Posted on Mar 27, 2019
How much authority does a leader have to mandate when a soldier can make medical appointments? Can they order them to miss/cancel it?
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I work shift work in a hospital. So everyone’s work schedule is irregular and all over the place.
At the beginning of the year the floor NCOIC informed us that we are not allowed to make appointments on days that we work and that if we do, for what ever reason, will be ordered to cancel/miss it?
We are allowed to swap two shifts a month and can request days off (RDO), so long as they are requested 6-8 weeks in advance. Clinics only schedule 8 weeks in advance.
This make scheduling an appointment extremely difficult or impossible. We have to try and schedule in that two week gap from the clinics availability and the RDO deadline or we can’t make an appointment at all if a) no one will swap, b) our schedule is published, or c) if the clinic isn’t making appointments for that time frame yet.
I understand why the floor requires that due to laws regulating patient-to-staff ratio and I believe that people should be mindful of their work schedule when making an appointment.
The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation.
At the same time what are service members to do when nothing is available to them? Do they forego treatment? Does “patient care comes first” not apply to people are both employees and patients at the same facility?
Does the NCOIC or anyone for that matter have the authority to deny someone a medical appointment? Can you be ordered to cancel/miss your appointment?
An example of this is; I’m having to forego a good chunk of Physical Therapy’s recommendations because my schedule is already out until May and I work majority of the days PT wants me to attend a specific rehab class for my shoulder.
At the beginning of the year the floor NCOIC informed us that we are not allowed to make appointments on days that we work and that if we do, for what ever reason, will be ordered to cancel/miss it?
We are allowed to swap two shifts a month and can request days off (RDO), so long as they are requested 6-8 weeks in advance. Clinics only schedule 8 weeks in advance.
This make scheduling an appointment extremely difficult or impossible. We have to try and schedule in that two week gap from the clinics availability and the RDO deadline or we can’t make an appointment at all if a) no one will swap, b) our schedule is published, or c) if the clinic isn’t making appointments for that time frame yet.
I understand why the floor requires that due to laws regulating patient-to-staff ratio and I believe that people should be mindful of their work schedule when making an appointment.
The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation.
At the same time what are service members to do when nothing is available to them? Do they forego treatment? Does “patient care comes first” not apply to people are both employees and patients at the same facility?
Does the NCOIC or anyone for that matter have the authority to deny someone a medical appointment? Can you be ordered to cancel/miss your appointment?
An example of this is; I’m having to forego a good chunk of Physical Therapy’s recommendations because my schedule is already out until May and I work majority of the days PT wants me to attend a specific rehab class for my shoulder.
Medical
Leadership
Posted 5 y ago
Responses: 10
SPC (Join to see)
Yes, no, kind of.
Your leadership can absolutely direct you to schedule appointments that are deconflicted with work. At the same time, as happens often, if the only available appointment time conflicts with work the leadership should absolutely make a exception to the policy.
The secret to making that work, Honesty and communication.
The SM has to honestly try and get a deconflicted appointment time, and communicate to the leader that no deconflicted appointment time slots were available.
The Leader should honestly listen and evaluate the impact of the SM being gone from place of duty for the appointment time and if manageable, allow it, even it makes things difficult.
With low density MOS's and short filled UMR's that can be a challenge at times.
If your the only Radiology Tech in the Peds unit this week, it would not be ok to have you gone to a appointment this week. And the policy of no appointments during scheduled work time would be upheld. If as the leader I was able to borrow an Xray Tech from another department to cover your appointment time I would make the exception and happily send you on your way.
Yes, no, kind of.
Your leadership can absolutely direct you to schedule appointments that are deconflicted with work. At the same time, as happens often, if the only available appointment time conflicts with work the leadership should absolutely make a exception to the policy.
The secret to making that work, Honesty and communication.
The SM has to honestly try and get a deconflicted appointment time, and communicate to the leader that no deconflicted appointment time slots were available.
The Leader should honestly listen and evaluate the impact of the SM being gone from place of duty for the appointment time and if manageable, allow it, even it makes things difficult.
With low density MOS's and short filled UMR's that can be a challenge at times.
If your the only Radiology Tech in the Peds unit this week, it would not be ok to have you gone to a appointment this week. And the policy of no appointments during scheduled work time would be upheld. If as the leader I was able to borrow an Xray Tech from another department to cover your appointment time I would make the exception and happily send you on your way.
