Why Most Clinicians Work While Sick

when the doctor is sick
A recent study shows that many physicians and advanced practice clinicians (APCs), including registered nurse practitioners, midwives and physician assistants, report to work while being sick despite recognising this can put patients at risk. In a survey of attending physicians and APCs at the Children's Hospital of Philadelphia, respondents reported working with symptoms that included diarrhoea, fever and the onset of significant respiratory symptoms. The findings are published in JAMA Pediatrics.

The survey was conducted by Dr. Julia E. Szymczak, a postdoctoral fellow at the hospital's Division of Infectious Diseases and Centre for Paediatric Clinical Effectiveness, and colleagues. They wanted to have a better understanding of the reasons why attending physicians and APCs in the U.S. work even when they are sick. Previous studies have shown that healthcare-associated infections can lead to substantial illness and death and excess costs. This is especially true for immunocompromised patients and others at high risk, including neonates. 

Survey responses were received from 280 physicians (61 percent) and 256 APCs (54.5 percent). Although most respondents (504, 95.3 percent) believed that working while sick put patients at risk, 446 respondents (83.1 percent) reported working while sick at least once in the past year and 50 respondents (9.3 percent) reported working while sick at least five times.

Primary reasons why physicians and APCs reported working while sick included not wanting to let colleagues down (98.7 percent), staffing concerns (94.9 percent), not wanting to let patients down (92.5 percent), fear of being ostracised by colleagues (64 percent) and concerns about the continuity of care (63.8 percent).

Also, an analysis of written comments about why respondents work while sick highlighted three areas:

  • Logistic challenges in identifying and arranging someone to cover their work and a lack of resources to accommodate sick leave;
  • A strong cultural norm in the hospital to report for work unless one is extremely ill; and
  • Ambiguity about what symptoms constitute being "too sick to work".

"The study illustrates the complex social and logistic factors that cause this behaviour. These results may inform efforts to design systems at our hospital to provide support for attending physicians and APCs and help them make the right choice to keep their patients and colleagues safe while caring for themselves," the authors conclude.

Source: JAMA
Image credit: Pixabay

References:

Szymczak JE et al. (2015) Reasons Why Physicians and Advanced Practice Clinicians Work While Sick. JAMA Pediatrics, July 6, 2015; DOI: 10.1001/jamapediatrics.2015.0684

Published on : Sat, 11 Jul 2015


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healthmanagement, healthcare associated infections, JAMA, doctor survey, sick leave, advanced practitioners A recent study shows that many physicians and advanced practice clinicians, including registered nurse practitioners, midwives and physician assistants, report to work while being sick despite recognising this can put patients at risk.

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