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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.

15 of 191 comments (clear)

  1. As a physician... by NigelTheFrog · · Score: 5, Interesting

    ...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.

    1. Re:As a physician... by Anonymous Coward · · Score: 5, Interesting

      I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.

      Also as an employee as opposed to a fee for service type physician, there is still the drive to work as to not pass your work onto other physicians. Its part of the mentality of "I can work through anything" similar to why you hear about surgeons working for 30+hrs straight.

    2. Re:As a physician... by gurps_npc · · Score: 5, Insightful
      I can tell you that as just an office worker, I get PISSED when my co-worker comes in with a cough, I know I will end up getting it.

      I would rather work harder and longer hours today than have to take off a day myself (and possibly come in a day or two when I am recovering myself).

      I know of NO ONE in my office that doesn't think people should stay home when we are sick.

      Of course, it helps that I work for a law firm that is more concerned with obeying the law than most work places.

      I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.

      It is truly a shame that hospital management is so penny-wise/pound foolish as not to insist on generous sick time.

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    3. Re:As a physician... by PopeRatzo · · Score: 5, Insightful

      Calling in sick does nothing but make my life harder. I feel bad about it

      There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.

      The corporatists have done a number on your head. Resist it.

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    4. Re:As a physician... by Anonymous Coward · · Score: 4, Interesting

      Cry me a river. The reason why physicians have to work so hard is because the AMA deliberately keeps the supply of doctors small, and deliberately ensures that health care can only be dispensed by their overpaid members. Hospitals and insurance agencies have their own rent seeking arrangements. And half the time, patients come out sicker than they go into the hospital.

      Physicians are a necessary evil. Some of them even have good intentions going into the profession. Don't expect any admiration simply for your job title or your self-inflicted working hours. Oh, and your conduct sounds irresponsible.

  2. Title is stupid by Anonymous Coward · · Score: 5, Insightful

    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?

    1. Re:Title is stupid by Actually,+I+do+RTFA · · Score: 5, Insightful

      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. In other words, double the number of medical schools, reduce the on-call stress that hurts the immune system and reform the residency system. 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.

      Medicine is pretty poorly done in, well, the US. Maybe the whole world, but I have no idea how other countries train doctors.

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  3. What's worse? by brian.stinar · · Score: 5, Informative

    "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.

  4. Re:Coincidentally... by jellomizer · · Score: 4, Insightful

    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.

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  5. Re:Coincidentally... by jd2112 · · Score: 5, Funny

    Plus they could get to treat their patient again for whatever illness they gave them. Bonus!

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  6. You need crappier doctors by penguinoid · · Score: 5, Interesting

    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.

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  7. It's expected by JazzHarper · · Score: 4, Insightful

    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.)

    1. Re:It's expected by Moof123 · · Score: 5, Insightful

      Medical school hours and conditions looks like a giant hazing ritual. Plenty of science shows it is dumb and make all mortal humans more error prone. Somehow the medical profession thinks they are super-human (or must act as if they are) and put their patients in increased danger from fatigue and apparently illness as well.

      Listening to an NPR piece on residency some months back sounded really pathetic. The pervasive attitude was that it made you a better doc, and since everyone else went through it then I have to too. Someone needs to get through that the emperor has no clothes and this is just stupid.

      In the end my experience with docs is they are all pretty darn human, and all this hazing and stupid over-work ethic does nothing more than give them a false sense that they are not.

  8. It starts in med school. by mark_reh · · Score: 4, Insightful

    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.

  9. Re:Doctors always know best by FlyHelicopters · · Score: 4, Informative

    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.