Dennis et all;

This is certainly a difficult issue for all of us who face it.  There
are several aspects of it that need to be considered.  From the
employer's side. Does the PWP have something material to offer.  In the
US it is illegal to fire someone solely on the basis of a handicap and
the employer must make reasonable accommodations so that the handicapped
individual is able to do his/her job.  With that accommodation if the
individual is unable to meet the major responsibilities of the job the
employer has the legal right to discharge him.  Hopefully the employer
has provided disability insurance to help the employee financially.

The other side is the responsibility of the PWP to realistically assess
his/her own ability to make a contribution to his/her employer.  I have
to look at the questions of whether I can still do the job or parts of
the job enough to make a substantive contribution?  Am I earning my keep
so to speak? Am I putting so much of a burden on my colleagues that it
is unfair?

Putting my personal situation into the mix,  I am a psychiatrist. As a
physician my first responsibility is to make sure my patients are
receiving first rate care and to minimize the effect of my PD on them.
Shortly after my diagnosis I sat down with the medical director of the
multidisciplinary mental health group in which I was a partner told him
about my diagnosis and that if at any point he observed changes in me
which he felt would endanger patients that I wanted him to act.
Somewhat later of my own volition I wrote a statement to be placed in my
personnel record and medical charts that if either my physicians or my
employer had concern about my ability to safely care for patients that
they were authorized to exchange information from the other.

Later, a number of the psychiatrists from our group joined a large
multispecialty medical group.  I do not know whether prior to the
beginning of employment they actually were aware of my diagnosis but I
was open about my need for income continuation insurance without a
preexisting condition clause.  Fortunately they offered such a plan.
Over the next several years my productivity declined somewhat but I kept
pushing myself.  Eventually it became clear to me that I was not able to
carry my weight and earn my salary.  My symptoms got worse my absences
increased  had to give up all hospital work 1-2 years before and the
burden of night call also became to great.  Yet I felt I was still able
to work professionally.

1 year ago I went on a leave of absence to participate in a fetal
transplant study.  I wrote a letter to all of my patients explaining my
absence and in the process the physical deterioration that most of them
had observed. I arranged for coverage and it turned out I remained on
leave until August. The return conditions were designed to protect my
patients,  be sure for my employer that I was no longer a financial
drain, and to prevent severe work stress.  I completed a battery of
neuropsychological tests to be certain that I did not have deficits
which would interfere with my ability to provide patient care.  Also I
arranged for a colleague to monitor my practice for a time.

  I- after $4000 in legal  fees obtained my disability benefits. ((The
problem was the insurance company -  my employer was great ) I continue
on partial disability and work 12 hours per week being paid by the hour
at a rate which takes into account a reduced frequency of patients being
seen.  I dictate all my notes since my medical records had deteriorated
with my handwriting. I do not see new patients at this point rather than
to add to their problems the concern of a dyskinetic physician.

What is the relevance of this story?  My employer treated me extremely
well and  part of the reason is I always took into account my ultimate
goal- good patient care - economically delivered.   Not every employer
is going to be as enlightened as mine. But-  assume your neurologist
developed a chronic degenerative disease like PD.  What would you as a
patient want him/her to do to protect your interests as a patient?  What
would you want her/his employer to do?  And if other people count on you
in the job you perform,  what is reasonable accommodation and when does
it cross the line into harming patients, customers or colleagues?
**********************************************************
CHARLES T. MEYER, M.D.
MADISON, WISCONSIN              52yrs old Dx 1989
[log in to unmask]
**********************************************************


  I- after $4000


Dennis Greene wrote:
>
> John,
>
> You wrote:
>
> > My advise is that when you believe that you are being eased out, cut the
> > best deal you can; don't fight it.  The employer generally, and the
> manager
> > specifically, feels guilty, and wants to ease his guilt.
> >
> I was able to turn retreat into a 'phased withdrawal' by approaching my
> regional manager with a (fully worked out) plan.  I explained my situation,
> slightly overstated my limitations (building in leeway, I didn't spend 20
> years
> in middle managment for nothing) and asked to be demoted to a job I could
> easily handle.  He was happy to accomodate me.  This extended my working
> life by more than 4 years.
>
> At the end of that four year period I found myself once more stretching my
> capacity to handle even the less stressfull job and I was eased out within
> 6 weeks of the arrival of a new broom.
>
> Some three months later I happened to meet the new broom at a party.  With
> tears in his eyes he told me that I had caused him 'one of the worst days'
> of his
> life.  Frankly, at that time I didn't give a damn.
>
> Truth be told,  on that score I still don't.
>
> Dennis.
>
> ++++++++++++++++++++
> Dennis Greene 47/10
> [log in to unmask]
> ++++++++++++++++++++