An unwavering work ethic is a hallmark of many health professionals. But a new survey finds that when a doctor is sick, staunch dedication can have unintended consequences.
A poll of 150 attendees of an American College of Physicians meeting in 2010 revealed that more than half of resident physicians had worked with flu-like symptoms at least once in the last year. One in six reported working sick on three or more occasions during the year, according to the survey conducted by researchers at the University of Chicago Medicine and Massachusetts General Hospital. Notably, when asked whether they believed they'd ever directly transmitted an illness to a patient, nearly 10 percent of respondents answered yes. More than 20 percent believed other residents had passed on an illness to a patient.
The results published in the Archives of Internal Medicine are further evidence of a culture of self-sacrifice long prevalent in medicine. Researchers say a physician's sense of loyalty to already-overwhelmed peers, along with a commitment to patient care, often conflicts with an ethical stance against exposing patients and staff to an illness or compromised performance. Unfortunately, most find health care cultures to be well established and incredibly stubborn.
"Resisting the pressure to work when ill can be particularly difficult for young doctors," said study author Anupam B. Jena, MD, PhD, an internal medicine resident at the Massachusetts General Hospital and an alumnus of the University of Chicago Pritzker School of Medicine. "A work-first, self-second attitude is often seen as ideal among peers, superiors and even patients."
In the first known account of the reasons for the phenomenon known as "presenteeism" among doctors-in-training, more than half of respondents cited obligation to colleagues who'd be forced to cover their duties or an obligation to patient care as the top reasons for not taking a sick day. Far fewer, 12 percent, indicated they'd worked when ill due to concerns their colleagues would think they were "weak" and 8 percent came to work sick because they felt pressured to repay colleagues for coverage.