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Discussion

Do you do this? entitlements for patients?

I have been asked to write letters for patients to the unemployment commission about why they are unable to look for work; their reasons are usually due to chronic pain issues, etc. I don't provide them, but I will of course provide copies of notes from their visits. I have also been asked to sign forms for the utility companies so they don't have to pay them, but I don't usually sign them either (I make an exception for one family with really egregious circumstances I will not detail here). I have some colleagues in my office who will and some who will not. I also get asked to write letters to judges about why they missed a court date, letters to schools about absences, etc. My policy is, no, I don't write letters.

Do you get asked for these things? Do you have a policy on them or do you take them on a case by case basis? I just say it is my policy not to provide anything other than the visit notes. I don't have time to write letters for every Tom, Dick and Harry and I'm not getting into the whole not paying the utilities thing. I only make an exception for that one family because as I say, their circumstances are really exceptional. I simply tell patients I don't sign them for anyone. How do you approach it?

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    I approach it on a individual basis, if the child has a condition that requires they have acess to electric for a documented condition then I sign so the power stays on. If I get a letter for a patient who required nebulizers as a infant for a bronchiolitis but this child is now 7 and has had no respiratory issues since then then no I don't sign it . In most states it does not waive the bill just gives them more time to pay

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    It is a case by case basis for me too. If the parent of one of my patients has an urgent appointment with us and has to miss a court date, yes I will document the time and date of the appointment for them. If we have a fresh post op patient at home who needs electricity, I will complete the form for the electric company. I have said no multiple times (probably more than I have said yes). Had a parent the other day whose son has a lot of medical issues but is stable and doing well. She wanted me to send her landlord a letter saying it was medically necessary for him to have air conditioning. Now it was over 100 that week and I really felt for the kid and his family, but it is not medically necessary. I called social work and they have ways of helping the families and they found a charity that would give them a window unit for his bedroom. Its hard, because especially in pediatrics, you feel bad for the families and the patients but I only do it if it is medically necessary. The other NP I work with is a lot more liberal about it than I am but to each their own!

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    • Expert

    I work with ESRD which the US government in all their wisdom....have decided that ESRD is an auto-disability. Believe me, my patients know all the loopholes. I do letters for utilities but in IL all it does is delay the due date. I also do handicapped cards/licenses but again I use these only for those pts that have a real need. If the pt doesn't drive, I refuse to do it for the driver.

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    I was asked to do this all the time in my previous job. There had to be a crystal clear, documented, currently valid medical reason for me to do a utility letter or school excuse. Social Services used to be on my case all the time to give these letters to patients, because, after all, what was the harm? Well, you all know the answer to that one! I'm rarely asked in my new position, but the same criteria apply.

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    • Author

    Oddly enough, today I got asked to sign something saying a pet that was NOT a service animal was in fact a service animal, so that the family wouldn't have to get rid of it or face eviction from a complex that didn't permit pets. A place they lived in long before they got the pet, when they knew in advance it wasn't permitted. :nono: My patient didn't have any condition that would require a service animal, the animal wasn't trained in any way...

    so picture me (I look a lot like my av ;) ) raised eyebrow, using my favorite communication technique of silence, which I break out when I just can't believe my farking ears, lol.

    People are just nuts. I'm convinced of it. I see fewer and fewer normal, rational people all the time. I can count on one hand the number of reasonable people I see in a week. I'm beginning to get cynical and lose my faith in humanity, lol.

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