Doctor, heal thyself

Post-grads ignore their own signs and symptoms of sickness

We all know the definition of absenteeism: you fall ill, you call in sick, you stay home and nurse your cold. If you think you know the meaning of presenteeism, then, you’d be right: you feel ill, you go to work anyway. Presenteeism has remained a going concern for many medical residents, despite reforms made over the last decade, according to a recent study conducted by the Accreditation Council for Graduate Medical Education.

It seems junior docs in specialties as diverse as internal medicine, pediatrics, general surgery and obstetrics/gynecology will risk infecting their patients and co-workers, and risk affecting the quality of their performance more often than what might be prudent, because of the extreme dedication to their jobs. Or, might it as likely be a protection of their image? Often, they don’t want to appear to be shirking their responsibilities in the competitive hospital environments in which they must practice. Some don’t relish finding a replacement, when he or she may also be doing a gruelling 80-hour sleep-deprived week. Plus, add to the mix sincere devotion and empathy for the patients, who would not be familiar or comfortable with the substitute doc.

Study co-author Dr. Anupam Jena, a Massachusetts General Hospital medical resident who did not take part in the JAMA-published study (http://jama.ama-assn.org/cgi/content/short/304/11/1166-a?rss=1), admitted to once working overnight, despite developing food-poisoning symptoms. He has company. Of the 537 medical residents anonymously surveyed, almost 58% said they’d worked at least once while sick the previous year, 31% said they’d done so more than once, and at one hospital, a full 100% reported working when sick. Many said they also could not find time to visit a doctor for their symptoms.

Despite the unique pressures on these groups of young physicians, isn’t it time that program directors heighten the emphasis on the benefits of being a healthy hospital practitioner – especially during flu season?
Milena Katz