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Please excuse the following tirade.

So I had to ask a patient to leave the clinic just now, and not to come back. This happened literally 30 minutes ago. Here is why.

Our local public transit workers are unionized, like most government employees. This means that they generally can’t be fired no matter how lazy and incompetent (leading to “rubber room“-ish situations), among other generous benefits such as about 5 weeks of vacation every year, free healthcare with zero copay, and unlimited sick days.

You read that right. Unlimited sick days. If they go over their paid sick day limit, they often employ overtime strategies to make up for the difference — and the indifferent management couldn’t care less. After all, the union actually isn’t unionized against management.

And this person, this… what is the term I should be using… anal opening, yes let’s go with that… is here every single week for a work excuse. I am not exaggerating. Every single week.

He has no real health issues, mind you. His excuses range from a backache to an upset stomach to, today, a toothache. That’s right, he wanted the taxpayers to pay him to sit at home because of a toothache… if he even had one. And he wanted more days off.

Oh, did I not mention that he had already been given three days off by the ER for his “toothache,” at taxpayer expense? On top of taxpayers funding every single one of these ridiculous doctor and ER visits?

When I mentioned that all this goldbricking might get him in trouble, he even bragged that he can’t get in trouble as long as he has a valid doctor’s note. Union rules.

So I gave him one day off and sent him on his way. But then he immediately came back because he had a problem with that. He accused me of being unprofessional and neglecting my duties as a doctor by not giving him more days. Because he knows all about work ethics.

At that point, I told him I would then do what I really should have done as a health care professional to begin with. I tore up the note right in front of him and asked him to leave the premises.

The smug feeling of entitlement of this public-union stool sample, with no real health problems, sucking up health-care resources when I have a waiting room full of real patients with real problems… being quite content to have my tax dollars subsidize his loafing at home, with quite literally more days out sick than working (I checked his past notes), and contributing to our local mass transit system sliding ever further into a morass of delays, disrepair and all-around indifference…

The moral character of a patient should never play a role in their health care. That is an iron-clad rule. If he had actually been sick, I would have gladly done anything I could to help him. Same as a serial killer, really. But “helping the sick” is not the same thing as “lying on an official legal document.” That is not covered by the Hippocratic Oath, it turns out. And I regret that I had to fire him for malingering.

To those in the private sector. How many paid days off do you get a year? Like, five, right? I bet for many of you, the answer is “zero.” Guess what? Your payroll taxes are going to people like this to sit at home, a remote in one hand and a blunt in the other. And public-union people like this brag about it.

It’s pretty rare for me to fire a patient. I reserve that mainly for people who have leveled threats against me or the staff, or who are what we call “malingerers.” Sadly, it was clear that a working doctor-patient relationship was not existent here as 1) he was not being truthful, 2) he was not seeking actual health care and 3) he was seeking other benefits that had nothing to do with his health or his well-being.

This is the textbook definition of malingering. It is a bigger problem with ERs than here, but as you can see, we still get our fair share. And this one was enabled by his public-sector union and the outrageous stunts they let him get away with.

The problem with public-sector unions is who they are unionized against. Labor unions were initially developed to protect blue collar workers in private, for-profit industries who need a say against the shareholders. That is who they are in opposition to: not the management. The shareholders, who are the true owners. That’s actually the beauty about private-sector unions. Don’t like ’em? Sell your stock in UPS or Ford, and you don’t have to deal with ’em. Simple as that. And if the private union demands too many benefits and tanks the corporate profits, the company folds, and therefore so does the union.

Now tell me this: who are the “shareholders” when it comes to the city and state government? Not the “management” of the Mayor and the Governor and so forth. That’s not who they are unionized against. They actually work against the shareholders. And who do you think that is?