Every emergency department visit ends the same way: “Be sure and check in with your primary care provider!” The patient, with a wad of discharge instructions in her hands, nods dutifully, wondering when in the world — between work, taking care of the kids, their extracurriculars, trying to get homework done, and dinner on the table — there’ll be time to get to the primary care provider.

Strict US corporate attendance policies don’t allow for much wiggle room. According to the Bureau of Labor Statistics, the average number of days missed by any general employee is 3.6. This does not include the 2 or 3 sick days employees take per year, which is apparently the max taken, even when employees have access to 6-20 sick days.

Those are just the “well” employees. A recent poll by the Harvard T.H. Chan School of Public Health, Boston, conducted among a national sample of US employees, found that 58% of employees in the US report having physical chronic health conditions, with many structuring their healthcare to account for their jobs or going without.

Notably, more than one third of employees with chronic conditions (36%) say they have skipped medical appointments or delayed getting care to avoid interfering with work in the past year. And 49% of those with chronic conditions say that in the past year, they felt they could not take time off work or take a break while at work, even though they needed to because of their conditions.

Of course, these statistics fail to account for those dealing with equally impactful chronic health conditions that affect them from a mental or psychological standpoint. Regardless of the genesis of a worker’s chronic challenge, what’s the role of the clinical community in helping these patients better balance their illnesses in the workplace?

Provider Understanding Leads to Advocacy

Ellen Feldman, MD, a psychiatrist with Altru Health System of Grand Forks, North Dakota, said the most effective partnership begins with trust between doctors and patients, which grows through meaningful connection.

“When providers take the time to understand a patient’s life beyond their diagnosis, they build relationships that improve engagement, follow-through, and clinical outcomes.”

Physicians should approach each patient interaction with curiosity — asking about patients’ daily lives, responsibilities, and emotional experiences, Feldman said. For instance, a patient with chronic pain may be quick to report physical symptoms but hesitant to share the deeper toll on their self-esteem or relationships. “Understanding these things can be integral to tailoring care that feels both relevant and supportive,” Feldman said.

Feldman noted that patients can be encouraged to stick with their health goals when they clearly understand their health plan.

“Patients managing chronic conditions alongside work, caregiving, or other responsibilities often face competing priorities,” Feldman said. “If they don’t fully understand the rationale behind a care plan, they may understandably deprioritize their health,” she said.

Training in health literacy, patient education strategies, and culturally competent communication equips the clinician to bridge that gap. “Providers who can explain complex information in plain language — and understand enough about those in their care to tailor recommendations to their patients’ lives — are much more likely to gain buy-in,” Feldman said. “And always invite questions. A patient who feels safe asking questions is more likely to leave the appointment with clarity — and return with confidence.”

This is especially true in chronic disease management, where knowledge can reduce fear around symptom flare-ups, improve day-to-day decision-making, and enhance overall quality of life. However, once the patient is sufficiently healthy and well educated enough on their condition to return to work, what happens next?

Functioning Safely and Sustainably at Work

One key step is proactively securing medical work accommodations that don’t just comply with the Family and Medical Leave Act (FMLA) or the Americans with Disabilities Act (ADA) but are also tailored to help patients function safely and sustainably in their roles.

“As a practicing physician, I see firsthand how chronic illness silently erodes both workplace productivity and patient dignity,” said Daniel Cham, MD, MBA, former Harvard research fellow and current owner of the medtech startup NexGen Innovative Solution in Oakland, California.

“Too often, patients delay treatment or miss appointments — not due to negligence but because they fear job loss, stigma, or workplace inflexibility. Physicians must champion work-health integration by advocating for employer education, flexible scheduling, and robust care coordination.”

“We also need to streamline treatment plans — using tools like asynchronous telehealth, home-monitoring kits, and mobile health check-ins — to make care more accessible without requiring full days off work. Our role extends beyond the clinic: Partnering with HR [human resources] leaders and occupational health teams to build chronic disease-friendly workplaces improves both health outcomes and retention,” said Cham.

Charles Sweet, MD, MPH, a board-certified psychiatrist practicing out of Linear Health in Austin, Texas, said normalizing conversations around challenges is one of the most important things doctors can do to help their patients.

“We play a critical role in helping patients with chronic conditions manage their health, which significantly impacts their work lives,” Sweet said. “One of the most impactful things we can do is normalize conversations about work challenges during clinical visits. By asking how a patient’s condition affects their job, and vice versa, we can better tailor their treatment plans to be both medically effective and practical while also ensuring sustainability.”

Other suggestions clinicians offered included flexible scheduling, designated personnel to help with documentation for workplace accommodations under the ADA, and encouraging the use of FMLA when applicable. Sweet said, “Proactive communication with care teams and employers (with patient consent, of course) can prevent crises that lead to missed appointments or medication lapses.”

Ultimately, when patients feel supported in both medical and occupational spheres, adherence to treatment plans improves and so do health outcomes.

“As a psychiatrist, I often see how chronic health issues — whether physical or mental — directly impact a person’s ability to function at work,” said Anoop Singh, MD, a psychiatrist at Mindpath Health in San Francisco.

Some patients push through symptoms because they’re afraid to ask for time off or accommodations, which can worsen their condition and lead to missed appointments or crises, Singh said. “Clinicians can play a key role by normalizing these conversations, helping patients advocate for workplace flexibility, and adjusting care delivery, like telehealth or outside-work-hour visits, to support continuity.”

Singh said sometimes even the smallest gesture can make an employee managing a chronic condition in the workplace feel more “seen.”

“Even brief interventions — like a medical letter or discussing workplace stress — can make a meaningful difference in outcomes.”