Should doctors go to work if they’re sick?

when I was a resident, we were allowed to take a few hours off for severe vomiting or diarrhea. Otherwise we were expected to show up

Dragging an IV pole is a bit extreme.

If I’ve waited weeks for an appointment having it cancelled because the Doc has the sniffles probably isn’t going to make me very happy.

I think it probably all depends. Many professionals, medical or otherwise, are expected to produce through thick and thin. That means being judicious about calling in sick.

I would have to agree I’m in a solo practice and if I don’t show up nobody sees the patient’s. I guess I can send all my patients to the emergency room that need to be seen but that seems to be a poor solution.

I would love to not work when I’m sick but where am I going to put these people and who is going to see them.

Many people, if they even have a job, have jobs for which it is the headache of their supervisor to find a replacement when they call in sick. They aren’t responsible for finding a replacement. And things may or may not run well in their absence; as long as they get a required doctor’s note (from someone who didn’t call out sick, we can suppose), they are covered. Most people have never started a business for themselves. Still fewer have the kind of job where one person might have to be present to meet with thirty or forty individuals, one at a time, appointments that may have been many weeks in the making and for which all the other parties have made arrangements to be available.

It is very difficult, not to mention expensive to call out when your job is structured that way. A doctor in solo practice doesn’t have someone to fill in when he is sick. He is fortunate to be able to get someone to cover for emergencies. When the doctor is out, the overhead still has to be paid, but there is no work done and billed and thus no income. When you run overhead figures over 60%, one or two days out will hurt the whole month. And it is very difficult to count the cost of lost goodwill from disappointed patients who are inconvenienced twice.

So in the twenty years since I started in medicine, I can recall only once when I called out sick. And I was pretty sick.

As for the poster Anonymous 8:38 P.M., you are so utterly without a clue and self-absorbed; for you, it is all about your “rights.”

Won’t delve into this too much, but I just want to confirm that the anecdotes about physicians and IV poles are true. My example, as a med student on my ED rotation, I had an attending with a family history of diabetes over a night shift realize that he was having polyuria and polydypsia. He checked a UA, had 3+ glucose, checked a BMP, and had a blood sugar over 700… I am not kidding. Luckily he didn’t have severe acidosis so he kept working.

As he began to feel sicker he had a nurse hang a bag of normal saline and give him some insulin, and he just stayed in the physician computer room while getting his bolus. All the while, he was the only physician in the ED, not counting the intern and me, the 4th year med student. Personally, I was just hoping nobody coded or needed an emergent procedure. I didn’t like how when I presented my cases to him he kept nodding off, finding it difficult to pay attention.

The fact is, this was unsafe. Luckily, nothing bad happened, and he didn’t need to do any procedures that night… god forbid he try a central line and drop a lung or worse. Point is, when you’re sick enough to compromise patient care, you need to call in reinforcements, whoever they are, and whatever it costs. Are an intern and a 4th year med student sufficient reinforcements? If you’re lucky, and I’m your med student. OK, I’m just kidding about the last part.

The question asks "should doctors go to work when they are sick?" There is no single answer. There are a million reasons why we simply don't have a good choice. The primary one is either show up sick, or there is noone there to take care of your patients. So given that scenario the answer is yes. Given the scenario when you do have adequate coverage, the answer is no (in day to day practice, this can be a rare occasion).

I think you should separate the issues of residency from the career, as they are two competely different worlds.

You ended with this question->
"Are cash-strapped hospitals willing to spend the money to increase the size of their residency programs?"

To the best of my knowledge, hospitals have nothing to do with determining the size of a residency program. The size of a program is determined by the RRC and ACGME based on the ability for a hospital system to support the training requirements. The hospital recieves governmental support for each residency position. Therefore, the "cash-strapped" hospitals actually are subsidized for each resident.

JFS

What about surgeons? Surely no expects a sick surgeon to operate, right?

As a resident, I get a little upset when I hear one of the residents on that rotation has called in sick – because I have to then pick up their work. It especially angers me when they come back to the hospital the next day – clearly they weren’t sick enough. However, that being said, I’d take off a day for my kids being sick, if needed (my wife usually does this) and would call in as being sick. My family is the one thing that trumps any and all of that irritation and feeling of hypocrisy that would be felt.