Slashdot Mirror
Most Doctors Work While Sick, Despite Knowing It's Bad For Patients
An anonymous reader writes: A new survey published in JAMA Pediatrics found that 95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year." The researchers doing the survey dug into the reasons for this: first of all, given the heavy workload of most doctors, it's very difficult to find others who can take up the slack when one is recovering from an illness. Beyond that, the profession is pervaded by a culture of working through the discomfort and pain of minor maladies. According to a commentary on the research, hospital policies don't help matters — they often incentivize long hours and don't encourage ill workers to leave the premises.
...I can agree this is totally true. Calling in sick does nothing but make my life harder. I feel bad about it, but from a job perspective, the alternative is piss off your co-workers who have to cover for you and get tagged with the reputation that you're lazy and trying to avoid work. Combine that with the need to get a doctor's excuse (another doctor; can't write your own), and it's just not worth it.
While it is true that there are doctors working while they themselves are not feeling well, you guys gotta understand that doctors have to face sick people ALL THE TIME, which means they have higher chance of getting infected with diseases, which means they have to spend more times feeling unwell
It is always so easy to criticize someone of doing something but why is it there is no mention of what makes that someone do that something in the first place?
"More than 95 percent believed that working while sick puts patients at risk, but 83 percent still said they had come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year."
I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk. Maybe in London (where Reuters is based) there are enough doctors working for the central government mandated health industry that sick doctors don't feel the pressure to come in. However, it looks like in Philadelphia (where the data was collected) there aren't enough doctors. I know that my medical doctor friends go to work sick, since the risks associated with someone catching a cold is much greater than the risks associated with not seeing a medical provider. In some places in rural New Mexico, you get to drive for 2+ hours to see a similar specialist. My urban Albuquerque isn't as bad, but things are still pretty backed up and doctors usually schedule months in advanced for routine things.
They might. The current system does not necessarily give them incentive to _do_ what's best though. Still, modern medicine beats whatever is in second place by a long long way.
Ideology: A tool used primarily to avoid the bother of thinking.
If a doctor contaminates patients, then the economic value of his work day is probably negative.
I noted the point of high workloads, but it just suggests that we need more doctors, and that subsiding would make sense.
Doctors are paid per service, they take the time off they don't get paid.
If they have a small practice then it is their whole staff that won't work that day so it is also 2 - 4 more people missing work. And those don't get paid nearly as well as the Doctor so they will really hurt.
If something is so important that you feel the need to post it on the internet... It probably isn't that important.
Plus they could get to treat their patient again for whatever illness they gave them. Bonus!
Any insufficiently advanced magic is indistinguishable from technology.
My dad is a pediatrician (retired), and this is true.
Doctors' offices and hospitals are full of people who carry infections. You already have a high chance (probably around 30%) of coming out with an additional disease to the one you went in with, both from transmission from other patients, and through medical error. One more sick person (the doctor himself) hardly makes a difference.
Maybe a little exaggerated, but not entirely. I work in technology, same employer for nearly 16 years, and we get PTO instead of vacation/sick time. Company policy is that you can take your PTO whenever you like for any reason (or no reason at all).
I've been dinged severely for "taking too much unplanned PTO" on performance reviews. In addition, my boss one year negatively called out a "lengthy unplanned absence", despite the fact that I was in the hospital after having a heart attack.
Seriously, if there aren't enough doctors it doesn't matter how good they are, enjoy waiting a month to get emergency* treatment from an overworked doctor who's only going to spend 5 minutes with you. If you drastically reduce the requirements for becoming a doctor, then you'll get prompt treatment from a well-rested doctor who can afford to spend a good long while with you and still charge you less. Sure, they'll make some mistakes... but so do current doctors. Requiring less training might actually reduce the number of mistakes. Especially if the mistakes were of the class of waiting too long due to busy schedules, patients avoiding the hassle, doctors going to work sick/tired, or any of the various effects of not enough doctors.
* there's some conditions that are serious enough that you ought to receive immediate treatment, but don't officially qualify as emergencies.
Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
Pilots don't want to use checklists either, but they put up with it because the checklists are written by other pilots and not HR folk, administrators or medical students given a task because everyone else is too busy.
It is slowly happening in some areas (trauma medicine) because it's being done well and being rejected in others because it is not.
Exactly like every single other profession? Seriously. Name one job which doesn't encourage you to go in to work even when you are sick.
This is the work ethic that is pounded into residents and interns.
You MUST work, regardless of sleep deprivation, personal trauma, or contagious illness.
(That is why I became an engineer, rather than a doctor like my father and my grandfather.)
Since there isn't enough staff to cover your absence.
I'm not feeling the best tonight myself
But there are only 4 aides and 2 nurses listed on the online schedule and another one of the PM crew working half the NOC shift
full staff for nights is 1 nurses and 7 aides or 1 nurse and 8 aides
They study for long hours without adequate sleep so they can learn to teach their patients how to live healthy lives. Then they get abused in the residency programs and work for less than minimum wage for 80 -100 hours per week. Then they finally finish and start to practice and have to work long hours without bathroom breaks, food breaks, or just letting off steam. They're getting screwed by insurance companies and hospital administrators at every turn. I'm amazed anyone still wants to go to med school in this country.
>"95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms"
If they are following universal precautions, it won't matter if they are sick or not... (yes, I work in healthcare). If they don't know this, they are not doing the right things.
Pilots don't want to use checklists either
Nonsense... a good pilot WANTS to use a checklist, the cockpit tends to reach the site of a crash first...
Humans are not perfect, more than once I've missed something trying to do it from memory or seen someone else do it, including high time experienced pilots.
A good training program will weed out the "I've got it, I've got it" attitude... No, no you don't... use the checklist...
Modern aircraft are too complicated to have it all perfect in your head every time, 100% of the time, in any situation. You should know your checklists and you should practice with them, but you should still pull them out and use them.
From a pure, selfless ethics point of view, the question is: Will humanity be better off if I go into work today or not?
Some things that may be going through doctors' heads when they decide whether to call in sick or not:
If I am sick and go in, then there's an increased chance of:
* me infecting others, and all that that implies
* me making a mistake that is worse than not being there at all
* Others perceiving me as not knowing/not following "the rules," which may impact my future career, which may negatively impact the future of the patients you would have had but won't have.
If I am sick and stay home, there's an increased chance of:
* A patient of a co-worker getting inferior care because my co-worker was covering for you
* A patient of a co-worker getting inferior care because my co-worker was tired because he covered for me in an earlier shift
* Others perceiving me as "not pulling my weight" and "wimping out," which may impact my future career, which may negatively impact the future of the patients I would have had but won't have
Similar thought patterns probably apply to most people in most careers.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
It seems unfair to me to pick on them. All allied health professionals are expected to work whether they are sick or not. It is just the result of the prevailing Judeo/Christian work ethic. Catholics seem to be the worst as personal sacrifice is expected by their beliefs, science be damned.
For example, one of the first things that got discarded was our previously secular hospital's very sane policy of forgiving a sick call by working an extra shift after being placed under the management of a Catholic institution. Apparently to their mind, if you can walk you can work.
In the meantime hospital acquired infections continue to be on the rise, and in many cases more deadly.
Time is what keeps everything from happening all at once.
I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk. Issues were either googled, or simply told to take some antibiotics and come back if it gets worse (ie the reboot). When you look at how much a modern economy spends on healthcare, I think there is room for a different health model which is a lot cheaper and more efficient.
holy christ this. IANADBIAMTO (I am not a doctor, but I am married to one). She is the worst patient in the world. The absolute worst.
Not all modern medicine is the same and IMHO, it is in decline in the U.S.
In the U.S. we have the most expensive healthcare by far, but the result is among the worst in the 1st world. It's rapidly approaching the point where we could replace doctors entirely with an expert system that walks the diagnostic tests then prescribes the most expensive drug at the end of the tree. Clinical diagnosis is dead.
That just seems to imply that doctors shouldn't be trained to work stupid-long immune system destroying hours, should be overstaffed (not understaffed) to allow for frequent sick days, etc.
