One of the most time-honored medical philosophies is “First, do no harm.” It means that the most important ethical practice is to make sure we don’t harm our patients as we try to help them get better. Yet it seems when it comes to illness, many doctors forget that vow: we go to work even when sick — exposing our own patients to our own germs — when we really shouldn’t be within miles of our hospitals and offices. Why? A new study in JAMA Pediatrics tried to find an answer. Researchers surveyed more than 500 doctors, nurse practitioners, and physician assistants. More than eight in 10 admitted going to work when they were sick, even though they knew they could be spreading germs to those who they were to be taking care of. And we’re not talking about going in to see patients with a mild case of sniffles. Those surveyed admitted working even when they were suffering from a fever, cough or diarrhea. The only things that seemed to keep sick providers out of the hospital or office was vomiting, and even in this case 5 percent said they still would try to gut it out and go to work. (No pun intended). How about a 100 percent yuck! The reasons for this stubbornness/foolishness were many, and included: – 99% said they didn’t want to let their colleagues down, and cause them to have to work harder. – 92% said they didn’t want to let their patients down by not showing up. – 64% said they were worried their co-workers would get angry at them for bailing out of work. – 56% said their bosses (executives) wouldn’t understand or would be upset with them for taking a sick day. It was also interesting that the study noted that a substantial number of physicians are employed by hospital systems and work on a productivity basis — meaning you don’t work, you don’t make money. Taking that to a local basis, there is at least one major hospital system in the Denver area that does not provide “sick days” to their employed physicians — meaning you take a day off for illness, you lose income for that day. Researchers offered a variety of solutions to the problem, such as more available staffing and backup; better support from administrators; and so forth. Nonetheless, the bottom line remains that the mindset of being indispensable needs to change. What good does it do anyone if we don’t care of ourselves — and make you sick in the meantime? A doctor coming in and sneezing all over the place isn’t just disgusting, it’s bad medicine. “Do as I say, not as I do” just doesn’t cut it when it comes to health — yours and mine. Source
