Working While Sick: Why Doctors Don't Stay Home When Ill

Jennifer Nelson

November 04, 2022

Before the pandemic, physicians came to work sick, as people do in many other professions. The reasons are likely as varied as, "You weren't feeling bad enough to miss work," "You couldn't afford to miss pay," "You had too many patients to see," or "Too much work to do."

In Medscape's Employed Physicians Report: Loving the Focus, Hating the Bureaucracy, 61% of physicians reported that they sometimes or often come to work sick. Only 2% of respondents said they never come to work unwell.

Medscape wanted to know more about how often you call in sick, how often you come to work feeling unwell, what symptoms you have, and the dogma of your workplace culture regarding sick days. Not to mention the brutal ethos that starts in medical school, in which calling in sick shows weakness or is unacceptable.

So, we polled 2347 physicians in the US and abroad and asked them about their sniffling, sneezing, cold, flu, and fever symptoms, and, of course, COVID. Results were split about 50-50 among male and female physicians. The poll ran from September 28 through October 11.

Coming to Work Sick

It's no surprise that the majority of physicians who were polled (85%) have come to work sick in 2022. In the last prepandemic year (2019), about 70% came to work feeling sick one to five times, and 13% worked while sick six to 10 times.

When asked about the symptoms that they've previously come to work with, 48% of US physicians said multiple symptoms. They gave high marks for runny nose, cough, congestion, and sore throat. Only 27% have worked with a fever, 22% have worked with other symptoms, and 7% have worked with both strep throat and COVID.

"My workplace, especially in the COVID years, accommodates persons who honestly do not feel well enough to report. Sooner or later, everyone covers for someone else who has to be out," says Kenneth Abbott, MD, an oncologist in Maryland.

The Culture of Working While Sick

Why doctors come to work when they're sick is complicated. The overwhelming majority of US respondents cited professional obligations; 73% noted that they feel a professional obligation to their patients, and 72% feel a professional obligation to their co-workers. Half of the polled US physicians said they didn't feel bad enough to stay home, while 48% said they had too much work to do to stay home.

Some 45% said the expectation at their workplace is to come to work unless seriously ill; 43% had too many patients to see; and 18% didn't think they were contagious when they headed to work sick. Unfortunately, 15% chose to work while sick because otherwise they would lose pay.

In light of these responses, it's not surprising that 93% reported they'd seen other medical professionals working when sick.

"My schedule is almost always booked weeks in advance. If someone misses or has to cancel their appointment, they typically have 2–4 weeks to wait to get back in. If I was sick and a full day of patients (or God forbid more than a day) had to be canceled because I called in, it's so much more work when I return...," says Caitlin Briggs, MD, a psychiatrist in Lexington, Kentucky.

Doctors' Workplace Sick Day Policy

Most employees' benefits allow at least a few sick days, but doctors who treat society's ill patients don't seem to stay home from work when they're suffering. So, we asked physicians, official policy aside, whether they thought going to work sick was expected in their workplace. The majority (76%) said yes, while 24% said no.

"Unless I'm dying or extremely contagious, I usually work. At least now, I have the telehealth option. Not saying any of this is right, but it's the reality we deal with and the choice we must make," says Briggs.

Additionally, 58% of polled physicians said their workplace did not have a clearly defined policy against coming to work sick, while 20% said theirs did, and 22% weren't sure.

"The first thing I heard on the subject as a medical student was that sick people come to the hospital, so if you're sick, then you come to the hospital work. If you can't work, then you will be admitted. Another aphorism was from Churchill, 'most of the world's work is done by people who don't feel very well,' " says Paul Andreason, MD, a psychiatrist in Bethesda, Maryland.

Working in the Time of COVID

Working while ill during ordinary times is one thing, but what about working in the time of COVID? Has the pandemic changed the culture of coming to work sick because medical facilities, such as doctor's offices and hospitals, don't want their staff coming in when they have COVID?

Surprisingly, when we asked physicians whether the pandemic has made it more or less acceptable to come to work sick, only 61% thought COVID has made it less acceptable to work while sick, while 16% thought it made it more acceptable, and 23% said there's no change.

"I draw the line at fevers/chills, feeling like you've just been run over, or significant enteritis," says Abbott. "Also, if I have to take palliative meds that interfere with alertness, I'm not doing my patients any favors."

While a minority of physicians may call in sick, most still suffer through their sneezing, coughing, chills, and fever while seeing patients as usual.

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