Bosses, Schedule Changes & T/Pdoc Appts

Hi guys,

I apologize in advance that this is really long -I'm big on context!

I got an e-mail from my boss today which upset me, maybe you can help me gain some perspective.

To give some context, I have therapy once a week, psychiatrist every 2-6 weeks and also a monthly appointment at a Pain Clinic for a chronic pain condition.

And then there's the occasional PCP or gyn appt., but very few and far between.

I used to work alongside my boss (we had a series of layoffs, my position was eliminated and now I have a different position) and I know from experience that she is more open and willing to allow for scheduling changes for staff when it comes to school, family, and transportation issues than medical issues (in fact a colleague of mine just changed his entire weekly schedule because it would be more convenient for him in catching his train, although this wasn't absolutely necessary -I know, he's a friend of mine; also I asked him and he said our boss had no problem with it).

I have historically gotten a lot of push back with schedule issues due to psych/medical appointments, whereas I've seen her deal with schedule changes for other reasons with no push-back.

A couple of years ago, when I was in my old position, my therapist changed his schedule, and the only time (without doing therapy and then going back to work, which is just not possible for me personally) I could be seen was at 3:30. So I needed to change my schedule one day a week. It was a big deal, it affected operations -to a point- so I get it, but I ended up going into a good 2 weeks of negotiations with my boss and her boss about this. At first they said no. My boss insisted that I do it during lunch, I had to explain why I just couldn't (which was very embarrassing for me). They eventually allowed it, but very grudgingly. I felt horrible and exposed telling her what it was for (I had to in these negotiations), she was really mad about it, it was pretty awful. Eventually I was allowed to change my schedule that one day a week. Maybe I should just be grateful she eventually allowed it, but it was an upsetting process.

That said, I have these other appointments that I mentioned. I always schedule them during lunch (which we're encouraged to do) to avoid affecting operations, but it does require having lunch at a very specific time (our lunches usually vary according to what's going on at any given moment/we do not choose when), so it does affect things. She's expressed some exasperation about how these appts affect operations, won't get into details here.

All of that said, we have to let her know of schedule changes (for us this includes asking for lunch at a specific time) 2 weeks in advance --I always do and often far more in advance. I also let staff know if I think it might go over lunch, because in our department that helps them plan things, and on a couple of occasions I've called from appointments to tell staff that it's going longer than I thought and I'll be done in x amount of time.

(I work in a hospital and all of my appointments are at clinics at the hospital, so I usually don't go over lunch and when I do, by no more than about 15 mins).

To my point/what upset me: Today I e-mailed my boss asking her if I could change my schedule by one hour on my therapy day (my therapist pushed up our appt by an hour for this week) because this way I wouldn't have an hour wait between work and therapy. I didn't tell her why in my request because it's personal (and the fact is, as above, she knows exactly what I do after work that day anyway).

She replied saying she didn't want to do so unless it's for something 'specific.' So I wrote back and told her my appointment had been changed to later (yuck, but I guess necessary -I'm a very private person and especially when it comes to mental health stuff).

So she responded no, because it's not absolutely necessary. I do agree/get it in principal -although I have to say that since that day I don't have my normal schedule, I'm not actually needed that early, I'm kind of extra, but whatever.

But this is what bothered me:

I understand, however, we already count on you being here at 7am on Wednesday. I think I make enough concessions, schedule-wise, and would rather not make any changes when not necessary.

Very possibly an over-reaction, but what hit me in the gut was "I think I make enough concessions." This refers, of course, to my psych and medical appointments. (The not making schedule changes when not necessary I am okay with).

My feeling is that these appointments are medically necessary and I don't like them being seen as 'concessions,' or the tone of "I make enough."

When I read the e-mail I immediately felt ashamed, embarrassed, soon to be followed by angry. I'm reasonably sure (another story) that she knows a lot of these appointments are with a psychiatrist. If she were 'annoyed' by just regular medical appointments, I don't think it would get this reaction out of me. I'm so private (up until posting on PC!) and I just feel all this struggle over schedules brings out in the open the kind of treatment I'm receiving and it makes me very uncomfortable.

