can be brought under control given time as both of your examples showed. If it can't, maybe medicine isn't for you in the first place.
 
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I'm frequently surprised/unsurprised how interested people on the outside actually are when you tell them about it

mostly I think because it's a touch bizarre and counter-intuitive

like any profession that deals with topics of human interest (military, clergy, education, police, social work, firefighting) the work itself is of interest, as well as the "culture" behind it - even high school teachers, one always wonders a little "what's it like in the teachers' lounge"?

studies have shown as well laymen have very pronounced feelings about our training and culture

From my experiences, Ive found that many people dont care about doctors' plights due to their grievances with our healthcare system ( and they wrongfully blame doctors when its the legislators', admins' fault) and they think they are payed really well so all concerns seem superficial.

Whereas the professions you listed require much self sacrifice along with nowhere near as much pay as doctors.

Until public perception changes in regard to how little doctors contribute healthcare costs, how much schooling is required to become a doctor and the hours spent at work, most people wont give a crap.
 
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First line of article says that this is from Pamela Wible, instantly, everything is suspect. She is unreliable and has the credibility of Spicer or Oz on this topic.

I am a huge advocate of better care for students and residents. The garbage that she spews has to be fact checked because she exaggerates and embellishes and frankly is harmful to the cause.
 
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I'm frequently surprised/unsurprised how interested people on the outside actually are when you tell them about it

mostly I think because it's a touch bizarre and counter-intuitive

like any profession that deals with topics of human interest (military, clergy, education, police, social work, firefighting) the work itself is of interest, as well as the "culture" behind it - even high school teachers, one always wonders a little "what's it like in the teachers' lounge"?

studies have shown as well laymen have very pronounced feelings about our training and culture

...and I hope you can see how that causes problems. The general public has an awful comprehension of even basic concepts in mental health, for example, much less so what's involved in treatment or the training to administer that treatment.
 
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...and I hope you can see how that causes problems. The general public has an awful comprehension of even basic concepts in mental health, for example, much less so what's involved in treatment or the training to administer that treatment.

I was just responding to someone saying laypeople or society doesn't care about doctor culture. They do. That is fact. I did not make any value judgement about this being true.
 
First line of article says that this is from Pamela Wible, instantly, everything is suspect. She is unreliable and has the credibility of Spicer or Oz on this topic.

I am a huge advocate of better care for students and residents. The garbage that she spews has to be fact checked because she exaggerates and embellishes and frankly is harmful to the cause.

The Medscape article was not from Dr. Wible. Author's name is Jason Watson. I didn't look into he is. The full article talks to more than one source, some appear to to be more biased than others, of course.

In my last post I simple bolded the edited statements from the Medscape article that represent my feeling and experience on the matter. That's it, my own subjective, not Dr. Wible's.

However, since I was selecting quotes that represented my own experience, I wanted to acknowledge the source.
 
The Medscape article was not from Dr. Wible. Author's name is Jason Watson. I didn't look into he is. The full article talks to more than one source, some appear to to be more biased than others, of course.

In my last post I simple bolded the edited statements from the Medscape article that represent my feeling and experience on the matter. That's it, my own subjective, not Dr. Wible's.

However, since I was selecting quotes that represented my own experience, I wanted to acknowledge the source.

I have no idea why you quoted my post. Nothing you said has anything to do with what I said.
 
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I have no idea why you quoted my post. Nothing you said has anything to do with what I said.

Perhaps I misunderstood. I thought you were dismissing the Medscape article because you thought it was written by Dr. Wible. I wanted to be sure that was clear.
 
I used to do disability exams for the state, so I'm quite aware of the legal definition. Nice try there. There are also lots of bull**** conditions people are on disability for, doesn't actually mean they are disabled. I have a cousin on disability for his back pain. 3 years ago he built a fence for his backyard. NPR even did a neat piece on this a year or so back: http://apps.npr.org/unfit-for-work/

Of course uncontrolled problems can screw with your job - residency isn't special in that regard. If its bad enough that you can't do your job, you take a medical leave of absence (allowed), get it under control, and go back to work.

The vast majority of medical problems can be brought under control given time as both of your examples showed. If it can't, maybe medicine isn't for you in the first place.

So much wrong with this, that despite you doing these exams, you are clearly biased in a way that you sort of miss the point. Were you doing exams for Social Security? Just because you did the exams still does not mean that you are knowledgeable beyond what a physician's role is, in a very complex process.

