Doctors feel obliged to work when sick

More than half of doctors admit to going to work with flu mostly out of a sense of obligation to their colleagues and patients, a study finds.

The survey of US trainee physicians found 51% reported working with flu-like symptoms at least once within the past year.

Sixteen per cent reported working sick at least three times during that period.

Out of the 150 resident physicians surveyed, 32 believed there were instances where other sick trainees had infected a patient, while 14 thought they themselves had transmitted an illness to a patient.

The study, published this week in the Archives of Internal Medicine (online), is the first to explore reasons why US trainees choose to work when sick, the authors claim.

“Residents appear driven mainly by a sense of obligation to patients and colleagues, exemplified by higher rates of presenteesim [working while sick] among more senior residents, who traditionally shoulder more responsibility … and therefore may feel pressured to provide care when sick,” the authors wrote.

About 57% of respondents said they felt obliged to work while sick in order to help their colleagues and patients.

Twelve per cent said they worked because they were afraid colleagues would otherwise think they were weak.

Doctors balanced these obligations against concerns that they would infect patients or not perform at their best, the authors wrote.

“High rates of presenteeism highlight that the current balance of these values is in favour of coming to work sick.”

Medical leaders needed to identify and address presenteeism better, by teaching that “refraining from work while ill is the best and most professional way to ensure responsible and safe care for patients”, they added.

There had been little research into whether medical staffers were contributing to rising rates of hospital-acquired infections, the authors said.

Archives of Internal Medicine 2012; online.