10/19/2026
"Doctor how on earth can you suggest light duty when he is doing PT twice a week, has an open wound on his leg, uses a cane, and is on pain medication?"
Sometimes you can explain the rules of the game from day one, and the worker still won't accept them when it's time to play.
At the very first visit, the doctor explained that returning to work would be part of his treatment plan.
Not full duty. Not before it was medically appropriate. But eventually, they would work toward getting him back to work safely.
He understood.
Fast forward three months.
His injury was healing, he was participating in physical therapy, and the doctor determined he could return to modified duty with appropriate restrictions, such as seated work only, and keeping the wound covered.
His family was not happy.
They questioned how the doctor could possibly recommend light duty while he was still healing, attending PT, and managing his wound.
The doctor explained again that returning to modified duty doesn't mean someone is fully healed.
In fact, appropriately modified work can be part of the recovery process.
But they wanted another opinion.
And the doctor respected that decision.
Here's the difficult part of Occupational Medicine.
You can educate. You can explain the evidence. You can set expectations early. You can communicate with compassion.
And the worker and their family may still reject your recommendations.
Our concern is what happens next.
Will the next physician continue emphasizing functional recovery and safe return to work?
Or will the worker remain off work simply because he hasn't completely healed?
We've seen how prolonged work absence can become a pathway to unnecessary long-term disability.
And it's frustrating when you recognize that possibility early but cannot prevent it.
However, we've learned something important.
Our responsibility is to provide sound medical recommendations, explain the reasoning, and give the worker a clear path toward recovery.
Our responsibility is not to make everyone agree with me.
Sometimes you have to be comfortable knowing you practiced good Occupational Medicine, even when the patient chooses a different path.
Because the goal was never to win an argument.
The goal was to help someone recover their function and get their life back.
