FFE Magazine

Why are doctors so guilty of working while sick?


It has happened to most of us, we go to see our doctor just to be examined by our family physician who look sicker than we are.


The results of a small survey published online by JAMA Pediatrics suggest that many clinicians show up for work when sick, despite knowing that this could put patients at increased risk.


Infections occurring while a patient is being treated can significantly exacerbate their illness and also lead to increased costs. Previous studies have shown that sick health care workers are the main source of influenza, Staphylococcus aureus andNorovirus within health care facilities.


Newborn babies and people with compromised immune systems are known to be especially at risk from these infections, which can prove fatal.


To find out why physicians and advanced practice clinicians continue to work while sick, despite the risks, researchers at the Children’s Hospital of Philadelphia, PA, polled workers at their hospital in an anonymous survey.


A total of 280 attending physicians and 256 advanced practice clinicians – including registered nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives – completed the survey.


The vast majority of respondents – 95.3% – agreed that patients are put at risk by health care providers working while sick. However, 83.1% of respondents reported working while sick at least once in the past year, and 9.3% reported working while sick at least five times.


Physicians and advanced practice clinicians reported the following reasons why they continued to work while sick:

  • Not wanting to let colleagues down (98.7%)
  • Staffing concerns (94.9%)
  • Not wanting to let patients down (92.5%)
  • Fear of being ostracized by colleagues (64%)
  • Concerns about the continuity of care (63.8%).


Resourcing, stigma and culture of ‘soldiering on’ contribute to problem


Analyzing the comments provided by respondents, the researchers found three main areas that drive health care providers to continue working while ill. These are logistical or resource problems with arranging for someone to cover their work, a culture of reporting for work unless extremely ill, and ambiguity over what symptoms make someone too sick to work.


The authors write:


“The study illustrates the complex social and logistic factors that cause this behavior. These results may inform efforts to design systems at our hospital to provide support for attending physicians and [advanced practice clinicians] and help them make the right choice to keep their patients and colleagues safe while caring for themselves.”


Dr. Jeffrey R. Starke, of the Baylor College of Medicine, Houston, TX, and Dr. Mary Anne Jackson, University of Missouri-Kansas City School of Medicine write in an accompanying editorial that a culture change is required in order to decrease the stigma associated with not turning up for work when ill.


To do this, they argue that health care workers require a “more equitable system of sick leave.”


“Identifying solutions to prioritize patient safety must factor in workplace demands and variability in patient census and emphasize flexibility,” they add. “Also essential is clarity from occupational health and infection control departments to identify what constitutes being too sick to work.” With Medical News Today





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