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SSG Dave Johnston
Sargant Major; As a retired 68W30, I take issue with this attitude from the NCOIC of the Ward/Floor:
1. "At the beginning of the year the floor NCOIC informed us that we are not allowed to make appointments on days that we work and that if we do, for what ever reason, will be ordered to cancel/miss it?".
2.The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation.
Yes, the SM is assigned to a Ward/Floor in a Hospital, yes there are duties and responsibilities that have to be meet, however, SM's are also required to take care of themselves and if this SM's NCOIC is unable to adjust, or rewrite the DA-6 duty roster to allow the SM to make scheduled Medical appointments that shows, to me, that this NCO is really not what you want or need in a Medical facility.(No Compassion to an injuried Soldier). We, as 68W's are not allowed to be unsympathetic or inflexible to the needs of both our patients and our subordinates; and for the NCO/NCOIC to be so inflexible to the staff [he/she]supervises that they would aggravate an existing injury or deny medical treatment???
"I’m having to forego a good chunk of Physical Therapy’s recommendations because my schedule is already out until May and I work majority of the days PT wants me to attend a specific rehab class for my shoulder." NOT GOOD...for either the NCO or the SM
It would appear that this NCO/NCOIC is inflexable with [His/Her] staff that they are willing to forgo the medical care required of a subordinate to avoid redoing a DA-6, or themselves cover the hour of two needed by the SM to make their appointment.
1. "At the beginning of the year the floor NCOIC informed us that we are not allowed to make appointments on days that we work and that if we do, for what ever reason, will be ordered to cancel/miss it?".
2.The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation.
Yes, the SM is assigned to a Ward/Floor in a Hospital, yes there are duties and responsibilities that have to be meet, however, SM's are also required to take care of themselves and if this SM's NCOIC is unable to adjust, or rewrite the DA-6 duty roster to allow the SM to make scheduled Medical appointments that shows, to me, that this NCO is really not what you want or need in a Medical facility.(No Compassion to an injuried Soldier). We, as 68W's are not allowed to be unsympathetic or inflexible to the needs of both our patients and our subordinates; and for the NCO/NCOIC to be so inflexible to the staff [he/she]supervises that they would aggravate an existing injury or deny medical treatment???
"I’m having to forego a good chunk of Physical Therapy’s recommendations because my schedule is already out until May and I work majority of the days PT wants me to attend a specific rehab class for my shoulder." NOT GOOD...for either the NCO or the SM
It would appear that this NCO/NCOIC is inflexable with [His/Her] staff that they are willing to forgo the medical care required of a subordinate to avoid redoing a DA-6, or themselves cover the hour of two needed by the SM to make their appointment.
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SGM Erik Marquez
SSG Dave Johnston - Your speaking to points I did not.
The poster presented what I call a math word problem.
A simple question surrounded by many words.
You spoke to the words, I spoke to the question "How much authority does a leader have to mandate when a soldier can make medical appointments? Can they order them to miss/cancel it?"
As to the non question verbiage..yes I agree it does read like the NCOIC is making blanket policies with no flexibility in an environment that all but demands flexibility (and more work on the NCO's part) to work well.
The poster presented what I call a math word problem.
A simple question surrounded by many words.
You spoke to the words, I spoke to the question "How much authority does a leader have to mandate when a soldier can make medical appointments? Can they order them to miss/cancel it?"
As to the non question verbiage..yes I agree it does read like the NCOIC is making blanket policies with no flexibility in an environment that all but demands flexibility (and more work on the NCO's part) to work well.
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SSG Dave Johnston
SGM Erik Marquez - … The question posted presents a very interesting premise concerning "Authority" vs. a SM's responsibility to maintain themselves physically fit to include 'rehab'. I believe the 'Poster' presented an actual issue that they are dealing with and they are looking for advice to respond to the NCO/NCOIC's inflexibility. Just my thoughts.
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The key is deconfliction. Of course, you have to show a genuine attempt at deconfliction before you go over the head of your NCOIC.
Ask for a printout of all the appointments available for you over the next 2 to 4 weeks. Take that to the ncoic and ask him which ones are okay. Ask for schedule of the class your physical therapist wants you to attend and run that by your ncyc as well.
Your ncoic cannot deny you seeking medical treatment. He should be capable of arranging the schedule several weeks ahead to accommodate your classes. If he refuses to oh, at that point you have two options.
Option one, make the appointments provide him with the appointment slips and even send an email calendar invite. If possible, find someone who is willing and capable I'm switching your shift. If the ncoic brings this to his Commander in order to push for Article 15, you have plenty of proof to show that you made all allowances possible for your leadership to accommodate your medical needs, and that you were being denied medical treatment.
