You go to the doctor’s office when you’re sick, but should a doctor come to the office when they’re not feeling well?

Apparently, most healthcare workers show up for work even when they’re under the weather.

A new survey published in JAMA Pediatrics explored the reasons why these employees would drag themselves into the office and consequently expose patients to their illnesses. 

Julia E. Szymczak, Ph.D., a researcher at the Children’s Hospital of Philadelphia, and her team conducted an anonymous survey at the hospital. In total, 538 healthcare workers participated. That included 61 percent of attending physicians and 54 percent of advanced practice clinicians.

About 83 percent said they worked while ill at least once during the past year. Slightly more than 9 percent said they worked sick at least five times. About 95 percent of the participating workers said they believe that working sick put patients at risk. 

The respondents said they worked when they had symptoms such as fever, diarrhea, and the onset of respiratory symptoms. If they had acute onset of respiratory symptoms, 55 percent said they’d still show up to work while only 5 percent said they’d work if they were vomiting. Nearly 75 percent said they would go to work with a cough or runny nose. 

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Why They Come Into Work

So, why did healthcare workers come into the hospital when they were sick?

Nearly 99 percent said they didn’t want to let colleagues down while 95 percent said staffing concerns were an issue. Slightly more than 92 percent said they did not want to let patients down.

About 64 percent said they were afraid about being disliked by colleagues and nearly the same amount had concerns about continuity of care. 

Other concerns, such as if hospital executives are supportive of the sick leave policy, was an issue for about 56 percent of respondents. About 65 percent said they work sick because their colleagues did the same.

Dr. Keith Roach, a physician at Weill Cornell Medical College and New York Presbyterian Hospital in New York City, said the healthcare specialists surveyed are highly dedicated professionals who want to help their patients.

“This desire may overwhelm our good sense,” he said.

Roach thinks a primary reason healthcare workers do their job when they’re sick is because they do not want to leave colleagues short-handed.

“I think this is an important study because it allows us to challenge these assumptions and design practices that allow ill healthcare workers to take sick time off without adversely affecting quality of care,” Roach said.

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What Needs to Change

In an accompanying editorial on the study, Dr. Jeffrey R. Starke, a professor at Baylor College of Medicine, said medical settings must change their culture to create a more equitable and safer system for medical workers to take sick leave.

“We can predict that these issues will be most difficult during the respiratory viral season, so advanced planning is crucial,” Starke noted. 

He advised looking more into barrier protections so workers who are sick but not yet experiencing symptoms cannot pass their illnesses on. 

Starke said that strong administrative and physician leadership, as well as creativity, will be vital to ensure adequate staffing and to support sick leave when appropriate. Occupational health officials must also better identify what counts as being too sick to go to work.

“Hospital leadership must ensure that the culture supports a paid sick leave policy that is adequate and nonpunitive,” his statement said.

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