EARLY CAREER:
WORKING WHILE SICK
The vast majority of doctors and other trained medical profession- als at a hospital went to work while sick within the past year, even though they realized the risk that decision places on patients, according to a recent study.
In fact, almost 1 in 10 hospital clinicians worked while sick at least five
times in the past year, primarily because
of staffing concerns or not wanting
to let colleagues down, reported Julia
Szymczak, Ph.D., and her associates
at the Children’s Hospital of Philadelphia (JAMA Pediatr. 2015 July 6 [doi:
10.1001/jamapediatrics.2015.0684]).
“A combination of closed- and open-ended questions illustrated that the decision
to work while sick was shaped by sys-tems-level and sociocultural factors that
interacted to cause our respondents to
work while symptomatic, despite recognizing that this choice may put patients
and colleagues at risk,” the authors wrote.
Of 929 surveys sent out, 538 clinicians
completed them, which included 280 of
459 physicians (61%) and 256 of 470
advanced-practice clinicians (54.5%).
The advanced-practice clinicians included
registered nurses, physician assistants,
clinical nurse specialists, registered nurse
anesthetists, and certified nurse midwives.
Of those who responded, 15.7% worked in
intensive care, 13.1% in surgery, 12.5% in
general pediatrics, and 44.8% in another
pediatric subspecialty.
Although 95.3% of respondents believed
working while sick put patients at risk,
83.1% reported having done so at least
once in the past year. Further, that proportion included 52% of all respondents who
reported coming to work sick twice in the
past year and 9.3% who worked while ill
at least five times in the past year.
Nearly a third of respondents said they
would work even if they had diarrhea
(30%), while 16% said they would work
with a fever, and 55.6% would work with
acute respiratory symptoms, including
cough, congestion, rhinorrhea, and sore
throat.
But doctors were more likely than oth-
WHY DO HOSPITAL
DOCTORS GO TO
WORK SICK?
IN THEIR OWN WORDS ►
Attending physician, pediatric subspecialty: “Our division does
not have any systems in place to support physicians calling out sick.
So on the occasions where I have called out sick, it was a disaster:
Patients were not called to reschedule, phone calls were not forwarded, etc.”
Attending physician, emergency department: “There is an unspoken understanding that you probably should be on your deathbed
if you are calling in sick. It inconveniences colleagues, is complicated to pay back shifts, and makes me look bad to do so (like I am
weak or something). It is much, much less stressful to suck it up and
come in sick than call out.”
Attending physician, ICU/critical care: “There is no reliable
mechanism to have another person cross-cover on short notice. Everyone is busy. If a person is not on service, he/she is usually doing
something that is not easily disrupted. I feel extremely guilty about
needing someone else to cover me due to an illness.” n
From JAMA Pediatr. 2015 July 6 (doi: 10.1001/jamapediat-
rics.2015.0684). Quotes are from a cross-sectional, anonymous
survey administered to 459 attending physicians and 470 advanced-practice clinicians.