I'm pretty sure I'm overreacting and my own shame is probably dictating much of my reaction... I'm also probably reading into what she is writing. I just find it upsetting and it makes me think back to all the struggle over my therapy appointment and -ugh.

So what do you guys think? Would any of you react negatively to this?

Have any of you guys had trouble with your boss when it comes to therapist and/or psychiatrist appts during work-time?

Also, for the lawyers out there, how does workplace law weigh in on medically necessary treatment vis a vis 'accommodations' such as these at work? Do employees have certain rights here, or is it entirely at the discretion of one's boss?

Thanks if you made it to the end and in advance for any comments!

My work gives us up to 2 hrs for medical appts but we could never use it weekly. I know my boss gets really annoyed about people using it weekly like the guy at work gets an allergy shot weekly during certain times of the year (you have to sit in dr office for a while afterwards)..

I personally only schedule therapy visits in the evening. When searching for a T, if they don't have evening appts they are off the list.

The only weekly appt I have is with my therapist and I changed my schedule for that permanently, so I'm not taking off work for it, I work full time that day, just start earlier/end earlier than other days.

So these 2 hours, that's interesting. Over how long can you use these two hours? Since my appts are during lunch and I only occasionally go over some 15 mins, that would last me a long time. A big part of the problem with me is needing lunch at a specific time -it's the way the department works, things are unpredictable so there are no set lunch times. If that weren't the case, this would be so much easier.

I started out going to therapy after work and the after work time was initially a deal breaker, but by the time he changed his schedule for various reasons, I already was sure I wanted to stay with him, so I changed my schedule. His reasons were perfectly reasonable, but it really sucked all around at the time.

I've had many issues with my current supervisor. You said yours is "more open and willing to allow for scheduling changes for staff when it comes to school, family, and transportation issues than medical issues". I suggest that you give her what she wants to hear. Yes, I'm saying to make up something - lie. Everyone will be happy and your leave will be approved. I would not ordinarily encourage lying but sometimes we are pushed into a corner and ya gotta do what ya gotta do. You've already told her what you're doing now but things could change in a week or two. You're T session could change to an opening at night but you find that you're spouse now needs you to drive her/him to a class every Wed afternoon (family, school and transportation in one, pretty good eh?). A supervisor like yours does not deserve to know the truth. That's just how I feel.

Sounds like your boss has a bug in her panties about the schedule, but bosses do take a lot of crap about schedules, from their employees and from their own bosses. I was awful about my own schedule, I should say that as a disclaimer right up front. My feeling is that you should have "eaten" that extra hour, gone window shopping, gone for a walk, stayed late and cleaned your desk, anything - but not made it your boss's "problem". I think that's all she was saying. It was a one-off, not that big of a deal.

I would talk to your t about why you feel embarrassed about it. I know - boy do I know - about feeling discounted by my bosses. Nothing they could do could make me feel special or that they recognized me "enough". But that is really like sibling rivalry issues brought into work, or attachment issues.

I would downplay it as much as possible at work, and let your t know it is a bit of an issue. My ts never believed me when I said it was a problem, but it would become a problem after a while, right? But I was so desperate for help, what could I do?

Actually you make a good point, given the history I really probably shouldn't have asked for that change in the first place, since it wasn't a big deal. Still upset, though, about the at least perceived by me attitude I sensed in the e-mail.

I really don't want or need support from my boss (I don't want her or anyone to know about the nature of my appointments in the first place it's just that it came out in the negotiations about my schedule change)just don't want grief about lunch time changes. That said, I've been a supervisor and I know what a pain in the butt schedule changes can be -especially with what I do. This is probably mostly my issue of my treatment being out in the open in some way.

I suspect the feelings of shame and embarassment are yours; but having said that, I'm amazed that your boss knows the nature of your med appointments. I would never have revealed such info in the workplace, partly out of my own shame, but also because no matter what official policies are, there's always a price to pay.

