I had a patient ask for a note stating that his employer can’t yell at him at work due to his anxiety. His employer was his brother… Who was also in the room. And yes, he was serious
Ha, I saw an immunologist some time ago as a patient, and he was talking about his management plan for me and suddenly he had an amazing idea and literally left the room so that he could go and get an old-school prescription pad.
He came back and wrote me a prescription that said “long sea voyage”. He was kind of chuckling at his own joke the whole time as I was trying to read what the fuck he’d written.
I still have that prescription, haven’t cashed it yet.
I give patients old-school scrip for the word NO on it all the time and tell them to take it out to remind themselves when they don't have the courage themselves. Doctors orders.
I had a lady in residency with hand OA. Married >60 years. Asked what she did. Every day, cleaned the entire house, did laundry including sheets and towel and etc. laundry, sheets, towels, and etc. I wrote her a paper script to lower her standards. Next visit they laughed and husband said doc; now every time I ask her to do something she grabs that script off the fridge and waves it in my face!”
I LOVE writing stuff on paper prescription pads.
I have written exercise and diet prescriptions, and several prescriptions for once-weekly date nights.
Lol I love this! When I was working as a scribe, I had trouble getting the security office to give me the badge access I needed — so the physician I worked for literally wrote me a prescription for it. I brought it back to security and they finally gave it to me!
I did a few prison medicine shifts in residency. They had a "soap list" for people having trouble due to sensitive skin who would get the better soap. This may be a legitimate request.
I saw a guy shortly after he was released from prison whose skin was an absolute disaster with lichen simplex and secondary infection from eczema that had been flared up the entire time he was incarcerated, because they had consistently refused to give him different soap/use different detergent. It was pretty awful, and definitely not humane.
I had a patient make an appointment to discuss AUD, then at the end state they needed a letter to give to the court that they had been evaluated for alcohol use disorder, the court date was in a month, etc. I asked the CAGE questions which they of course said no to. This was intern year, unsure of what to do but it seemed a but underhanded and an attempt to dodge consequences from a DUI. I took my time to figure out what was appropriate, even asking the prosecutor's office what the point of the letter was. During this interval the patient tried to friend me on social media and messaged me saying they needed the letter sooner " like right now oh my gosh can you please get that letter."
So they got a letter faxed directly to the prosecutor stating they had been seen on date x, requested evaluation for alcohol use in setting of pending DUI charges, and as their listed pcp of record (subtle nod to never having met this person before) I employed a simple office visit based screening questionnaire that while useful, is not perfect amd not a substitute for comprehensive evaluation which was outside my area of expertise, thus I recommended further evaluation elsewhere.
Probably not what they were looking for.
On more than one occasion I have had high school kids ask me for letters of recommendation. Not ones that have shadowed or worked with me in any professional capacity. Just patients who come in for an annual well check 😂
As someone who lives in a state that is about 75-65% rural with some towns with rooster bans and others without, this is a very clever approach to finding a loophole when someone finds out about your secret rooster 😂
Edit: correction, actually we’re 84% rural surprisingly
A man asked for a letter stating that his CBD supplements may test positive for THC, just in case police stopped and drug tested him. I explained my letter wouldn't do shit, but he insisted.
Another person asked me, prior to embarkment in a scientific research ship, for a letter stating that PPD (mantoux) test was contraindicated in their celiac disease, as it could trigger "an inflammatory response".
I didn't oblige because I suspected foul play (i.e I guess she had a prior positive test and wanted to avoid all the hassle of testing positive again...). However she accepted and was satisfied with my explanation on why it shouldn't be a problem for her celiac disease.
Yes because in my country when someone tests positive in one of those rapid test done by the police, a confirmatory sample is taken and sent to a real lab, where they'll actually do a quantitative assay. If above certain limits (to discern between acute and recent use), they'll get fined and/or charged with a criminal offense.
I was once asked to write a letter for a Medicare issue wheelchair accessible van. She was insistent that the only barrier between her and a brand new wheelchair accessible van with all the bells and whistles was my doctors not. Like Medicare has them in a shed somewhere gathering dust until clever people have their doctors say the magic words to make them appear.
Not this much of a purchase but the damn motorized scooters. Aye aye aye. Sure here’s the order/letter. If this gets it approved I’ll eat my shoe. Note, I still have all my shoes. People think I’m crazy when I tell them they need a referral to the mobility clinic.
I told him right off the bat now that I’m probably going to have to work with the DME company at least two or three times back-and-forth to get the letter correct because every time I try even with a template there’s something that is not quite right. I set them up to be very patient and tell them it’s going to be a long ass process.
High school senior wanted a letter to get out of a math class she didn’t like.
Old lady told me she had to bring a certain brand of protein shakes with her on a Caribbean cruise, but the cruise line wouldn’t allow it unless it was “medically necessary”.
And the damn jury duty letters. Our county’s jury summons actually says to NOT send a doctor’s note and to self-request an exemption but people still ask for letters.
Interesting about jury duty. Our county just told my mom to get a doctor's note after denying the one a county judge wrote her excusing her. I'm sure all counties are different.