Option 2, ask your ncoic to place the denial in writing for you. Then, take that denial to your company Commander with your grievance. At the same time, you could also take that to IG and explain that you have made all attempts to work with your leadership for medical treatment, but you are being denied medical treatment
Ask for a printout of all the appointments available for you over the next 2 to 4 weeks. Take that to the ncoic and ask him which ones are okay. Ask for schedule of the class your physical therapist wants you to attend and run that by your ncyc as well.
Your ncoic cannot deny you seeking medical treatment. He should be capable of arranging the schedule several weeks ahead to accommodate your classes. If he refuses to oh, at that point you have two options.
Option one, make the appointments provide him with the appointment slips and even send an email calendar invite. If possible, find someone who is willing and capable I'm switching your shift. If the ncoic brings this to his Commander in order to push for Article 15, you have plenty of proof to show that you made all allowances possible for your leadership to accommodate your medical needs, and that you were being denied medical treatment.
Option 2, ask your ncoic to place the denial in writing for you. Then, take that denial to your company Commander with your grievance. At the same time, you could also take that to IG and explain that you have made all attempts to work with your leadership for medical treatment, but you are being denied medical treatment
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1SG (Join to see)
^^^What he said. Do your best to make it work.
I'll add that it is important to document your efforts and communications, electronically, or in writing. If there is a risk for long term negative consequences to your physical health, state it. If you're on profile, you're likely to be on profile for a longer period, state it. If there is a risk that you could end up facing a PEB, state it. Permanent profile....etc., etc.
Save the documentation to use, if needed.
I'll add that it is important to document your efforts and communications, electronically, or in writing. If there is a risk for long term negative consequences to your physical health, state it. If you're on profile, you're likely to be on profile for a longer period, state it. If there is a risk that you could end up facing a PEB, state it. Permanent profile....etc., etc.
Save the documentation to use, if needed.
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SSG Dave Johnston
1SG (Join to see) - "The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation. Communication??? R i g h t!!!
This NCOIC has issues, the 68W career field should have NCO's that are accommodating to situations that develop with both patients and staff, and adjust. We, as 68W's are not allowed to be unsympathetic to the needs of both our patients and subordinates and be so inflexible to the staff we supervise that we would aggravate an existing injury.
This NCOIC has issues, the 68W career field should have NCO's that are accommodating to situations that develop with both patients and staff, and adjust. We, as 68W's are not allowed to be unsympathetic to the needs of both our patients and subordinates and be so inflexible to the staff we supervise that we would aggravate an existing injury.
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1SG (Join to see)
SSG Dave Johnston Glad you asked, so I could clarify what you may have missed. I'll restate.
Stop complaining about the supervisor, and schedule the appointment. The Soldier can act like he's in a civilian job, where you either figure it out, or you get fired or quit. Act like a part of the team, if you know the personnel staffing and scheduling issues, so the supervisor isn't bothered with making avoidable changes to the schedule.
After trying to work ot out, then take it to the supervisor for assistance, and/or clarification as to whether the supervisor is really going to force the Soldier to miss treatment, and document that, if it happens.
Yes, the supervisor has issues. One issue may be having to make a schedule, change it, then change it again, because Soldiers aren't taking the scheduling issues into consideration or just not may an additional effort to take care of it themselves.
Another issue may be a habit of Soldiers to ask whether something a leader does is lawful, permitted, within the authority of, etc., rather than trying to come up with a solution to deconflict the situation.
I didn't advise the Soldier to permit himself to have the injury aggravated.
The supervisor could be wrong (and would likely be) by canceling an appointment. However, the Soldier would be wrong, and in jeopardy of UCMJ if the Soldier elected to go to the appointment, despite what was ordered.
If you don't know thos NCO personally, you don't know whether he has issues based solely on this post. As you only have part of the information.
It is possible to be sympathetic, and demanding.
The Soldier should not aggravate the injury by not completing the recommended physical therapy. Finding a solution is the answer.
Trying to determine if the NCO has some legal authority, before one gives their supervisor the opportunity to make a decision to change the schesule regarding their specific issue because the Soldier believes him to be unsympathetic, is not the answer.
The post wasn't clear with regard to what the supervisor was unsympathetic about. Some may have inferred, but it wasn't stated whether the unsympathetic talks were related to medical appointments.
