Many doctors who tell sick patients they should take a day off from work and rest are not taking their own advice, according to a survey conducted by the Children's Hospital of Philadelphia.
The study, which was done to investigate reasons why doctors prefer to work when sick instead of staying at home, involved 280 attending physicians and 256 advanced practice clinicians. Respondents were interviewed from January 15 to March 2014, and the survey results are published in the journal JAMA Pediatrics on July 6.
According to the survey, although 95.3 percent of the doctors agreed that working while sick may put their patients at risk, 83.1 percent reported having worked while sick at least once; and 9.3 percent reported to work when sick at least five times in 2013. The respondents, particularly attending physicians, said they had worked when suffering from diarrhea, fever and onset of respiratory symptoms.
Respondents offered various reasons for deciding to work even when they were sick. The first is they did not want to let their colleagues down, a reason cited by majority (98.7 percent) of the respondents.
Concerns about staffing and finding other doctors to fill in for them was the second most frequent reason offered by 94.9 percent of respondents. These are followed by not wanting to let their patients down (92.5 percent), avoiding being ostracized by colleagues (64 percent) and providing continuity of care to patients ( 63.8 percent).
"Our division does not have any systems in place to support physicians calling out sick. So ... I would have to make a decision about the risks of being contagious vs the certain knowledge that my division will not appropriately handle me being out," an attending physician wrote.
"There is an unspoken understanding that you probably should be on your deathbed if you are calling in sick," another attending physician wrote. "It inconveniences my 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,"
Other doctor respondents said sickness has varying degrees, and it is not clear when it becomes "too sick" to work.
"It is hard to know when to draw the line between a little sick but well enough to see most patients and sick enough that we present an unreasonable risk to patients," one respondent wrote.
Dr. Jeffrey Starke from the Department of Pediatrics of Baylor College of Medicine in Houston believes sick health care workers put patients at a real risk, particularly those who are immunocompromised such as transplant and cancer patients, Reuters reports.
"Most of us have policies restricting visitation by visitors who are ill, we screen them for signs or symptoms, yet we don't do the same thing for ourselves," he told Reuters.
He said hospitals should develop policies restricting health care workers who are sick to prevent risking the health of patients. Such policies, according to him, should allow other people to determine who is well enough to report to work, a decision that doctors shouldn't make on their own.
"Creating a safer and more equitable system of sick leave for health care workers requires a culture change in many institutions to decrease the stigma associated with health care worker illness. Identifying solutions to prioritize patient safety must factor in workforce demands," Starke wrote in an editorial regarding the survey results.
"We can predict that these issues will be most difficult during the respiratory viral season, so advanced planning is crucial," Starke added.