I don't know your cousin with respect to his particulars besides this fence incident, his back pain, and the rest of his life. I will use the example to make some points many people don't think about with disability.

1) - his back pain could easily be such that he can exert himself for a one-time task over which he has total control of pace. Perhaps he was quite altered, even on pain medications? When the task is finished, he may well need an amount of rest etc to recuperate that wouldn't be consistent with similar employment should employment cause similar strain.

The fact he put in a fence really tells me jack **** about how his back pain affects his ability to be employed in the national economy with accommodation including sedentary work with a sit/stand accommodation or at reduced production speed, how putting that fence in affected other areas of important functioning, subjective pain and mental illness/symptoms.

It is not proof of his ability to sustain enough effort to be employed AND not worsen his condition AND maintain functioning in other areas considered important enough one is no expected to sacrifice in order to be employed, and in effect may keep one from employment (ie ability to do ADLs such as bathe, obtain groceries, cook meals, etc).

2) - people frequently improve on disability when they stop working. Of course that would be the case for many conditions. If full-time work in a field for which one is qualified, exacerbates the condition, (there are many like this), people can get better when they stop.

They might get better enough to regain a lot of function in a lot of areas (putting in a fence for example), however, if they were to go back to full-time work, they would in not tall order find themselves back to meeting the definition of disability. If it is reasonably believed that employment would substantially worsen a patient's condition, then again, they are not expected to participate in the national economy.

Thankfully we don't expect people to work themselves into the ground, just because when they stop doing so they may get well enough to try working themselves into the ground again.

3) - the fact your cousin put in a fence tells me nothing about the nature of his pain or his ability to hold a full-time job in the national economy taking into account his skillset, prior work history, current conditions, needed accommodations, or work pace.

4) - perhaps your cousin would be expected to need to miss 2 or more days a month due to his back pain, without notice to his employer. Even on a good week when he doesn't put in a fence, he just does ADLs. That would make him considered unemployable.


I too am quite aware of the definitions. I get the sense you aren't too sympathetic to people with disabilities, and that your general attitude is "suck it up." It's typically the physicians that feel that way that get a lot out of doing the disability exams and denials. Perhaps I'm wrong and shouldn't read too much into your posts on the topic.

You did the exams, but you are not a vocational expert. Have you listened to one when they go through the hearing process with a judge, attorney, and disability applicant? From what I know of what the physician's role in these determinations, figuring out if what YOU have determined about a patient from a medical standpoint is consistent with any job in national economy, is not part of your job and I wouldn't expect you to be knowledgeable on it. Physicians are part of determining FRC (functional residual capacity), they do not determine if you are employable or not, although they may give an opinion on how employment would likely affect the patient and their conditions.

As far as what happens with a vocational expert, For example, say you used to be an attorney and you're applying for disability. The vocational expert may find that you are able to spend 8 hours a day with a whole host of accommodations, watching a security monitor and merely hit a button should you see a bad guy appear, then they will deny your claim because even if that is ALL you can do, then you are employable. If you could put shoes in shoeboxes at pace that is 80% production speed, the government would actually subsidize an employer to employ you. Nevermind how one even goes about actually getting such jobs.

I don't deny there are people gaming this system.

Now, do people figure out internet blog start ups or other part time jobs and get along financially? Sure. But the government even with laws in place to protect the disabled, does not consider it reasonable accommodation for an employer to provide a full time job to someone that may miss more than 2 days per week without some amount of notice. Employers are not held to that standard. I think that is completely fair to employers. It can leave a lot of people up the creek with no paddle. Once the government recognizes that this is not a reasonable accommodation, then it begs the question, how do we expect people to be employed when we've basically just said that we won't expect any employer to employ them given their limitations?

So they are approved for disability, and if they are able to get well enough while on it, go back to school, do vocational rehabilitation, or are able to find employment, or a source of income where they either no longer qualify to receive payments, then they are supported in doing so!! If none of that works, then they have a safety net. There's nothing like having no income and being unable to work.


Lastly, for why I explained so much about this, the idea that whenever your conditions get bad enough that you take a medical leave of absence and then return to work, is willfully ignorant, not even naive. I posted quotes why residency IS special in this regard. The environment is far more structured and punitive than other workplaces, and there is great resistance to accommodating even healthy workers - let alone those that struggle health-wise.

You statement literally dismisses without even a comment what the whole point of this entire thread is - discrimination. The whole point is that when you get too sick for residency, try to invoke RIGHTS from LAWS, those rights are infringed, the law is broken, residents suffer greatly, and they have little recourse about it.