I do think her accommodations for family, etc, reveal her own bias against other reasons for absence.

But I don't understand how it's possible to schedule appts for lunch-time if there's no predictable time period for lunch? I also find it difficult to understand why there isn't a set lunch time, even if it means rotating staff.

I've just never worked in such an environment. I generally saw my T in the evening or on Sat AM, but he had those hours because his private practice was in addition to a Univ position.

Does your work-place HR office have stated policies about this? Or is the problem that you're management and exempt? If so, there needs to be a conversation because there needs to be a balance between responsibility and flexibility. If your boss is acting out a preferential bias among "worthy" reasons, that needs to be addressed. I don't envy you that situation!

I am not sure where you are, but I am in the USA. We have laws that make employers give time off for medical issues:
U.S. Department of Labor -- ODEP - Office of Disability Employment Policy - Publications - Employment Laws: Medical and Disability-Related Leave

My T has to fill out a form once a year detailing my needs. They include PTSD related breakdowns and time off for therapy during the workday. HR sends it off to the dept of labor and they reply back with a form for the company that says what they need to do to comply with the law. Thankfully I have a great company and they never give me flack.

To answer your question specifically, I would have been mortified by that boss's response and then trembling with rage and emotion. It wouldn't matter if I was wrong - maybe el jefe had a point - but the way it was written is so condescending that I'd have felt like a kid being yelled at.

Even though I'm a lawyer, I often encourage people to start negotiations by communicating clearly about what you need and see where that goes first. My feeling is that you work with the "rules" that are expressed, and explain how they fit your situation. In your shoes, I would say something like the following:

"For privacy reasons, I have not communicated clearly about the importance of regular therapy appointments for my emotional and physical well-being. I am asking now for you to re-consider my schedule change, because these appointments are medically necessary to me. Without regular therapy, my health will deteriorate. I can forward documentation of this necessity if you require it."

Some other thoughts I have are more lawyerly-- and there are many sources of rules that relate to this sort of thing. First of all, your employer (hospital) probably has something about this in your employee handbook. The HR department or the Employee Assistance Program may be able to help you with that. Your state may have specific laws related to the workplace and protection from discrimination due to "disability". And of course the federal law, if you are in the US, may offer some protection as well. I am not a specialist in these laws, even in my state, so I don't have any real advice to offer.

I do think that this is a situation where you are clearly in the "right", and I think you can benefit from being understated at first in your approach, because you can always start kerfluffering about your rights under this or that policy and/or you can visit human resources or the EAP. It is in your employer's best interest that you remain healthy, so you all are really on the same team. They don't want you to get sick or become disabled, those things cost them lots of money.

Good luck. And I understand the shame/embarrassment issues and would feel the same way in your shoes. It is a good topic to explore in therapy, as others have suggested.

Lots of people here will know way more than me about legal stuff, so I'll leave that to the experts. As for workplace stuff, I am very luckily to have a permissive schedule, and my most recent bosses have had very progressive views on mental health care. One I never told about it, but I knew if I ever felt I had to it would be ok; the other is actually a psychiatrist, and I did tell him because of a horrible termination that was so stressful it was showing in my demeanor at work, and boss-man was worried.

But what your boss said in the e-mail really hit me too, because it's something that would really hurt me. I'm just going to describe how I'd feel and why, and maybe something useful will pop out.

I try SO HARD not to be too much trouble for other people. It's a pathological thing. I cannot bear the idea of being too much trouble. I feel massively guilty if anyone has to make any type of concession, even a harmless one. So phrases like this are like kryptonite for me. I'd rather be punched in the face.

My mom used to say stuff like this to me all the time, and never let me forget how much she was sacrificing or how much I was putting her out. Good news, I didn't wind up spoiled or ungrateful. Bad news is that it went too far, and I had no good idea of how much was too much to ask and how much was reasonable, which is actually a really important skill in the real world.

I wonder if you had a similar sort of thing going on with you.

