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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] > ++++++++++++++++++++