• I like physicians! I really do!

    I have been accused of being too hard on physicians in this blog. I find that ironic, given that I am a physician, my father is a physician, my co-workers are physicians, my friends are physicians, etc. Whatever. I’ll keep poking them with a stick. That’s how I show my love.

    But never let it be said that I can’t say nice things about docs. For instance, here’s a nice little study in JAMA: “Why Physicians Work When Sick“:

    Despite ongoing attention to rising rates of hospital-acquired infections and efforts to stem this growth, limited focus has been given to whether physicians and other health care personnel contribute to workplace transmission of illness by choosing to work when ill. Presenteeism —the act of working while ill—has important implications for health care personnel, whose repeated interactions with patients make productivity declines from illness more dangerous and disease transmission more likely. While the pressure to work while ill is common across all health care workers, the demand among resident physicians may be particularly great due to pressure from peers and lack of an adequate system of coverage. Most residents report coming to work when sick at least once annually, with rates varying little according to sex, specialty, or hospital. These results suggest that presenteeism is ubiquitous and not confined to specific specialties or hospital cultures. Despite evidence that most residents work when ill, little is known about the reasons they choose to do so.

    Methods

    We conducted a paper-based, anonymous, in-person survey of 150 resident physicians present during the 2010 meeting of the American College of Physicians, Illinois chapter. The sample included residents from 20 internal medicine programs in Illinois. We asked residents whether they worked with flulike symptoms in the prior training year and, if so, their reasons for doing so.

    The findings?

    More than half of residents reported working while sick in the last year. The top reasons for doing do were basically obligations to their colleagues and obligations to patients.

    I’m not advocating this as an acceptable practice. I think there’s an argument to be made that by coming to work while sick, the residents are putting their patients at risk for catching whatever illness is affecting them. But it’s nice to see that it’s a sense of duty that still drives physicians to put the needs of others over themselves.

    Oh, and for the record, more female residents reported patient needs as the reason they came to work while sick than male (65% versus 49%). Just saying.

    @aaronecarroll

    UPDATE: Yes, I know it’s a small sample size, and questionably generalizable. I also know some results aren’t significant. Can’t you just let me say something nice and leave it at that? 🙂

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    • Interesting. I am a current 3rd year internal medicine resident writing this comment as I’m sitting home sick. It took quite a bit for me to call in, though, as I’d worked through the previous 3 days (including a 24 hour call). My attending basically had to order me to call in coverage yesterday. This was my first time calling in sick in 3 years despite working sick previously.

      For me, a big portion of it was feeling guilty about calling in a colleague to take my place on the wards. I only speak for myself, but I also think there is a strong “ain’t no mountain high enough” mentality among residents and a bit of pride in trying to make it through residency without calling in sick.

      Our program operates under a fairly strong shared responsibility for patient care, so that wasn’t quite as big of a factor. But thanks for the kind words J