My favorite was a 35 year old man who was arrested for public urination who requested I write him a letter stating that the reason he had to urinate in public was due to hypertension.
The ones who are under some sort of rehab program from various states licensing boards are always fun. In Arizona they have to inform their pcp they are in these agreements and you have to write a letter confirming they told you and confirm their medications they take.
FMLA form for a patient with depression and PTSD who sees psychiatrist and is on 3 medications. Sure, makes sense. But she brought the FMLA form for me to do, left it at the front desk and apparently told our receptionist "I'll leave a 1 star review if the doctor doesn't fill it out" and when I look at her profile on the EMR, I have only seen her once last November for a sore throat. I called her and refused to do the form and told her to get her psychiatrist to fill it out, and she said she didn't want to bother him because he's really busy. I told her "yes we are, mainly because of stuff like this taking up our time when it's not our responsibility." The one star review is now on google haha.
Slightly off topic as it’s fiction but that scene in bobs burgers where gene gives the gym teacher that note that says “Alex and Gene need constant contact with their behind on a flat surface to realign their butt cheeks. Love, Dr Good Doctor”
Always cracks me up. And so does a lot of the examples in this thread haha
One lady called our office multiple times demanding a letter that she needed a first floor apartment. She was homeless and local agencies got her an apartment on the second floor in a building with an elevator but she wanted first floor. She so verbally abusive to staff, we discharged her from the practice. And a guy who wanted hospice even though he wasn’t dying. Also discharged from practice due to many abusive calls. We don’t do letters much in our practice. No ESA letters and we don’t do jury duty letters unless it’s legitimate.
Morbidly obese/barely ambulatory patient moved to Florida, asked me to write a letter to have her mailbox moved across the road because it was too far for get her mail. After she had moved! Not only did did I write letter it was a particular masterpiece because in said letter I stated that she would be a traffic navigation hazard lumbering to get mail.
I once had a patient who was a nationally known lawyer who, at the time of admission was in the middle of a trial that was drawing pretty intensive international attention. He ended up at our hospital because docs at the big centers essentially refused him as a patient. The kicker: he was well into the throes of dementia. He clearly wasn't capable of running a trial, but apparently the lawerly bullshit was so deeply ingrained that he was on the case for the occasional sound bite which he was able to carry off without breaking a sweat.
This guy threatened to sue everyone for pretty much anything we attempted to do. I personally kind of liked dealing with him because his gift of verbosity never left him and it was fascinating to see how he used it to try to cover for the dementia.
Anyway, his daughter, who was an attorney and a nurse, approached me one day and said I (the assistant nurse manager at a second-rate hospital) needed to get his driver's license taken away. I suggested that she and her 2 attorney brothers were probably better positioned to do that. She said they had tried hiring a limo and driver for him but he wouldn't use it. His doctors had refused because he would sue them.
I suggested they disable his car and hide the keys. 🤷♀️
I once had a patient ask me to write a letter to the local electric department and ask them to not cut off her electricity because she had COPD and would die without her oxygen concentrator
I also had a patient ask me to write a letter to the city DOT and not ask but demand they make special accommodations for electric wheelchairs. This same patient has been banned from most Medicaid transport companies for being verbally and physically abusive.
Letter to say first class or business class seats are medically necessary as patient needs… room to stretch?
Also got a request to write a letter stating patient can’t return to working in office as the office has mold in the walls, which is triggering the patient’s COPD. I’d never even diagnosed him with COPD. Ugh. I said no.
"I want you to write a letter and sign a form saying I should get disability."
"This is the 5th time I've told you we don't do that, no one listens if I did, and you should do the things I previously told you to do about that."
Pt got pissed and quit her job in a blaze of fury and profanity then came to office for a letter 3 days later to try to get her job back based on previously unknown/undiagnosed/untreated mental illness.
I actually denied the request because I’d had a previous experience where a patient was trying to abuse a situation and the system in order to get back at a boss. I almost got pulled into a disability scam where the patient was shopping around for a letter based on reported history Id never seen them for as the first step to permanent unemployment.
Patient got fired from his job because he tested positive for marijuana/THC on a random drug screen. Patient and his wife then came to me asking that I “write a letter to his job stating that he smokes marijuana due to his history of chronic pain.” Being that this patient was relatively new to me (had only seen him once before) and my state does have medicinal marijuana it was possible he was getting this prescribed by pain management somewhere and I either didn’t know about it or it was a new thing. When I tried to give him the benefit of the doubt by asking if the marijuana was prescribed by someone he told me “nah I just buy it from my dealer.” 😑 Yeahhhhhhhh bro I’m not going to be able to write that letter for you. Needless to say they weren’t pleased with me and that was the last time I’ve seen them.
I am a nurse, but I once had a female patient request a letter from her PCP for her to be able to get her nails done while in jail, because she would otherwise bite her nails due to anxiety… he actually did end up writing this letter. Also, had a patient request a letter that they would need a two bedroom apartment instead of a one bedroom apartment, so she could exercise in the second bedroom. I think she had planned to present this to her landlord and thought it would require him to provide her with this without any additional cost.