That would be nice but it cannot realistically happen without a single payer government run health care system. Since that is a political impossibility it seems unlikely to happen. Furthermore, low staffing levels are sometimes an economic or functional reality. If you work in a rural area, odds are good there is no backup. Long hours? That's not unusual in a lot of professions including programming. Given the almost limitless need for medical care I don't really see doctors ever working short hours. It's just not a 9-5 sort of profession. Overstaffing will not lower medical costs - quite the opposite. So how do you propose to overstaff AND reduce the already outrageous cost of medical care in the US without going to a government run medical system? That's just not economically realistic.
In other words, double the number of medical schools, reduce the on-call stress that hurts the immune system and reform the residency system.
Doubling the number of medical schools will not necessarily have your desired effect and cannot be done overnight. For one, who is going to teach in them? Basically the only people qualified to teach doctors are other doctors. It would take a generation or two at minimum to double the number of med schools. And how do you do it without lowering standards? I can assure you that the lawyers would LOVE it if standards for doctors were lowered.
As for reforming the residency system, I agree completely there. My wife is a MD and the residency system is a soul crushing hazing ritual from a bygone era that needs reform drastically. The biggest problem with it is that the residents are funded primarily by the government so they are essentially free labor to the hospitals they work in. So the hospitals use them as hard as possible to save money on their own bottom lines. It's a huge profit center which makes it very hard to reform.
Maybe also get rid of the concept that doctors are so much smarter/more honorable than the poluace instead of just having a different skillset.
Just as soon as ambulance chasing lawyers cease to be a thing. Doctors ARE quite frankly held to a standard that you probably are not in your job and I certainly am not in mine. They have to constantly be considering whether they will be sued because most are at some point. My wife has to write all her reports bearing in mind the non-trivial possibility that she may have to defend it in a courtroom. She can even do everything properly with the best standard of care and she still is likely to get sued at some point. Her. Personally. Do you have to worry about that constantly in your job? I'm guessing probably not. Do you have to buy expensive liability coverage? I'm guessing probably not. Doctors ARE held to a higher standard than most other professions. People are extremely unforgiving of mistakes in medicine despite the fact that such mistakes are 100% inevitable because the human body is incredibly complex and we don't understand a lot about it.
I am a medical doctor, and work in a government owned hospital. That makes me kind of a civil servant. I get paid per month, not per patient/treatment.
I completely recognize my colleagues and myself in this report. One doesn't call in sick, unless one has 39,5C fever or isn't capable of driving the car to work.
Financial interest has nothing to with this, your remark reflects your utter ignorance for the matter and lacks any form of humour.
Are you claiming there are no doctors who get paid per visit or per service offered? Because unless that is the case, your remarks reflect your utter ignorance for the matter.
Even for you and your colleague who never calls in sick, I doubt there are no financial interests at play. Do you have a limited number of sick days? Do you have to take vacation days after those sick days are exhausted? Are you compensated at the year's end for unused sick days? Are your sick days and vacation days all combined into a single PTO group? Does your hospital not keep enough staff on hand to cover for sick doctors? If you said "Yes" to any of these questions then there are financial interests at play.
These issues are either caused by financial interests, ignorant doctors, or doctors who don't care about their patients' health. I am betting on the first, and would be very sad if you think it is one of the two latter explanations.
-- All that is necessary for the triumph of evil is that good men do nothing. -- Edmund Burke
FYI, but you may be interested to know that the AMA does not have quite the monopoly on producing new physicians that you think.
There is actually a second source of physicians in the U.S., the American Osteopathic Association. Just after the civil war, Osteopathic Physicians (who carry the D.O. degree instead of M.D.) split off from mainstream medicine. While initially a fringe movement focused on Osteopathic Manipulation practices, over time it eventually evolved into a full-fledged "second track" for producing physicians of pretty much all different types. Since then, D.O.s have been growing in number, and unlike M.D.s the majority enter the primary care fields (Family Medicine, General Internal Medicine).
Note that this is a distinct USA phenomenon, as Osteopaths in other countries are not licensed physicians and are more like chiropractors.