Stop complaining about the supervisor, and schedule the appointment. The Soldier can act like he's in a civilian job, where you either figure it out, or you get fired or quit. Act like a part of the team, if you know the personnel staffing and scheduling issues, so the supervisor isn't bothered with making avoidable changes to the schedule.
After trying to work ot out, then take it to the supervisor for assistance, and/or clarification as to whether the supervisor is really going to force the Soldier to miss treatment, and document that, if it happens.
Yes, the supervisor has issues. One issue may be having to make a schedule, change it, then change it again, because Soldiers aren't taking the scheduling issues into consideration or just not may an additional effort to take care of it themselves.
Another issue may be a habit of Soldiers to ask whether something a leader does is lawful, permitted, within the authority of, etc., rather than trying to come up with a solution to deconflict the situation.
I didn't advise the Soldier to permit himself to have the injury aggravated.
The supervisor could be wrong (and would likely be) by canceling an appointment. However, the Soldier would be wrong, and in jeopardy of UCMJ if the Soldier elected to go to the appointment, despite what was ordered.
If you don't know thos NCO personally, you don't know whether he has issues based solely on this post. As you only have part of the information.
It is possible to be sympathetic, and demanding.
The Soldier should not aggravate the injury by not completing the recommended physical therapy. Finding a solution is the answer.
Trying to determine if the NCO has some legal authority, before one gives their supervisor the opportunity to make a decision to change the schesule regarding their specific issue because the Soldier believes him to be unsympathetic, is not the answer.
The post wasn't clear with regard to what the supervisor was unsympathetic about. Some may have inferred, but it wasn't stated whether the unsympathetic talks were related to medical appointments.
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The Commander can do pretty much anything (s)he wants regarding your medical appointments, and is held responsible for the results, both good and bad. Floor NCOIC is not the Commander. Unless the Commander has specifically delegated the authority to cancel your appointment, the floor NCOIC cannot cancel them himself. He CAN put in place a policy regarding appointments and availability, however if that policy effectively prevents you from obtaining full and proper medical treatment, than his policy is not viable and needs to be re-worked.
But it is entirely possible his policy is workable. You have to request days off 6 weeks in advance - when is the schedule published? If it is published 5 weeks out, then you have all but one week of scheduling availability. If it is published 2 weeks out, ask (respectfully) why you have to submit 6 weeks out when the schedule won't be published for a month, explaining (tactfully) the problem this creates with trying to take care of yourself (as you are supposed to do within the Soldier's Creed - you aren't slacking, you are fulfilling your responsibilities). Then ask if there is any leeway, or you can get a regularized schedule so that you can better plan medical appointments.
Try to make this a collaborative effort, where you are working to fulfill your NCOIC's needs (work your shifts) and he is fulfilling yours (availability for appointments and ability to schedule).
If none of that works, then go above him to the next higher step in the CoC and explain the situation. Work your way up to 1SG and CO, if necessary. But at the CO, it stops, because (s)he is the one who ultimately has that authority and responsibility.
Also, make SURE that as you work up the chain, it is a "seek guidance"/ "ask for help with ME" conversation and NOT a "tattle" / "ask for help with that mean NCO" conversation. The former will get leaders invested, the latter gets shut down real quick, in most cases. Tact and respect (to include respect for your Floor NCOIC) go a LONG way here.
But it is entirely possible his policy is workable. You have to request days off 6 weeks in advance - when is the schedule published? If it is published 5 weeks out, then you have all but one week of scheduling availability. If it is published 2 weeks out, ask (respectfully) why you have to submit 6 weeks out when the schedule won't be published for a month, explaining (tactfully) the problem this creates with trying to take care of yourself (as you are supposed to do within the Soldier's Creed - you aren't slacking, you are fulfilling your responsibilities). Then ask if there is any leeway, or you can get a regularized schedule so that you can better plan medical appointments.
Try to make this a collaborative effort, where you are working to fulfill your NCOIC's needs (work your shifts) and he is fulfilling yours (availability for appointments and ability to schedule).
If none of that works, then go above him to the next higher step in the CoC and explain the situation. Work your way up to 1SG and CO, if necessary. But at the CO, it stops, because (s)he is the one who ultimately has that authority and responsibility.
Also, make SURE that as you work up the chain, it is a "seek guidance"/ "ask for help with ME" conversation and NOT a "tattle" / "ask for help with that mean NCO" conversation. The former will get leaders invested, the latter gets shut down real quick, in most cases. Tact and respect (to include respect for your Floor NCOIC) go a LONG way here.
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