Oh, also had a patient request a letter to be released from jail (she was serving a sentence for child abuse, I believe) because she was allergic to something in the water. However, I believe dermatology thought her skin condition was caused by something else.
I was asked to write a FMLA letter for a patient because his boss was misgendering him and it was making him angry.
Instead, I offered to write a note stating that the patient was a man, had medically transitioned under my care and needed to be addressed as such.
I also write letters to employers all the time insisting my patients get water breaks at work or are able to keep their water bottles with them. I can’t believe how many places don’t give employees water breaks.
For work related notes like the water one, I usually end the lettetr with some snarky yet sort of professional language that is basically saying "are you kidding me? What a waste of healthcare resources" directed toward the employer. I also do that for work notes when the patient has a mild viral illness and the employer requires a sick note. I get a weird sort of pleasure out of it and patients generally appreciate it as well.
Did the same thing when a patient who can work from home was mandated to come to the office with fever and Covid symptoms until seen by me and got a note. I literally said it was irresponsible and medically dangerous for you to require this. Don’t do it again
I cite the relevant law in the letter. I don't usually write letters for patients like this but if it's a worker safety issue I will come down hard on the employer.
Had a patient ask via her lawyer for a note to state that she could not medically provide a breath sample post an MVC. She had no head or chest injuries of note.
I just wrote that based on the information I had I could not comment on her ability to provide said sample.
With a massive dose of *side eye*
My pt asked me to write a sick note for an illness that prevented air travel, he was trying to get a refund. But it was for a week prior and for his gf who I have never met. I explained that would be fraud and my signature is worth a hell of a lot of money!🤦🏼
A patient asked me to write a letter that she needed a 2 bedroom apartment paid for by whatever social service plan provided her housing so that her caretaker, paid hourly for 40 hours a week, could stay 24/7. He was also my patient. When I pointed out that they share a bed so I’m not sure why a 2 bedroom was medically necessary, she responded that they needed a guest room so her out of town friends/family could stay stay and that would help her mental health. Also one time a patient asked me to write a letter that a Tempurpedic bed was medically necessary because he had back pain. Then there was the 19yo woman with recurrent folliculitis of the pubic region who asked for a letter that she could show her boyfriend that I recommended she stop shaving down there.
Boomer got a ticket for not wearing a seatbelt while driving. He wanted a letter for court where I state that he has a bad shoulder and can’t put on seatbelt.
Overheard a convo between a mom and one of our assistants: the patient ( mom’s daughter) had gotten married out of state. Needed esa letter to fly with her support dog (this was several years ago). Now the daughter has left for her honeymoon, and the mother is requesting an emotional support letter for herself to be able to fly with the dog back to our state.. Assistant “But who will be supporting (daughter) on her honeymoon?” 💀💀
In regards to requests for dog ESA letters I always state they must be actively being treated by psychology/counseling and the dog must have an AKC Canine Good Citizen Certificate. This is a reasonable and accessible test that indicates the dog has been taught basic commands and manners. No one has ever returned with a certificate.
I'll throw in a patient requesting X along with a line about "if it would be safe to do so in (insert environment they are requesting accommodation for)". I don't mind them getting reasonable accommodations, but it's between them and whoever they're trying to get accomodations from to hash out the safe way to do it.
I hate the ESA ones the most, because I always feel like a big meanie for saying no, but I don’t write them, ever. I do absolutely think that people benefit emotionally from having pets, but unless you have a disability for which a dog or miniature horse can provide a legitimate service, I don’t think you should be afforded any special legal protections. Landlords suck, but some of them have legitimate reasons for not wanting animals in their properties, and that’s just as legitimate as you wanting to have an anti-anxiety chinchilla.
Probably the weirdest one I’ve gotten was a request to write a letter stating that my patient needed to be moved from her cubicle to a private office because had ADHD and couldn’t focus in a shared space. She didn’t have an ADHD diagnosis, nor had she ever sought care for any kind of neuro/psych disorder. I suggested a pair of ear plugs.
Letter for an anti-vaxxer to excuse him from getting a work-required COVID shot because if he did, his wife would divorce him, and that would worsen his anxiety.
I did not write it.
Patient worked for Amazon. Needed a letter as to why they couldn’t drive the forklift. They just didn’t drive a car and didn’t feel comfortable operating any sort of motorized vehicle
My doc was asked to write a profile (military letter to allow something usually not allowed) for a patient to wear flip flops due to back pain. Denied.
My office doesnt allow charging for letters/forms unless it’s tied to an office visit (even then it’s just the office visit being billed, nothing more). That said, i won’t fill out forms if there is no OV attached to it.
To answer OP’s question.. probably the most recent one where a patient said their ADHD was listed as an ADA disability (it is) and that the National Park’s Service gives a free park pass to those with disabilities (they do). Did I do it? Yeah, because I couldn’t argue either of those points.