The examples I gave you - was literally to demonstrate how migraines and asthma can be disabling, since you asserted that you didn't see how either was a disability or would need accommodation. Just because the examples I gave, the training was successfully completed does not mean the people in question were not subjected to discrimination. You think the only illegal bad thing that a medical school or residency can do to you about your conditions is terminate you? JFC.

The next point - just because your conditions are controlled, just not mean that you no longer need workplace accommodations.

The vast majority of medical problems can be brought under control given time as both of your examples showed. If it can't, maybe medicine isn't for you in the first place.

TLDR:
-suggesting that a person on disability putting in a fence as evidence of employability, proves my point that someone does not understand how disability or coping with chronic pain works
-people frequently have improved function and health on disability - this does not mean they are not disabled, and in fact, is one reason it is granted
-I brought up asthma and migraine to illustrate how they can cause disability in medical training and require accommodation, because it was asserted they were not on a list of disabling conditions
-the fact people may take time off or return with accommodations, does not mean they are not subjected to illegal discrimination or denied full reasonable accommodations
-it is naive to think people can just leave and return as the law allows without discrimination taking place
-residency shouldn't be so difficult healthy people can be expected to fall ill, given that is the case, I don't think it's a surprise that those already with chronic illness may not keep up
-if people are getting sick or too sick to keep up with the pace, which DOES NOT have to exist to train doctors, I don't think the solution is to say "maybe medicine isn't for you in the first place"
-the fact someone would even say that about this problem of exclusion, is part of the discrimination
 
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TLDR:
-suggesting that a person on disability putting in a fence as evidence of employability, proves my point that someone does not understand how disability or coping with chronic pain works
-people frequently have improved function and health on disability - this does not mean they are not disabled, and in fact, is one reason it is granted
-I brought up asthma and migraine to illustrate how they can cause disability in medical training and require accommodation, because it was asserted they were not on a list of disabling conditions
-the fact people may take time off or return with accommodations, does not mean they are not subjected to illegal discrimination or denied full reasonable accommodations
-it is naive to think people can just leave and return as the law allows without discrimination taking place
-residency shouldn't be so difficult healthy people can be expected to fall ill, given that is the case, I don't think it's a surprise that those already with chronic illness may not keep up
-if people are getting sick or too sick to keep up with the pace, which DOES NOT have to exist to train doctors, I don't think the solution is to say "maybe medicine isn't for you in the first place"
-the fact someone would even say that about this problem of exclusion, is part of the discrimination
In order:

Yes. If you can fence in your whole back yard then you can work. Full stop. Maybe you can't do a job putting up fences every day, but light work or sedentary is possible. This may surprise you, but most physicians do understand a bit about chronic pain especially primary care these days.

If your function improves on disability then maybe find out what's different and do that while re-entering the work force. If that required a 15 minute stretch break every 2 hours then so be it. Smokers get that, not hard to get.

Asthma and migraines are great examples of temporary issues, until brought under control. Once controlled, not really disabling on a regular basis.

If you are subject to something illegal, get the legal system involved. Pretty simple.

Likewise if illegal discrimination occurs, prove it and get a lawyer.

Residency doesn't expect people to fall ill. I'd even wager that the overwhelming majority of residents don't have major issues. Those that do crop up can be dealt with. ****, I passed a kidney stone while on call 2nd year. The backup person came in. I got the next day off then came back. Repaid those two people who covered for me. Same thing happens when people are sick with whatever.

Residency could be made somewhat easier, but you can't escape the bare truth that being a doctor is not easy. If you're mid C-section, it's not all that easy to just stop if you feel bad or are tired. Medicine isn't like being a barista - patients depend on us and we can't always take a break when we need to. Residency is the time to learn that.

As for not being cut out for medicine - if you can't go 3 days without a migraine so bad you can't do your job for the rest of the day then no, you shouldn't be a doctor. Sorry, but that's how it is with jobs like this. Same with first responders and military.
 
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In order:

Yes. If you can fence in your whole back yard then you can work. Full stop. Maybe you can't do a job putting up fences every day, but light work or sedentary is possible. This may surprise you, but most physicians do understand a bit about chronic pain especially primary care these days.

If your function improves on disability then maybe find out what's different and do that while re-entering the work force. If that required a 15 minute stretch break every 2 hours then so be it. Smokers get that, not hard to get.

Asthma and migraines are great examples of temporary issues, until brought under control. Once controlled, not really disabling on a regular basis.

