July 14, 2015
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Physicians working sick despite health risk to patients

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Many physicians and advanced practice clinicians work while sick regardless of the health risks they pose to patients, according to a survey published in JAMA Pediatrics.

“This descriptive survey investigates the frequency with which and reasons why attending physicians and advanced practice clinicians at a single hospital provide clinical care while sick,” Julia E. Szymczak, PhD, of the division of infectious diseases at The Children’s Hospital of Philadelphia, and colleagues wrote. “These health care workers work with possibly contagious symptoms despite recognizing that this choice puts patients at risk.”

image of Szymczak, Julia

Julia Szymczak

 

The researchers anonymously surveyed 459 attending physicians and 470 advanced practice clinicians at the hospital during a 2-month period in 2014. Sixty-one percent of the physicians and 54.5% of the clinicians responded for an overall response rate of 57.9%.

The researchers found that almost all of the respondents (95.3%) recognized working while sick puts their patients at risk. However, a majority of the physicians and advance practice clinicians (83.1%) responded that they worked sick at least once in the last year despite this risk.

The survey found that a significant amount of respondents reported that they would work while sick with symptoms associated with infectious disease. Results indicated that 55.6% of respondents would work while experiencing acute onset of significant respiratory symptoms; 30% responded they would work while having diarrhea and 16% with fever.

The reasons cited for working while sick included fear of letting colleagues down (98.7%), staffing concerns (94.9%), fear of letting patients down (92.5%), because others work while sick (65%) and fear of being ostracized by colleagues (64%).

Study researchers concluded that health care workers feel pressure to work when sick because of systems-level and sociocultural factors. They recommended realistic and clearly defined sick leave policies that account for the reality that health care workers may work with potentially infectious diseases due to these sociocultural reasons.

“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,” Szymczak and colleagues wrote.– by David Costill

Disclosure: The researchers report no relevant financial disclosures.