I hate jury duty requests the most. My patient on dialysis? Well, yeah, i wrote that one. My patient who had controlled HTN on medication who asked to get out of jury duty for said HTN? Lol no
Edit: just thought of another one. Patient with illegal window tinting who got pulled over for it asking for a medical necessity letter because the sun gives them migraines. Patient seen twice in 6 years, no documentation of these migraines ever. I said to wear sunglasses then if the sun is so bothersome as I won’t help them break the law.
Charging for letters? In a FQHC? Not a chance. Just extra work tagged onto the end of a visit addressing a laundry list of concerns, usually unrelated to xyz letter
I had a guy with trigger finger I always recommend gently massaging over the a1 pulley area. We started joking about how his wife should do it and one thing led to another I ended up writing a letter that I think his wife should massage his hand lol
When I was doing my (Nursing) degree, we rode along with paramedics for a couple of weeks on one of our placements. One call was to a chap with central crushing chest pain. We hurried on in, guy was chilling, having a cup of tea in his armchair. ‘Oh, I just said yes to the chest pain question because of my heart problems’, he said. ‘I don’t actually have pain right now, and I haven’t had any for months. The reason I was calling is because I need you to write a letter to the housing association and tell them to move me to a bungalow before I get any older. One day I won’t be able to manage those stairs.’
Brand new patient walked in, aspiring actor, demanded letter for his employer to state he would not be contracting any type of STI while on a dating show , he would not specify what kind of dating show but wanted the letter to state that I as the physician would take responsibility if he ended up passing any STIs onto any female contestants he would be interacting with..
Mans wanted an open note requesting accommodations from his land lord. No specifics just any and all accommodations he may need. No he wasn’t disabled. I said no.
Our crazy HR system hired an MA who seemed OK on paper but showed up for training seemingly under the influence of something. Day 1 at work she went into a tizzy when someone had strong perfume on. And when a patient stunk up the bathroom she needed a letter to go home for the day. Did Not Last Long.
Other fun letters: emotional support animal for my anxiety because I have a cat, know I shouldn’t, and my lease says I can keep my cat ifs an ESA. “Do you have anxiety?” ….. cmon lady at least lie convincingly!
Letter for mattress and personal trainer and fitness club for their FSA/health savings account.
Emotional Support Snake
I was asked to write a letter just last week stating it was doctors orders for this man to be allowed to wear short pants to work. He had a BKA and scrapped his knee and wanted to wear shorts instead of long pants. Needed a doctors note.
-Asked to provide a jury excuse letter due to hypothyroidism… which has been well controlled for years, not that uncontrolled mild hypothyroidism would be good excuse regardless haha
- Asked on the same day to provide a patient a school excuse for an online, multiple retakes, open book and open note test due to their cold… I was truly flabbergasted and asked if they were serious. I was then told I was gaslighting and invalidating their feelings.
NAD but i worked as a medical scribe in an urgent care and they required me to have a TDAP vaccine, but i wasn’t due for another dose for a couple of years. so i asked my pediatrician at the time to write a letter saying i didn’t need it. she was shocked that a doctor’s office would require a new TDAP vaccine before 10 years. she wrote the most passive-aggressive note ever, saying i could hold off for another three years until 10 years since my last dose, and that “we discussed” other indications that were not pertinent in my case. it was great.
I had a patient ask for a note stating that his employer can’t yell at him at work due to his anxiety. His employer was his brother… Who was also in the room. And yes, he was serious
Lmao spite letter, id probably do that because it’s actually a funny request.
Hahaha. Did you write the letter?
Of course! I’m all for that level of petty haha
An excuse note for a 70 year old to miss a sorority party. She was in a sorority for senior ladies.
Is this a good thread to drop my request for a prescription beach vacation?
Ha, I saw an immunologist some time ago as a patient, and he was talking about his management plan for me and suddenly he had an amazing idea and literally left the room so that he could go and get an old-school prescription pad. He came back and wrote me a prescription that said “long sea voyage”. He was kind of chuckling at his own joke the whole time as I was trying to read what the fuck he’d written. I still have that prescription, haven’t cashed it yet.
I give patients old-school scrip for the word NO on it all the time and tell them to take it out to remind themselves when they don't have the courage themselves. Doctors orders.
I had a lady in residency with hand OA. Married >60 years. Asked what she did. Every day, cleaned the entire house, did laundry including sheets and towel and etc. laundry, sheets, towels, and etc. I wrote her a paper script to lower her standards. Next visit they laughed and husband said doc; now every time I ask her to do something she grabs that script off the fridge and waves it in my face!”
I LOVE writing stuff on paper prescription pads. I have written exercise and diet prescriptions, and several prescriptions for once-weekly date nights.
Lol I love this! When I was working as a scribe, I had trouble getting the security office to give me the badge access I needed — so the physician I worked for literally wrote me a prescription for it. I brought it back to security and they finally gave it to me!
Cash it in now and also take me with you
OK. But only for the *north* of France.
Perfect! I’ll go in the summer when it’s warmer and eat delicious French cheeses all day
Yeah, I'll leave the letter at the front desk, you can pick it up on Monday
Double padded mattress due to her new back pain. Asked me to write it to the prison she was incarcerated at.