If you are subject to something illegal, get the legal system involved. Pretty simple.

Likewise if illegal discrimination occurs, prove it and get a lawyer.

Residency doesn't expect people to fall ill. I'd even wager that the overwhelming majority of residents don't have major issues. Those that do crop up can be dealt with. ****, I passed a kidney stone while on call 2nd year. The backup person came in. I got the next day off then came back. Repaid those two people who covered for me. Same thing happens when people are sick with whatever.

Residency could be made somewhat easier, but you can't escape the bare truth that being a doctor is not easy. If you're mid C-section, it's not all that easy to just stop if you feel bad or are tired. Medicine isn't like being a barista - patients depend on us and we can't always take a break when we need to. Residency is the time to learn that.

As for not being cut out for medicine - if you can't go 3 days without a migraine so bad you can't do your job for the rest of the day then no, you shouldn't be a doctor. Sorry, but that's how it is with jobs like this. Same with first responders and military.

Agreed. Saying residents experience "human rights violations" is insulting. And while I'm all for residencies taking care of their residents, the truth is that depending on the extent of the "accomodations" that need to be made, at some point you've got to acknowledge that maybe this isn't the career for you.

There are definitely some malignant residency programs out there, but suggesting that there is some widespread culture of human rights abuse is just absurd.

(I'm a girl who did a very old-school surgery residency in the Northeast, I would know)
 
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There are a lot of variables but in the case of Dr. Waggel things seem pretty cut and dry - I hope she gets some soap opera type jury and she ends up basically owning the place.
 
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(I'm a girl who did a very old-school surgery residency in the Northeast, I would know)

Sometimes I wonder if I'd have gone into a surgical specialty if I'd stayed in the Midwest for med school. It was kind of a shock to learn that not everyone in general surgery was as sh-tty and miserable as the people I worked with on my 3rd year surgical rotation out east.
 
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In order:

Yes. If you can fence in your whole back yard then you can work. Full stop. Maybe you can't do a job putting up fences every day, but light work or sedentary is possible. This may surprise you, but most physicians do understand a bit about chronic pain especially primary care these days.

If your function improves on disability then maybe find out what's different and do that while re-entering the work force. If that required a 15 minute stretch break every 2 hours then so be it. Smokers get that, not hard to get.

Full stop, you're wrong. You did not address a single point I made about why someone on disability doing something on their own time at their own pace, possibly coping with side effects or quite altered from medications they are on, possibly exacerbating their condition, possibly having an exacerbation that leads to being unable to function in one 0r more important areas, possibly needing recuperation, does not = employable. It is far more complex than that not only legally, but from a common sense standpoint, and I addressed those complexities.


You are not a vocational expert to my knowledge. Neither am I. However, have you ever been assessed by one? Have you ever watched the hearing process between a judge, the medical evidence, witness statements, an attorney representing an applicant for SSI, and then the testimony and cross-examination of a vocational expert? Just curious. I have seen this process up close. Not only that, I am willing to share what I have learned, and will even reference the Social Security policies that govern this. But in a few weeks. Until then, I think I wrote enough on what the caveats are.

TLDR:
determining disability and employability is often far more complex than what a SINGLE physician makes of any of it
you are NOT qualified to make that call, even if you did disability exams
put in a fence DOES NOT equal employable by SS standards without a lot of other data points to go with it
 
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Agreed. Saying residents experience "human rights violations" is insulting. And while I'm all for residencies taking care of their residents, the truth is that depending on the extent of the "accomodations" that need to be made, at some point you've got to acknowledge that maybe this isn't the career for you.

There are definitely some malignant residency programs out there, but suggesting that there is some widespread culture of human rights abuse is just absurd.

(I'm a girl who did a very old-school surgery residency in the Northeast, I would know)

The thing is though, there is and has been a long history of ingrained learned helplessness in residency programs. If the culture is such that you can't speak up, then we really don't know just how widespread the issue is, right?

I think we all get that the "verified attending physicians" have paid their dues and so kind of feel that everyone else has to do the same in order to earn status, but you gotta open your ears to us and not simply dismiss EVERYTHING we say as some perverse manifestation of our inability to actually become attendings.

It's only a matter of time before the culture of dismissiveness on these threads loses its luster as well. Then where will we be?
 
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As someone who works at a VA, I find this statement darkly amusing.

honestly, I don't know how it works internally at the VA. I made it explicit I was discussing Social Security Disability. I would be curious to know how the system works for vets.

