May 13th, 2009

Working While Contagious: Why Do We Do This?

File this under, “physicians behaving badly”:  The nearly universal MD practice of going to work while sick.

The ironic thing is we think we’re being selfless — after all, if we don’t show up, our patients will need to be rescheduled, or someone will need to cover, or some administrative/teaching task will not get done — but let’s imagine for a second that we actually asked our patients what we should do.

Answer:  Go home.  Get better.  Don’t infect me.

Or, to quote the signs that have appeared in our hospital since H1N1 hit, “If you have a cough, sore throat, and fever, please do not enter the hospital unless you are here for care.”

(Patients with these symptoms who are here for care are instructed where to obtain a surgical mask.)

One primary care internist, writing in the New York Times, seems to have kicked the habit:

As a resident, my greatest pride was in never having missed a day for illness. I’d drag myself in and sniffle and cough through the day.  Once, I’m embarrassed to admit, I trudged up York Avenue to the hospital making use of my own personal motion sickness bag every few blocks while horrified pedestrians looked on. Now, though, I see the foolishness of this bravura.

Sadly, I think she’s in the minority.

3 Responses to “Working While Contagious: Why Do We Do This?”

  1. Marcella says:

    Dear Prof,
    Thank you for your reminder. I am guilty of this ‘selfless” behavior. The reason is simple, the community clinic I am working at has very few doctors and many patients. Though I did wear a surgical mask but honestly I should be resting at home instead. But to say that MDs like me are behaving badly is rather harsh I think.

  2. Paul Sax says:

    >>But to say that MDs like me are behaving badly is rather harsh I think.

    Fair enough. But I hope you could understand from “reading between the lines” that I am just as guilty of this behavior as the next doc! That I’m an ID specialist makes this all the more ironic.

    Our commitment to our patients and to hard work is praiseworthy, but we shouldn’t put ourselves into the position of being vectors of disease.

  3. F-Fallahian says:

    thanks for selection of the topic. I beleive MDs even should regard patients as their relatives and talk about their disease and bad outcomes with notes on subjects bear and gradually, while remid all possibilities. MDs should never let their own difficulties had effects on the behaviour to patient. But before being a MD, they should treat themselves and their family member as a priority, otherwise they wont forgive themselves to neglect them as humans!

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

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NEJM Journal Watch
Infectious Diseases

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