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Antiwork

My patients have to prioritize their jobs over their health

I am a physician and we have our own issues in healthcare like the severe power imbalance in residency that I won't even go into, but I have been absolutely gutted recently on behalf of some of my patients who are showing me just how utterly broken our social safety net is here in the US. I am not going to go into significant details to protect my patients' privacy but two recent cases really stick out in my mind. Both patients were in their 80s (!) and both still working. One needed a new prescription for a blood thinner as a potentially life-saving measure. Because of the nature of his job, he can't continue working if he is on a blood thinner according to his company's policy. He tells me he needs to work 6-8 (?!) more years to pay off his debt. I told him he could easily…


I am a physician and we have our own issues in healthcare like the severe power imbalance in residency that I won't even go into, but I have been absolutely gutted recently on behalf of some of my patients who are showing me just how utterly broken our social safety net is here in the US.

I am not going to go into significant details to protect my patients' privacy but two recent cases really stick out in my mind. Both patients were in their 80s (!) and both still working.

One needed a new prescription for a blood thinner as a potentially life-saving measure. Because of the nature of his job, he can't continue working if he is on a blood thinner according to his company's policy. He tells me he needs to work 6-8 (?!) more years to pay off his debt. I told him he could easily die by then without being on a blood thinner. His reply? “These are the cards I've been dealt, and I have to play them.”

The other has a new cancer diagnosis and his job was pestering his family for a work excuse note while he is still hospitalized, which is unheard of and something I've never had to do before (usually this is something we send with the patient on discharge). His family were very caring but expressed to me how stressed they were over finances because they depend on his income to survive. Again, this patient is in his 80s! And then I have to fill out FMLA paperwork for him, and his family tells me he “stands all day for his job”! This is a frail elderly cancer patient at high risk for falls; there is no way he should be standing all day or walking around without a walker. I have no idea how he can go back to work in his condition.

I feel so awful for my patients and their families and our system has utterly, completely failed them. I feel completely helpless because all I can do is make my best recommendations but they are completely limited by outside factors outside of my control. They should not be worried about finances while struggling with severe health issues, especially when (as with the first patient here), their job requirements are actually putting their lives at risk.

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