Anyway, like with my mom, I expect this reveals a lot about your boss. My mom would get most angry about the things that she had to go out of her way for that SHE wanted and felt guilty about -- and indeed at the same time would sometimes do extraordinary mom things without complaining a peep. I don't know about your boss and therapy, but she probably has some similar negative prejudice toward it. I know you probably know in your head that it's not right for her to have this bias, but that doesn't really make it not hurt or feel extremely upsetting and uncomfortable.

I've also been lucky to have a T who works really hard to meet with me at times that will cause me minimal trouble. It doesn't always work out, but it can. I'm sure you've talked to T about this, but is there any compromise to be made on that end?

Thanks Feralkitty.

My boss knows about the therapy because of all of the drama around me changing my schedule to accommodate my earlier therapy time. My schedule at the time was 9-5:30 and I asked for it to be changed to 7-3:30 (we open at 7) just on Wednesdays. This was the only way I could continue to see my therapist, because his hours at the hospital clinic changed and are very limited -he has a private practice with a much fuller schedule but I don't think he takes insurance there.

I ended up having to reveal the reason why I needed the change because my boss asked and because she really didn't want to do this. I told her because I figured that it being 'medical' it would be the only way I could get it. The initial answer was no, so I told her more (therapist changed schedule, I can't do therapy in the middle of the day), she asked why I couldn't and I tried to explain why (she clearly didn't 'get' it though). So it all came out. It just really got me because I could write a page on all of the weird schedules staff have, she's actually exceptionally flexible when it comes to schedules, but hasn't been for me -then, or since then. (I don't think it's about me personally at all, it's about the reasons, and I know it's a pain in the butt for her).

For the record, and as you might guess about me, I hated revealing all of that to her (and she was in contact with her boss about it). But it was just the only way.

I could fill a whole page on other peoples' bizarre schedule due to school (and to a lesser extent family), but I'll spare you guys -you'll have to take my word for it.

What I do in healthcare is very unique, so I feel like if I reveal it I'll potentially really 'out' myself here. But no, we don't have set lunches, we in theory get lunch more or less according to our schedules, but it really depends. We often cannot predict patient need and, for example, I wouldn't normally just leave a patient encounter for lunch, I'd finish it, then go to lunch. Having to have a set time for lunch because of an appt means that I can't see the next patient in need if it's going to take too long/interfere with when I need to leave for the appt.

I have at times considered going to the EAP about this and asking them -it's for counseling, but they may well have useful information about my rights. I'm not comfortable going to our HR rep (for various reasons) about this -unless there is some really obvious, provable bias.

I'm so uber responsible about my appts, as I mentioned before, and I know from my old job that most staff are not so much. It really gets to me. Maybe I'll go to the EAP, not to challenge her on these things, but just to get a better idea of my rights/for my own peace of mind, because as it is I end up feeling guilty about my appts (which is partly my stuff).

Thank you SO much, WePow, I had no idea of any of this. I'll look into it. Yes, I'm in the U.S. But in order to get these accommodations, did you have to reveal then your diagnoses, etc. to your boss?

I try SO HARD not to be too much trouble for other people. It's a pathological thing. I cannot bear the idea of being too much trouble. I feel massively guilty if anyone has to make any type of concession, even a harmless one.

This is me to a t! Thanks so much for sharing this, makes me feel less alone with it. Yes, I've talked about this in therapy, but I see I need to talk more about it, deal with it. And funnily enough, your mother sounds like mine -basic needs were often a massive inconvenience and, yes, she would get furious about these needs. I had actually never made this connection -thank you.

Actually, the therapy appt/schedule change has been a done deal for some time now, I have the new schedule. It's just that the other appts continue (Pdoc, pain center once a month, a couple of times a year at gyn for a chronic issue there). She's occasionally given me push-back about these, and it only takes a little to make me feel hugely guilty, etc. The therapy schedule change, although a done deal, I think just still kind of sticks in her craw (sp?) basically piles on to on-going appts.

As I write this, it sounds like I have appts right and left, but I actually don't. A big part of this is how our department works, that despite the fact that I do them during lunch affects operations. Although in reality it doesn't affect it that much. Well, ugh.

