Why Physicians Say Sick Days Aren’t Worth the Trouble

In 2001 and 2002, researchers Rosvold and colleagues looked at physicians’ illness behaviors in Norway and showed that they often treat themselves and use their colleagues for medical advice instead of establishing a relationship with a primary care doctor or taking sick days.² Dr. Rosvold reported that physicians use the least amount of sick leave compared with other hospital employees, and the reasons for physicians not taking sick days were similar and unchanged from the 1997 report. He noted that finding a “stand in” or substitute was difficult for physicians, whether one practiced in a university setting or private practice.³

“Not much has changed in the landscape of medicine, where more volume means more profit,” says Dr. Meara. A recent issue of JAMA Pediatrics featured two articles exploring why physicians don’t take sick leave and the risks that this tendency imposes on patients.^4,5 “The top reasons for physicians working while sick were related to inconveniencing their colleagues and the problem of not having enough staff to cover their patients, which is very similar to the articles written close to 20 years ago,” she says.

“Currently, doctors see a high volume of patients, making a sick day beyond inconvenient as explored in the JAMA Pediatrics article,” Dr. Meara says. “Physicians, therefore, find it easier to work sick.”

Another less-often-discussed topic is the overarching theme in the culture of medicine that physicians are a group of strong heroes who get the job done. Researchers Starke and Jackson in JAMA Pediatrics discuss how physicians are demeaned when taking sick days: When a group of physicians are together, they tell each other about their worst call, best save, why they finally had to call off or what they did to not call off. Physicians are rewarded for working very hard.⁴

“I echo their sentiment. There is a need for culture change to support appropriate paid sick leave without punitive repercussions,” Dr. Meara concludes.

References

1. McKevitt C, Morgan M, Dundas R, et al. Sickness absence and ‘working through’ illness: A comparison of two professional groups. J Public Health Med. 1997 Sep;19(3):295–300.
2. Rosvold EO, Bjertness E. Illness behaviour among Norwegian physicians. Scand J Public Health. 2002;30(2):125–132.
3. Rosvold EO, Bjertness E. Physicians who do not take sick leave: Hazardous heroes? Scand J Public Health. 2001 Mar;29(1):71–75.
4. Starke JR, Jackson MA. When the health care worker is sick: Primum non nocere. JAMA Pediatr. 2015 Sep;169(9):809–810. doi: 10.1001/jamapediatrics.2015.0994.
5. Szymczak JE, Smathers S, Hoegg C, et al. Reasons why physicians and advanced practice clinicians work while sick: A mixed-methods analysis. JAMA Pediatr. 2015;169(9):815–821. doi:10.1001/jamapediatrics.2015.0684.