Newspaper article International Herald Tribune

Why Doctors Don't Take Sick Days

Newspaper article International Herald Tribune

Why Doctors Don't Take Sick Days

Article excerpt

Most doctors ignore their symptoms unless they are sick enough to be hospitalized in the next bed over.

The bottle of Maalox sat perched on the triage desk in the emergency room. It was mint flavor, or maybe lemon -- I don't recall exactly -- but it shimmered temptingly. I had just finished with a new admission, and my stomach had been groaning ominously for hours. It was after midnight, the whole night was still ahead of me, and I was getting desperate. I scribbled the last of my medication orders and snagged the Maalox bottle, popping the top and chugging two revolting capfuls on my way to the elevator.

As I rode upstairs, I could feel the intestinal protestations growing. There was going to be an apocalyptic resolution to this. The elevator opened and I burst into the restroom, just in time to disgorge the Maalox and everything else into the toilet, conscientiously keeping my white coat and stethoscope clear of the fray.

I staggered into the call room and flopped onto the couch. My fellow resident listened to my tale of gastrointestinal woe and did what any residency buddy would do: he slid an 18-gauge IV into my antecubital vein and strung up a bag of IV saline. I spent the pre- dawn hours prostrate on the couch doing phone work -- renewing medications, answering calls from nurses, ordering labs -- while my colleagues did the foot work on the wards and in the emergency room. Together we kept everything running.

After morning rounds, I caught a few hours of sleep at home, showered, and then reported back to the hospital at 10 p.m. for my next shift.

What I didn't do was call in sick.

It has long been known that doctors make the worst patients. From day one in medical training, the unspoken message is that calling in sick is for wimps. Much of this is logistics. The staff has to scramble to reschedule patients -- many of whom have been waiting weeks or months for their appointments. Patients who need medical attention that day are crammed into someone else's schedule or sent to the emergency room. Your already overworked colleagues are saddled with extra work, and patients usually get the short end of the stick.

So most doctors ignore their symptoms and resist taking the day off unless they are sick enough to be hospitalized in the next bed over.

This, of course, is ridiculous behavior on the part of medical professionals who would never recommend such nonsense to their patients. Medical workers with respiratory infections are contagious. Caregivers with gastro- intestinal infections -- as I had -- can easily infect their patients.

A 2005 outbreak of the norovirus stomach bug in a nursing home highlighted the role of medical personnel in spreading communicable disease. The most disturbing aspect of the case was that medical staff members continued to come to work while ill, well into the outbreak, despite strenuous and public exhortations to stay home. …

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