I just read through some of the EEOC stuff -very helpful. Do you know which form your T filled out?

I'll probably end up talking to the EAP, but if after consulting them it seems reasonable, then I think it would be helpful for me to have forms filled out by my therapist, psychiatrist and pain doctor really just saying that I need the appointments. Then it will be out there, I'm backed up, and presumably no more grief about them.

Thanks again.

Ultramar, you need to contact your HR dept and ask about going on Intermittent FMLA leave. I am on Intermittent FMLA and it means job protection - I cannot be reprimanded for needing time off (or have it held against me in a performance evaluation) to go to my T or pdoc appts. It is defined as "An employee is taking time off in separate blocks due to a serious health condition that qualifies for FMLA. Intermittent leave can be in hourly, daily, or weekly increments. Intermittent FMLA is often taken when an employee needs ongoing treatment for their condition."

I am appalled and horrified that you felt pressured into revealing why you need this time off. I am in HR and we counsel our supervisors that they should diplomatically discourage employees from revealing medical information. It's very sensitive, and the less detail we know, the better.

Anyway, I had my T fill out the FMLA certification provided by my HR dept., and made sure that he didn't provide any revealing details on it before I turned it in. Your T has to provide information about how much time you'll need off, so make sure he/she includes any time you need for your pdoc appts. I have days when I can't even make it in to work, so I had my T include that I might occasionally need a full day off to tend to my serious health condition.

I didn't know this existed either, thank you so much!!

Do check your Personnel Manual as well, for your company's policies on leaves. It should mention something about FMLA as well.

Hi guys,

Just bumping this up to give you an update.

I've met with our EAP (there was a specialist in disability) and spoken at length with the Disability Resource Coordinator for the consortium of hospitals where I work.

This has all also afforded me the opportunity to work through some things in therapy brought up by this process (my own shame of my mental illness and this making me very sensitive to others' responses to related needs (boss), not wanting to be seen as 'special' or being singled out through this process, my need for privacy, etc.).

So I'm planning now on filing paperwork under the Americans with Disabilities Act -notes from doctors stating my 'disabilities' (I hate to have it put like that, but this is how it works). In the workplace this means that you are capable of fulfilling the duties of your job, but may need certain accommodations. At the moment (and for some time now) acceptance of flexible scheduling due to ongoing appointments, in the future perhaps, for example, reduced hours due to a chronic pain condition and severe spine degeneration triggered by a long ago accident (I asked for reduced hours once and was turned down).

In any case, I'm told that the doctors' notes and forms will go to and stay at Occupational Health -my boss need not know about it (until and unless I need it, even then without details). The Disability Resource Coordinator strongly suggested I do this as it can protect me in the future; I'd already have the 'evidence' I need for any accommodations I might need -regarding mental or physical health.

I haven't started the process yet, have just been gathering info to help me make a decision, but we'll see how it goes.

Just wanted to give an update and thank you guys for your support!

Wow, that's great news. I am proud of you for starting the process to protect yourself--and impressed by the awesome folks here at PC who were able to get you started on the right road.

I am glad they seem like they may be able to help you. Good luck with it.

I think that statement was meant matter-of-factly, but you may be hearing it as an angry statement. What do you think?

Accommodating and tracking scheduling exceptions is extra work for the boss, and I can empathize with that, too.

Sometimes we are limited by work schedules. Frustrating, for sure.

I answered before I fully read the thread.

I'm glad things worked out for you!

I know, I was a manager -when people change their schedules it's a huge pain in the butt! I was probably over-sensitive to what she wrote, yes. It was in the context, though, of a series of such comments over time. In most jobs it wouldn't matter much, I almost always have appointments during lunch, but in my job that does cause problems since we don't have set lunches, it depends on patient need. In any case, I talked to my therapist about my reaction to her, and I've definitely learned from it -it really is mostly my 'stuff' but I'm glad it led me to finally take steps to file that paperwork and protect myself for the future.