Almost All Doctors Admit They Work Sick

NBC News
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We’ve all done it — gone to work with a cough or a sniffle or even worse.

Now a new study shows that most health professionals do it, too, even though they know better than anyone that they shouldn’t.

Julia Szymczak at Children’s Hospital of Philadelphia and colleagues surveyed 500 physicians, nurse practitioners, nurses, physician assistants and certified nurse midwives. Virtually all of them agreed that working while sick put their patients at risk.

Yet more than 83 percent admitted they’d done it at least once in the past year. That includes working with a fever, diarrhea and significant respiratory symptoms — not just a sore throat or the sniffles, the team reported Monday in the Journal of the American Medical Association’s JAMA Pediatrics.

Dr. Jeffrey Starke, a pediatrician at the Baylor College of Medicine in Houston, admits he’s done it.

“Of course,” Starke told NBC News. “When I saw the results, I said 80 percent of them admit they work when they are sick and the other 20 percent are lying,” he said, only half-kidding.

“I really do think it’s out of good will and dedication.”

That’s what most of the health care professionals on the survey said. Nearly 99 percent said they worked sick because they did not want to let their colleagues down. Another 95 percent said there were not enough staffers to cover all the work, 92 percent didn’t want to let down their patients, and 64 percent worried their colleagues would think less of them if they called in sick.

“Some respondents described a complete absence of a sick relief system in their clinical area, whereas others were aware that their area had a sick relief policy but reported it was not used in practice,” Szymczak’s team wrote.

“Others suggested that their clinical work area lacked enough staff to make designing a sick relief system feasible. Respondents reported having extreme difficulty finding coverage when they suddenly become symptomatic,” they added.

“One of the things we found very surprising was how much their productivity was an issue,” said Starke, who helped write an independent commentary on the study.

“Physicians who work in hospitals are heavily monitored in terms of productivity,” said Starke. They’re watched to see how many patients they see in a day, for instance, he said.

Infection control experts have been urging Americans for years to stay home when they are sick. Depending on the germ, one sick person can infect several others. People can catch measles just from being in a room where a sick person was — just recently, a man caught measles from walking by a sick baby.

And viruses such as influenza are passed on little droplets that people spread by coughing, sneezing or even talking. They can be picked up in face-to-face contact, or from a shared phone, desk top or communal coffee pot. Norovirus, which causes severe vomiting and diarrhea, is similarly passed fingertip-to-mouth.

Hospitals can be the worst. One South Korean man carried the Middle East Respiratory syndrome virus (MERS) to Seoul and set off a chain of infection that, at latest count, has infected 186 people and killed 33 of them.

“We transmit infections among our own families all the time,” Starke said.

So doctors, nurses and other people working in them should really know better. Why don’t they act like they do?

“There is something called cognitive dissonance, when you know something but act contrary to it,” said Starke. “The problem is, we have competing interests. People in medicine have such dedication, devotion to their patients and their colleagues.”

But health care systems do not help, Starke said. “In the study, people talked about how one of their problems was they couldn’t find someone to do their work for them,” he said. “Why should the person who’s ill have to go out and find someone to cover for them?”

Hospitals and group practices should make it easy to call in sick, Starke said — something that’s supported by infection control experts.

In the meantime, patients should keep an eye out for sick professionals when they are getting treatment. This is especially true for the very vulnerable, such as the elderly and children getting cancer treatment.

“I tell parents, look, particularly if your child is vulnerable, if somebody comes into your child’s room and they have signs and symptoms of a contagious disease, ask them to leave,” Starke said.

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