In a recent survey, the majority of physicians and advance practice clinicians (ACPs) admitted that they had worked while sick at least once in the previous year despite also believing that this can put patients at risk. The results appear in JAMA Pediatrics.

Julia E. Szymczak, PhD, of the Children’s Hospital of Philadelphia, and colleagues distributed an anonymous survey to 280 attending physicians and APCs, including certified registered nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives. Questions were included on self-reported frequency of working while experiencing symptoms of infection, perceived importance of various factors that encourage working while sick, and free-text comments written in response to open-ended questions.

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An overwhelming number of respondents said that working while sick put patients at risk (96.3%), yet 83.1% reported that they worked while sick at least once in the past year. A total of 9.3% had worked while sick at least five times in the past year. Symptoms experienced while working included diarrhea, fever, and the onset of significant respiratory symptoms; physicians were more likely to report working with each of these symptoms compared to ACPs. Reasons why they worked while sick were not wanting to let down colleagues (98.7%), staffing concerns (94.9%), not wanting to let down patients (92.5%), fear of being ostracized by colleagues (64%), and concerns about continuity of care (63.8%). Other reasons for working while sick were extreme difficulty in finding coverage, a strong cultural norm to come to work unless remarkably ill, and ambiguity regarding what constitutes being “too sick to work.”

Systems to provide support for attending physicians and ACPs could not only help in reducing healthcare-associated infections but also improve physician and APC health and wellness while reducing burnout, the authors concluded.

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