Reviewing the thread, SS disability came up just because we were discussing what disability means and how that might apply to residents and reasonable accommodations.
 
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From my experiences, Ive found that many people dont care about doctors' plights due to their grievances with our healthcare system ( and they wrongfully blame doctors when its the legislators', admins' fault) and they think they are payed really well so all concerns seem superficial.

Completely agree. It's the bitter truth.

Disagree. I think it's less about the general public not caring and more to do with their complete ignorance about what becoming a doctor and then practicing actually entails. I've had multiple patients who were shocked to find out that I'm on year 21 of my education and that I've got at least 4.5 years left before I'm done with residency. I've actually had more than one patient whose jaw literally dropped. I've also had many patients who were shocked to find out the physician seeing them wasn't working a typical 9-5 job and that some of them start at 6 am or earlier or work well after 5. One of my attendings works from ~5am to 5pm Mon-Sat. and works about 6 hours each Sunday. He gets 1-2 days off per month. Patients just don't get that a lot of physicians don't just work at one clinic or one hospital and that we're not late because we're lazy or irresponsible, but because we were seeing other patients whose condition demanded our attention. They don't see that skipping lunch is often the norm or that we still have to stay an extra hour or two in order to chart or take that work home after we're done seeing the last patient.

I think if people knew even half of what we put up with or have to go through, physicians would get a lot less crap from society and be respected a lot more like they used to be.
 
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Disagree. I think it's less about the general public not caring and more to do with their complete ignorance about what becoming a doctor and then practicing actually entails. I've had multiple patients who were shocked to find out that I'm on year 21 of my education and that I've got at least 4.5 years left before I'm done with residency. I've actually had more than one patient whose jaw literally dropped. I've also had many patients who were shocked to find out the physician seeing them wasn't working a typical 9-5 job and that some of them start at 6 am or earlier or work well after 5. One of my attendings works from ~5am to 5pm Mon-Sat. and works about 6 hours each Sunday. He gets 1-2 days off per month. Patients just don't get that a lot of physicians don't just work at one clinic or one hospital and that we're not late because we're lazy or irresponsible, but because we were seeing other patients whose condition demanded our attention. They don't see that skipping lunch is often the norm or that we still have to stay an extra hour or two in order to chart or take that work home after we're done seeing the last patient.

I think if people knew even half of what we put up with or have to go through, physicians would get a lot less crap from society and be respected a lot more like they used to be.

Definitely, BUT if the culture is such that MS/Residents have to keep their mouths shut otherwise they are whiny babies then that's never going to happen.

The culture needs to change. It is OK for doctors to complain.
 
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Disagree. I think it's less about the general public not caring and more to do with their complete ignorance about what becoming a doctor and then practicing actually entails. I've had multiple patients who were shocked to find out that I'm on year 21 of my education and that I've got at least 4.5 years left before I'm done with residency. I've actually had more than one patient whose jaw literally dropped. I've also had many patients who were shocked to find out the physician seeing them wasn't working a typical 9-5 job and that some of them start at 6 am or earlier or work well after 5. One of my attendings works from ~5am to 5pm Mon-Sat. and works about 6 hours each Sunday. He gets 1-2 days off per month. Patients just don't get that a lot of physicians don't just work at one clinic or one hospital and that we're not late because we're lazy or irresponsible, but because we were seeing other patients whose condition demanded our attention. They don't see that skipping lunch is often the norm or that we still have to stay an extra hour or two in order to chart or take that work home after we're done seeing the last patient.

I think if people knew even half of what we put up with or have to go through, physicians would get a lot less crap from society and be respected a lot more like they used to be.

I agree with everything you said. That's why the end of the post says this:

Until public perception changes in regard to how little doctors contribute healthcare costs, how much schooling is required to become a doctor and the hours spent at work, most people wont give a crap.
 
Sometimes I wonder if I'd have gone into a surgical specialty if I'd stayed in the Midwest for med school. It was kind of a shock to learn that not everyone in general surgery was as sh-tty and miserable as the people I worked with on my 3rd year surgical rotation out east.
Based on your screen name we may have worked together on said surgical rotation ;)
 
Sometimes I wonder if I'd have gone into a surgical specialty if I'd stayed in the Midwest for med school. It was kind of a shock to learn that not everyone in general surgery was as sh-tty and miserable as the people I worked with on my 3rd year surgical rotation out east.

It's crazy how a single month can somehow alter decades of your life.
 
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