Why are doctors getting down with the sickness?

docs Doctors might as well drop the Hippocratic oath and start using the USPS creed, because they don’t let such petty things as the flu or diarrhea get in the way of their calling. The bad news is that instead of following their calling so overzealously, they should be calling in sick. According to a recent survey at the Children's Hospital of Philadelphia, which found that most doctors feel a moral obligation to report to work when they are sick even though they are aware that they may be doing their patients more harm than good. “There is an unspoken understanding that you probably should be on your deathbed if you are calling in sick. It inconveniences my colleagues, is complicated to pay back shifts, and makes me look bad to do so (like I am weak or something),” one of the doctors who took the survey wrote. “It is much, much less stressful to suck it up and come in sick than call out.”

This and other 900 anonymous responses from attending physicians and ‘advanced practice clinicians,’ such as nurse practitioners, physician assistants, clinical nurse specialists, nurse anesthetists and nurse midwives, were collected early in 2014 by researchers with the hospital’s infectious diseases division and published, along with other results, in the Monday 6th edition of JAMA Pediatrics. “Working while sick was common,” report author Julia Symczak wrote. “Systemic, logistic and cultural factors combine to create a climate in which respondents perceived that they have no choice but to work while sick despite recognizing that this choice puts patients at risk.” A little over 95% of doctors polled said they believed working while sick endangers patients. However, about 83% reported coming to work with symptoms at least one time during last year; more than 50% did it 2-4 times, and 10% reported doing so 5 or more times. Additionally, 55.6% said they would work with cough, congestion, sore throat and other respiratory symptoms, while 30% would work with diarrhea. Over 90% of respondents cited concern that they would let down co-workers and patients, or that the hospital would be understaffed as reasons for not taking sick days.

On the other hand, about two-thirds were afraid they would be shunned by their workers, and of course, there was the age-old rationalization that they do it because others do it. More worrisome is the fact that more than half said hospital management was “not supportive of the sick leave policy.” And equal number of doctors said that it wasn’t clear how sick is too sick to work. “Determining what constitutes being too sick to work is complicated” Dr. Jeffrey R. Starke of the Baylor College of Medicine and Dr. Mary Anne Jackson of the University of Missouri-Kansas City School of Medicine wrote in an accompanying editorial. They added that “creating a safer and more equitable system of sick leave for HCWs requires a culture change in many institutions to decrease the stigma—internal and external—associated with HCW (healthcare worker) illness.” Until that happens, “dedicated HCWs will likely continue to come to work when mildly ill, especially when they identify their role as being essential for care and unique within the institution.”

Or as one of the hospital’s pediatricians put it, “Over the past few years, our hospital has increasingly become a place where everyone is expected to work at peak capacity at all times, and there is minimum redundancy or give to accommodate acute illness. As such, we all feel pressured to deny our own needs (often giving up meals, bathroom breaks, and, yes, caring for our own illnesses) in order to continue to meet the high pressure/high demand/productivity expectations of the healthcare system.” What’s next? Doctors wearing adult underwear so they don’t have to go the bathroom? Not only working harder than mailmen (or the Mailman) but they are also expected to pull a Michael Jordan in Game 5 of the 1997 Finals – the legendary Flu Game. The difference is that MJ was not a doctor – nor was Dr. J for that matter – and did not work at a hospital where healthcare workers can spread several infections to immunocompromised patients during routine activities.


Related Read:

- C'est difficile: Superbug kills 29,000 a year