Scott talks about a bit of medical theater, in which companies demand doctors notes to allow people to bring in their own chairs to work; he is often the person in best position to provide that note, despite being a psychiatrist who usually works remotely. He’s knows little about back pain and nothing about chairs. His compromise has been to write out a note saying “[Patient] reports back pain that would be improved by a chair they have chosen.” This shouldn’t work because he’s not adding any additional information to the patient’s complaint, but it does.
I had my own experience with this in my first real-world programming jobs. The overhead lights in my office gave me a headache, so I turned them off. Someone noticed and didn’t think it was fair my roommate be forced to work in the dark (although he said he hadn’t complained). I indeed had to go to the doctor, who dutifully wrote out “Elizabeth says the lights give her headaches…”. Luckily I had fabulous health
care insurance and flexible hours at my job, so this was a minor annoyance.
I really disliked the way the company handled it though. Their solution was a lamp, which was fine, but there was a lot of pressure to say either “yes, the problem is entirely solved” or “no, it is definitely not solved.” “Can I take a week to see if I develop a headache?” was not an option. I don’t think I even got to pick out my own lamp.
Several years later I had a similar problem at a different large tech company you have definitely heard of, one known for being an amazing place to work. I hated working in an open office and tried to leverage my post-dental-surgery fragility into a private office or the right to work from home. In retrospect, this was not a reasonable accommodation: despite having offices in 50 countries and running much of the world’s telework infrastructure, that company’s workflow was set up for in person communication. But they couldn’t just say that, so they tried to find ways to meet the letter of my doctor’s note without actually giving anything up. This was a problem because what I really wanted was control over my environment, and that was the exact thing they didn’t want to give me.
I think a thing that’s going on with the notes is that gatekeeping makes sense in some circumstances (such as the company buying a braille keyboard for a blind programmer), and it was no skin off the decision-maker’s nose to make that a universal rule. “Protection from lawsuits” factors in, but if companies were paying the cost of the note they would draw the line in a different place. As it stands, it’s worth infinite amounts of your time and money to avoid risk of a lawsuit that might cost them either.