Reasons Why Physicians and Advanced Practice Clinicians Work While Sick: A Mixed-Methods Analysis

Published in JAMA Pediatrics, the authors of the following study aimed to identify a comprehensive understanding of the reasons why attending physicians and APCs work while sick. The authors performed a mixed-methods analysis of a cross-sectional, anonymous survey administered from January 15 through March 20, 2014, in a large children’s hospital in Philadelphia, Pennsylvania. Most of the respondents believed that working while sick put patients at risk. Despite this belief, 446 respondents reported working sick at least 1 time in the past year, and 50 reported working while sick at least 5 times. Reasons deemed important in deciding to work while sick included not wanting to let colleagues down, staffing concerns, not wanting to let patients down, fear of ostracism by colleagues, and concern about continuity of care. Systematic qualitative analysis of free-text comments from 316 respondents revealed additional reasons why attending physicians and APCs work while sick, including extreme difficulty finding coverage, a strong cultural norm to come to work unless remarkably ill, and ambiguity about what constitutes “too sick to work.”

Safety and Patient Outcomes

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