[amdelamar]

It really boils down to trust. My manager trusts I will make up lost time after my doctor's appointment, as they generally know if I've been falling behind work or not. We also give daily standup status updates so its obvious if work isn't progressing after some time.

This also works in reverse. If I work on Sat/Sun for some system maintenance then my manager tells me to swap time off during the week. But in my experience, What usually happens is I work my full week anyway because something important arose and I push that "time off" to the next week until I forget I had it.