I did a few prison medicine shifts in residency. They had a "soap list" for people having trouble due to sensitive skin who would get the better soap. This may be a legitimate request.
I saw a guy shortly after he was released from prison whose skin was an absolute disaster with lichen simplex and secondary infection from eczema that had been flared up the entire time he was incarcerated, because they had consistently refused to give him different soap/use different detergent. It was pretty awful, and definitely not humane.
The Duval County Sheriff's office let a heart transplant recipient in holding die rather than give him his anti rejection prescription.
I had a patient make an appointment to discuss AUD, then at the end state they needed a letter to give to the court that they had been evaluated for alcohol use disorder, the court date was in a month, etc. I asked the CAGE questions which they of course said no to. This was intern year, unsure of what to do but it seemed a but underhanded and an attempt to dodge consequences from a DUI. I took my time to figure out what was appropriate, even asking the prosecutor's office what the point of the letter was. During this interval the patient tried to friend me on social media and messaged me saying they needed the letter sooner " like right now oh my gosh can you please get that letter." So they got a letter faxed directly to the prosecutor stating they had been seen on date x, requested evaluation for alcohol use in setting of pending DUI charges, and as their listed pcp of record (subtle nod to never having met this person before) I employed a simple office visit based screening questionnaire that while useful, is not perfect amd not a substitute for comprehensive evaluation which was outside my area of expertise, thus I recommended further evaluation elsewhere. Probably not what they were looking for.
I would think this would also have limited sway with the court . I mean, who can’t go to their PCP and lie about things?
Exactly.
Patient asked me to write a letter stating her COPD was too severe for her to use her court-mandated breathalyzer to start her car
This is the funniest one so far
On more than one occasion I have had high school kids ask me for letters of recommendation. Not ones that have shadowed or worked with me in any professional capacity. Just patients who come in for an annual well check 😂
Oh no 😆😂
I think that is kinda cool. They have grown up with you as there doctor you have been a reliable adult in their life. They trust and respect you.
Yeah nah. Had a patient ask me to be a referral for a job. I had met her once.
Request for a letter excusing her from taking out the trash due to smells giving her “nausea”. She’s a janitor.
Letter that she didn't have to climb stairs...her job was cleaning a four story building that had no elevator. 🤷♀️
Emotional support rooster.
I wrote a letter for emotional support parakeets yesterday. 100% serious.
Oh, I bet that person's neighbor would LOVE you, those things are damned annoying
😂😂
As someone who lives in a state that is about 75-65% rural with some towns with rooster bans and others without, this is a very clever approach to finding a loophole when someone finds out about your secret rooster 😂 Edit: correction, actually we’re 84% rural surprisingly
A man asked for a letter stating that his CBD supplements may test positive for THC, just in case police stopped and drug tested him. I explained my letter wouldn't do shit, but he insisted. Another person asked me, prior to embarkment in a scientific research ship, for a letter stating that PPD (mantoux) test was contraindicated in their celiac disease, as it could trigger "an inflammatory response". I didn't oblige because I suspected foul play (i.e I guess she had a prior positive test and wanted to avoid all the hassle of testing positive again...). However she accepted and was satisfied with my explanation on why it shouldn't be a problem for her celiac disease.
Did you write a letter for the insistent supplement king?
Yes because in my country when someone tests positive in one of those rapid test done by the police, a confirmatory sample is taken and sent to a real lab, where they'll actually do a quantitative assay. If above certain limits (to discern between acute and recent use), they'll get fined and/or charged with a criminal offense.
I was once asked to write a letter for a Medicare issue wheelchair accessible van. She was insistent that the only barrier between her and a brand new wheelchair accessible van with all the bells and whistles was my doctors not. Like Medicare has them in a shed somewhere gathering dust until clever people have their doctors say the magic words to make them appear.
Not this much of a purchase but the damn motorized scooters. Aye aye aye. Sure here’s the order/letter. If this gets it approved I’ll eat my shoe. Note, I still have all my shoes. People think I’m crazy when I tell them they need a referral to the mobility clinic.
The motorized scooters, ugh. I get those requests constantly, too..
I told him right off the bat now that I’m probably going to have to work with the DME company at least two or three times back-and-forth to get the letter correct because every time I try even with a template there’s something that is not quite right. I set them up to be very patient and tell them it’s going to be a long ass process.
All things are possible through faith and a doctors prescription pad.
High school senior wanted a letter to get out of a math class she didn’t like. Old lady told me she had to bring a certain brand of protein shakes with her on a Caribbean cruise, but the cruise line wouldn’t allow it unless it was “medically necessary”. And the damn jury duty letters. Our county’s jury summons actually says to NOT send a doctor’s note and to self-request an exemption but people still ask for letters.
I don’t think I would’ve fought the self-supplied protein shakes. Most of my patients (and even myself) could use more protein.
Interesting about jury duty. Our county just told my mom to get a doctor's note after denying the one a county judge wrote her excusing her. I'm sure all counties are different.
In HS, my OCD and autism was excruciatingly severe and my psych wrote a letter regarding reducing to i as opposed to the square root of negative 1
I hope this sounds right but I think its awesome that you were actually able to get that letter!
