Does your doctor have the flu?

NEW YORK Tue Jun 19, 2012 3:10pm EDT

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NEW YORK (Reuters Health) - Many doctors-in-training have gone to work with flu symptoms, ignoring the risks of passing on bugs to vulnerable patients, a new survey shows.

Half of 150 Illinois residents said they'd worked sick during the previous year, and one in six had done so three or more times.

Their excuse? A sense of obligation to colleagues and patients, explained Dr. Anupam Jena, a senior resident at Massachusetts General Hospital in Boston, who led the new research.

But it's not clear whether that's a worthwhile sacrifice, he told Reuters Health, even if a given physician is more familiar with his or her patients.

"They're less productive and more likely to make errors," Jena said. "And they can transmit the disease to somebody else."

Just last year, for example, a sick doctor kicked off a small outbreak of norovirus at Jena's hospital. Several doctors and patients ended up with diarrhea and the affected unit had to reduce its staff for a number of days.

Like other hospitals, Mass General now has rules to prevent health workers from coming to work with infectious diseases. "The main question is whether those policies are being enforced," said Jena.

‘PRESENTEEISM'

The survey, conducted in 2010 and published Monday in the Archives of Internal Medicine, is based on answers from Illinois residents only. But the rate of "presenteeism" matches findings from an earlier survey by Jena and colleagues done at hospitals across the country.

Although it's unclear how many full-fledged doctors choose to drag themselves to work when they feel lousy, the pressure to do so might be even higher than among residents.

"When residents fall sick, there are a large group of residents that can fill in," said Jena. "When you are in private practice and you become sick, you don't have a pool of physicians that you can draw on to cover for you."

In a comment on the new report, journal editor Dr. Deborah Grady described a recent meeting with one of her residents, who, while usually jolly and energetic, looked "as if he had lost his last friend."

He had diagnosed himself with a respiratory infection and had chosen to go to work despite feeling "terrible."

"Working while sick may demonstrate an admirable sense of responsibility to patients and colleagues," Grady wrote, "but clinicians also need to worry about the real danger of infecting vulnerable patients as well as colleagues and staff."

SOURCE: bit.ly/Nfdnqi Archives of Internal Medicine, online June 18, 2012.

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