* * Anonymous Doc

Tuesday, April 26, 2011

Clinic patient yesterday, having some chest pain. Ruled out heart attack, did some other tests, he was fine, no need to admit him.

"Can I get a note to get out of work?" he asked.

"You mean a note saying you were here and saw a doctor?"

"No, I mean, I probably shouldn't do my job for a few days, right? Because it's pretty stressful. Physically, I mean."

I look at his chart. Because I was pretty sure I'd read what his job is, and so I was a little confused.

"You're still at the same job as last time?"


"And your job is physically stressful... how?"

"It's a lot of sitting. Hours at a time."

"Yeah, I'm not sure why you can't do that job. I'm happy to write a note saying you saw a doctor, but I think you'll be okay at work."

"You don't know how it is. It's very physically taxing."

"You review television shows for a website. I'm happy to write you a note, I'm just not sure why you feel like this is physically strenuous work."

"I told you, it's a lot of sitting. And eye strain."

"Those didn't cause your chest pain."

"I think all the sitting might have."

So I wrote him a note for his employer, saying that he shouldn't sit for so many hours a day, for the next 5-7 days, to avoid physical strain. He thanked me profusely. I didn't really know what to do. I think he probably faked the chest pain for a note, so that he could, I don't know, go on vacation? I have no idea. I don't know what his motives were, what kind of website boss needs a doctor's note, what kind of boss is going to take this note seriously... maybe the patient was insane, I don't know. But he got a note.

So, people looking for doctor's notes-- apparently, I can be convinced to write a stupid note, as long as you ask me enough times and tell me a ridiculous story. Good to know, right? I'm bringing his case up in our discussion group this week, to find out more appropriate responses...


  1. Did you include in his note that since he should not sit for so long a period of time that he should perhaps EXERCISE or something useful like that? That would have been amusing. I sit all day at my computer, too, transcribing for doctors. It can be stressful. Not the sitting though, the mumbling.

  2. What a nob. You should have held strong. Don't compromise because some twit wants a few days off his "stressful" job. Or take a page out of Whitecoat's book


  3. Try working in pediatrics. I got a nasty look today because I told a dad his daughter was playing him and only wrote her school note for the morning and told her to go back to school this afternoon! The nasty look was from the dad!

  4. Possible post request -- my brother once went to a doctor for foot pain and got a note saying he shouldn't work overtime for two months. The foot healed, but my factory changed its policy so their own choice of doctor has to approve this. (Their practice is mandatory overtime for everyone.)

    Do you feel like you have the power to rule over people's working conditions, or do you feel like there would be pushback if you try?

  5. I understand the temptation to say yes, but you need to say no. It's going to take practice, but you're going to be getting this sort of thing from patients for the rest of your career. This week I had a patient hand me a bunch of bullshit symptoms - nothing wrong with her on exam - and tell me her work was stressful and that she needed time off. Now I have patients who are in fact under unbelievable stress, but she wasn't one of them and I told her no.
    (ace in the hole: if they really push you, tell them you will authorize unpaid time off but that they don't qualify for disability. That almost always works.)