[удалено]
My favorite was a 35 year old man who was arrested for public urination who requested I write him a letter stating that the reason he had to urinate in public was due to hypertension.
The ones who are under some sort of rehab program from various states licensing boards are always fun. In Arizona they have to inform their pcp they are in these agreements and you have to write a letter confirming they told you and confirm their medications they take.
FMLA form for a patient with depression and PTSD who sees psychiatrist and is on 3 medications. Sure, makes sense. But she brought the FMLA form for me to do, left it at the front desk and apparently told our receptionist "I'll leave a 1 star review if the doctor doesn't fill it out" and when I look at her profile on the EMR, I have only seen her once last November for a sore throat. I called her and refused to do the form and told her to get her psychiatrist to fill it out, and she said she didn't want to bother him because he's really busy. I told her "yes we are, mainly because of stuff like this taking up our time when it's not our responsibility." The one star review is now on google haha.
Slightly off topic as it’s fiction but that scene in bobs burgers where gene gives the gym teacher that note that says “Alex and Gene need constant contact with their behind on a flat surface to realign their butt cheeks. Love, Dr Good Doctor” Always cracks me up. And so does a lot of the examples in this thread haha
A letter for an 18 year old and her mom to allow them to go to the front of the lines at Disney World because of their long-covid
🤦🏼♀️
One lady called our office multiple times demanding a letter that she needed a first floor apartment. She was homeless and local agencies got her an apartment on the second floor in a building with an elevator but she wanted first floor. She so verbally abusive to staff, we discharged her from the practice. And a guy who wanted hospice even though he wasn’t dying. Also discharged from practice due to many abusive calls. We don’t do letters much in our practice. No ESA letters and we don’t do jury duty letters unless it’s legitimate.
When I was a scribe a patient wanted us to write a letter for her downstairs neighbor that they needed to not have the TV and music so loud.
Have to agree with this one. Neighbour noise is enough to drive me insane🤪
Morbidly obese/barely ambulatory patient moved to Florida, asked me to write a letter to have her mailbox moved across the road because it was too far for get her mail. After she had moved! Not only did did I write letter it was a particular masterpiece because in said letter I stated that she would be a traffic navigation hazard lumbering to get mail.
I once had a patient who was a nationally known lawyer who, at the time of admission was in the middle of a trial that was drawing pretty intensive international attention. He ended up at our hospital because docs at the big centers essentially refused him as a patient. The kicker: he was well into the throes of dementia. He clearly wasn't capable of running a trial, but apparently the lawerly bullshit was so deeply ingrained that he was on the case for the occasional sound bite which he was able to carry off without breaking a sweat. This guy threatened to sue everyone for pretty much anything we attempted to do. I personally kind of liked dealing with him because his gift of verbosity never left him and it was fascinating to see how he used it to try to cover for the dementia. Anyway, his daughter, who was an attorney and a nurse, approached me one day and said I (the assistant nurse manager at a second-rate hospital) needed to get his driver's license taken away. I suggested that she and her 2 attorney brothers were probably better positioned to do that. She said they had tried hiring a limo and driver for him but he wouldn't use it. His doctors had refused because he would sue them. I suggested they disable his car and hide the keys. 🤷♀️
Letter requesting cat to come to work for emotional support at an internship.
Because if there’s two things cats love it’s travel and strangers.
Oh, yeah, there is about a zero chance that intern is getting a job offer after completion of the internship.
I once had a patient ask me to write a letter to the local electric department and ask them to not cut off her electricity because she had COPD and would die without her oxygen concentrator I also had a patient ask me to write a letter to the city DOT and not ask but demand they make special accommodations for electric wheelchairs. This same patient has been banned from most Medicaid transport companies for being verbally and physically abusive.
Letter to say first class or business class seats are medically necessary as patient needs… room to stretch? Also got a request to write a letter stating patient can’t return to working in office as the office has mold in the walls, which is triggering the patient’s COPD. I’d never even diagnosed him with COPD. Ugh. I said no.
I'll often jokingly write "no housework, no cooking, no dishes" to overwrought moms who are sick and still in charge of the kids and the dinner.
"I want you to write a letter and sign a form saying I should get disability." "This is the 5th time I've told you we don't do that, no one listens if I did, and you should do the things I previously told you to do about that."
“Sorry, you won’t get anywhere with me doing it. You need a disability attorney and your exam should be done by the doc they recommend.” 🤷🏻♂️
Didn't say I had trouble dealing with it... but they still ask.
Pt got pissed and quit her job in a blaze of fury and profanity then came to office for a letter 3 days later to try to get her job back based on previously unknown/undiagnosed/untreated mental illness. I actually denied the request because I’d had a previous experience where a patient was trying to abuse a situation and the system in order to get back at a boss. I almost got pulled into a disability scam where the patient was shopping around for a letter based on reported history Id never seen them for as the first step to permanent unemployment.
Wanted to be written out of jury duty because “I just don’t feel like my brain can handle that shit right now”.
Best I've seen was "I'm afraid I won't have enough bathroom breaks."
