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Majority of medical residents have worked while sick


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ill medical resident many of whom work when sickSome professions have to worry about absenteeism—employees not reporting to work. But in the medical field, researchers are calling attention again to the troublesome trend of "presenteeism" among health care workers, and its implications.

It’s common knowledge that medical residents often work well beyond the 30-consecutive-hour limit—and sometimes put in more than 80-hour workweeks. Now, a new analysis shows that in addition to fatigue, many residents treating patients are sick themselves.

Of 537 medical residents who responded to a 2009 survey, about 58 percent said they had worked while sick at least once during the previous year. Nearly a third said they had done so at least twice. "Residents may work when sick for several reasons, including misplaced dedication, lack of an adequate coverage system or fear of letting down teammates," the authors of the new analysis wrote. The results were published online in a research letter September 14 in JAMA, Journal of the American Medical Association.

"We noticed that if residents called in sick, people questioned their motives; and if they came in sick people questioned their judgment," Anupam Jena, a resident at Massachusetts General Hospital and co-author of the analysis, said in a prepared statement. At five of the dozen hospitals in the survey, more than 90 percent of residents respondents reported having worked while sick. "Hospitals need to build systems and create a workplace culture that enables all caregivers, not just residents, to feel comfortable calling in sick," Vineet Arora, an associate professor and associate director of the internal medicine residency program at the University of Chicago and study co-author, said in a prepared statement. "Their colleagues and their patients will thank them," she noted.

Residents were more likely to have worked while sick in their second year post graduation from medical school than in their first, the researchers found.

It might be little wonder that frequently sleep deprived physicians get sick, and because of their busy schedules, more than half (about 53 percent) of the residents surveyed had no time to see a doctor themselves.

"The real issue here is what is best for patient care," Jena said. "Knowing your patient well doesn’t compensate for being infectious." He suggests that for residents, "If it’s contagious—for example a viral cold—or if it’s enough to cloud your judgment, stay home."

Image courtesy of iStockphoto/geotrac





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  1. 1. Archimedes 7:50 am 09/15/2010

    Working long hours and/or working while one is ill (unless, of course, there is an emergency) violate the meaning and intent of the Hippocratic Oath.
    The following is the English translation of the original Hippocratic Oath:

    I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:
    To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

    I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

    I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

    But I will preserve the purity of my life and my arts.

    I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

    In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

    All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

    If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot."

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  2. 2. dbowman1101 5:58 pm 09/19/2010

    Doctors and medical residents need to be given more slack in regards to their health and wellness on a day to day basis. Doctors seem to be under pressure to attend work under nearly any circumstances. As implied in the article, medical residents often cover 30 hour shifts and sometimes 80 hour work weeks. The expectations and pressure put on these doctors is detrimental to their physical and mental health. This leads to medical staff attending work sick, which could potentially harm the patients. This is not acceptable. Sick people attend medical facilities to get healthier, not to obtain a new sickness on top of their previous illness. How would you feel if you were being treated for an illness and the doctor infected you with another one? Also, hospitals need to hire a greater amount of medical residents to reduce the pressure on the medical staff, prevent potential harm to patients, and contribute to lower the United States growing unemployment rate.

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  3. 3. enthusiastic-_- 11:42 pm 09/19/2010

    Honestly, I would be appalled if the doctor I was seeing made me ill; however, when I think about the fact that my doctor is working while they are sick, I feel trust rather than terror. I know that doctors work around sick patients for the majority of their careers. They have had the training and the schooling on how to take sanitary and protective measures so that they do not pass an illness from individual to individual. I would first trust that any doctor I went to would ensure that I did not contract their illness by their own sense of integrity. Aside from integrity, doctors also have their careers to think about. No one wants to go to a doctor that has even a brief history of making any number of patients sick.

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  4. 4. enthusiastic-_- 11:43 pm 09/19/2010

    Honestly, I would be appalled if the doctor I was seeing made me ill; however, when I think about the fact that my doctor is working while they are sick, I feel trust rather than terror. I know that doctors work around sick patients for the majority of their careers. They have had the training and the schooling on how to take sanitary and protective measures so that they do not pass an illness from individual to individual. I would first trust that any doctor I went to would ensure that I did not contract their illness by their own sense of integrity. Aside from integrity, doctors also have their careers to think about. No one wants to go to a doctor that has even a brief history of making any number of patients sick.

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  5. 5. cferguson 7:56 pm 09/22/2010

    Doctors, residents, nurses, whoever, are really all at the most risk to be judged, no matter what they do by the community: "We noticed that if residents called in sick, people questioned their motives; and if they came in sick people questioned their judgment," Anupam Jena. That being said, it shouldn’t matter what the motives of these people are. When it comes down to fact and logic, a patient would rather have a doctor who could do their job well and do it without risking the patient’s health as well. It’s already obvious that these people have good motives; they went to medical school and are probably severely in debt from it. It is needless to say that they take their jobs seriously and care about the profession, but making it an obsession is not good for anyone. They should really just observe that part of the job and being good at it is being healthy and prepared for the work.

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