Should doctors go to work if they’re sick?

The work ethic instilled in most physicians may actually be a detriment to patient care.

In this piece in Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines write about the culture in medicine where doctors are expected to show up for work (via, no matter what their malady is: “Sick doctors have been known to do rounds while dragging IV poles and receiving fluids for GI illness. Gross, but it happens. This culture of work-first/self-second may not be such a terrible thing: Patients want dedicated doctors who study hard and won’t sleep unless their patients are tucked in. But this hard-nosed culture can cause problems, especially when overtired doctors make mistakes because a cold has stuffed up that same hard nose.”

I don’t think I’ve ever seen doctors attached to IV poles rounding on patients. But, their point is duly noted.

Part of the problem can be linked to the tightening restrictions of resident work hours, where coverage is already stretched thin. If a resident calls out sick, another has to be pulled, sometimes from their vacation or time off, to fill in. This creates intense pressure for these doctors to show up, regardless of the severity of their illness.

Perhaps as medicine evolves towards a kinder, gentler lifestyle, the stigma of calling in sick can be reduced. That shift, however, has to start in training. Which means that more residents will be needed on hand to cover for those calling in sick.

Are cash-strapped hospitals willing to spend the money to increase the size of their residency programs?