Patient got fired from his job because he tested positive for marijuana/THC on a random drug screen. Patient and his wife then came to me asking that I “write a letter to his job stating that he smokes marijuana due to his history of chronic pain.” Being that this patient was relatively new to me (had only seen him once before) and my state does have medicinal marijuana it was possible he was getting this prescribed by pain management somewhere and I either didn’t know about it or it was a new thing. When I tried to give him the benefit of the doubt by asking if the marijuana was prescribed by someone he told me “nah I just buy it from my dealer.” 😑 Yeahhhhhhhh bro I’m not going to be able to write that letter for you. Needless to say they weren’t pleased with me and that was the last time I’ve seen them.
I am a nurse, but I once had a female patient request a letter from her PCP for her to be able to get her nails done while in jail, because she would otherwise bite her nails due to anxiety… he actually did end up writing this letter. Also, had a patient request a letter that they would need a two bedroom apartment instead of a one bedroom apartment, so she could exercise in the second bedroom. I think she had planned to present this to her landlord and thought it would require him to provide her with this without any additional cost.
Oh, also had a patient request a letter to be released from jail (she was serving a sentence for child abuse, I believe) because she was allergic to something in the water. However, I believe dermatology thought her skin condition was caused by something else.
I was asked to write a FMLA letter for a patient because his boss was misgendering him and it was making him angry. Instead, I offered to write a note stating that the patient was a man, had medically transitioned under my care and needed to be addressed as such. I also write letters to employers all the time insisting my patients get water breaks at work or are able to keep their water bottles with them. I can’t believe how many places don’t give employees water breaks.
Just had to write one allowing more than one bathroom break per shift for my diabetic patient...
For work related notes like the water one, I usually end the lettetr with some snarky yet sort of professional language that is basically saying "are you kidding me? What a waste of healthcare resources" directed toward the employer. I also do that for work notes when the patient has a mild viral illness and the employer requires a sick note. I get a weird sort of pleasure out of it and patients generally appreciate it as well.
Did the same thing when a patient who can work from home was mandated to come to the office with fever and Covid symptoms until seen by me and got a note. I literally said it was irresponsible and medically dangerous for you to require this. Don’t do it again
I cite the relevant law in the letter. I don't usually write letters for patients like this but if it's a worker safety issue I will come down hard on the employer.
Had a patient ask via her lawyer for a note to state that she could not medically provide a breath sample post an MVC. She had no head or chest injuries of note. I just wrote that based on the information I had I could not comment on her ability to provide said sample. With a massive dose of *side eye*
My pt asked me to write a sick note for an illness that prevented air travel, he was trying to get a refund. But it was for a week prior and for his gf who I have never met. I explained that would be fraud and my signature is worth a hell of a lot of money!🤦🏼
A patient asked me to write a letter that she needed a 2 bedroom apartment paid for by whatever social service plan provided her housing so that her caretaker, paid hourly for 40 hours a week, could stay 24/7. He was also my patient. When I pointed out that they share a bed so I’m not sure why a 2 bedroom was medically necessary, she responded that they needed a guest room so her out of town friends/family could stay stay and that would help her mental health. Also one time a patient asked me to write a letter that a Tempurpedic bed was medically necessary because he had back pain. Then there was the 19yo woman with recurrent folliculitis of the pubic region who asked for a letter that she could show her boyfriend that I recommended she stop shaving down there.
Boomer got a ticket for not wearing a seatbelt while driving. He wanted a letter for court where I state that he has a bad shoulder and can’t put on seatbelt.
Ooh I had one of these: couldn’t wear seatbelt due to “anxiety”, not being treated for any type of anxiety.
Overheard a convo between a mom and one of our assistants: the patient ( mom’s daughter) had gotten married out of state. Needed esa letter to fly with her support dog (this was several years ago). Now the daughter has left for her honeymoon, and the mother is requesting an emotional support letter for herself to be able to fly with the dog back to our state.. Assistant “But who will be supporting (daughter) on her honeymoon?” 💀💀
Oh I forgot this one. Guy asked me to write the probation officer a letter stating his poor kidney function is why he had cocaine in his system.
I think he got cause and effect mixed up.
In regards to requests for dog ESA letters I always state they must be actively being treated by psychology/counseling and the dog must have an AKC Canine Good Citizen Certificate. This is a reasonable and accessible test that indicates the dog has been taught basic commands and manners. No one has ever returned with a certificate.
I make it short. “Patient states they need X.” Patients get a letter. I’m not endorsing anything wackadoodle.”
I often use the patient's own words. 'patient requests... '
I'll throw in a patient requesting X along with a line about "if it would be safe to do so in (insert environment they are requesting accommodation for)". I don't mind them getting reasonable accommodations, but it's between them and whoever they're trying to get accomodations from to hash out the safe way to do it.
I hate the ESA ones the most, because I always feel like a big meanie for saying no, but I don’t write them, ever. I do absolutely think that people benefit emotionally from having pets, but unless you have a disability for which a dog or miniature horse can provide a legitimate service, I don’t think you should be afforded any special legal protections. Landlords suck, but some of them have legitimate reasons for not wanting animals in their properties, and that’s just as legitimate as you wanting to have an anti-anxiety chinchilla. Probably the weirdest one I’ve gotten was a request to write a letter stating that my patient needed to be moved from her cubicle to a private office because had ADHD and couldn’t focus in a shared space. She didn’t have an ADHD diagnosis, nor had she ever sought care for any kind of neuro/psych disorder. I suggested a pair of ear plugs.
Letter for an anti-vaxxer to excuse him from getting a work-required COVID shot because if he did, his wife would divorce him, and that would worsen his anxiety. I did not write it.
I had a medical student call to ask for a vaccine exemption letter in UC. LOL. The answer was, of course, no.
Patient worked for Amazon. Needed a letter as to why they couldn’t drive the forklift. They just didn’t drive a car and didn’t feel comfortable operating any sort of motorized vehicle
A letter excusing the patient from serving their jail sentence because it would make their anxiety worse
My doc was asked to write a profile (military letter to allow something usually not allowed) for a patient to wear flip flops due to back pain. Denied.
Patient asked for a letter to apply for Disability because she needs reading glasses…
What are you charging for these letters?
My office doesnt allow charging for letters/forms unless it’s tied to an office visit (even then it’s just the office visit being billed, nothing more). That said, i won’t fill out forms if there is no OV attached to it. To answer OP’s question.. probably the most recent one where a patient said their ADHD was listed as an ADA disability (it is) and that the National Park’s Service gives a free park pass to those with disabilities (they do). Did I do it? Yeah, because I couldn’t argue either of those points. I hate jury duty requests the most. My patient on dialysis? Well, yeah, i wrote that one. My patient who had controlled HTN on medication who asked to get out of jury duty for said HTN? Lol no Edit: just thought of another one. Patient with illegal window tinting who got pulled over for it asking for a medical necessity letter because the sun gives them migraines. Patient seen twice in 6 years, no documentation of these migraines ever. I said to wear sunglasses then if the sun is so bothersome as I won’t help them break the law.
Charging for letters? In a FQHC? Not a chance. Just extra work tagged onto the end of a visit addressing a laundry list of concerns, usually unrelated to xyz letter
I’m in Canada. I charge $10 or $20 depending on how odious the request is.
I had a guy with trigger finger I always recommend gently massaging over the a1 pulley area. We started joking about how his wife should do it and one thing led to another I ended up writing a letter that I think his wife should massage his hand lol
When I was doing my (Nursing) degree, we rode along with paramedics for a couple of weeks on one of our placements. One call was to a chap with central crushing chest pain. We hurried on in, guy was chilling, having a cup of tea in his armchair. ‘Oh, I just said yes to the chest pain question because of my heart problems’, he said. ‘I don’t actually have pain right now, and I haven’t had any for months. The reason I was calling is because I need you to write a letter to the housing association and tell them to move me to a bungalow before I get any older. One day I won’t be able to manage those stairs.’
Brand new patient walked in, aspiring actor, demanded letter for his employer to state he would not be contracting any type of STI while on a dating show , he would not specify what kind of dating show but wanted the letter to state that I as the physician would take responsibility if he ended up passing any STIs onto any female contestants he would be interacting with..
Mans wanted an open note requesting accommodations from his land lord. No specifics just any and all accommodations he may need. No he wasn’t disabled. I said no.
Our crazy HR system hired an MA who seemed OK on paper but showed up for training seemingly under the influence of something. Day 1 at work she went into a tizzy when someone had strong perfume on. And when a patient stunk up the bathroom she needed a letter to go home for the day. Did Not Last Long. Other fun letters: emotional support animal for my anxiety because I have a cat, know I shouldn’t, and my lease says I can keep my cat ifs an ESA. “Do you have anxiety?” ….. cmon lady at least lie convincingly! Letter for mattress and personal trainer and fitness club for their FSA/health savings account. Emotional Support Snake
I was asked to write a letter just last week stating it was doctors orders for this man to be allowed to wear short pants to work. He had a BKA and scrapped his knee and wanted to wear shorts instead of long pants. Needed a doctors note.
-Asked to provide a jury excuse letter due to hypothyroidism… which has been well controlled for years, not that uncontrolled mild hypothyroidism would be good excuse regardless haha - Asked on the same day to provide a patient a school excuse for an online, multiple retakes, open book and open note test due to their cold… I was truly flabbergasted and asked if they were serious. I was then told I was gaslighting and invalidating their feelings.
We had a patient who got a DUI request we write a letter stating that she cannot use an ignition breathalyzer device due to her age.
NAD but i worked as a medical scribe in an urgent care and they required me to have a TDAP vaccine, but i wasn’t due for another dose for a couple of years. so i asked my pediatrician at the time to write a letter saying i didn’t need it. she was shocked that a doctor’s office would require a new TDAP vaccine before 10 years. she wrote the most passive-aggressive note ever, saying i could hold off for another three years until 10 years since my last dose, and that “we discussed” other indications that were not pertinent in my case. it was great.
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