Wednesday, March 25, 2009

Sick Days

I have been sick this week. At first I just thought I had bad hay fever and was over tired from a long week at work and a weekend packed with social activities. But by Sunday night I realized that I just felt like crap. So I called in sick.

What's the big deal? I am in residency so calling in sick can be fraught with peril. My work has to be covered by someone else. In theory, if we miss too much time we could have to make up the days or the year might not count towards accreditation. Luckily for me we have an extra resident on service right now and I had covered some of his work when he was out last week. So I knew the coverage would not be a big issue. That doesn't mean I did not feel a sense of guilt about staying home for a day.

Overall, medicine as a profession does not take kindly to people calling in sick. Logically, this makes little sense. As physicians we should know that coming in to work with illness and exposing everyone around us, including patients, makes little sense from a public health perspective. We should know that we are not at our best when we are sick and that clouded thinking can lead to adverse outcomes for patients. And we do know that rest is essential to getting well. It is what we advise our patients to do. But somehow this all can get lost in our culture where work reigns supreme above all else and where we feel a sense of obligation to provide for our patients no matter what.

I doubt that any of this will change anytime soon. I know that I am guilty of participating in the culture myself. After spending a day at home sitting on the couch, I dragged myself in yesterday and worked a full day, despite people telling me to go home early and rest because I looked awful.

How can we make changes? We have to start by acknowledging that it is okay to take time off to get better if we truly are sick and convincing our colleagues to do the same. And systems that provide sick coverage need to be in place to allow people to take the time they need without feeling guilty and that they are burdening their colleagues. This can be especially difficult in residency where it is residents on "elective" and "call free" months who get pulled in to cover for sick colleagues. It will take a systemic shift in attitude, but a new perspective on sick days would be healthy for our profession.


Resident Anesthesiologist Guy (RAG) said...

Hard to do. I've not taken a sick day either, despite having puked a few times once on call - even had an upper level surgical resident almost lose it once while in the OR and had to call me in to cover while they ran to the bathroom. Of course we both didn't leave. It seems counter-intuitive, but you feel a huge pressure to come in, regardless.

I think if I had to take a day it would be for my kids. Most of the time my wife will cover when our daughter can't go to preschool (the older is 13, so he can stay home alone), but I feel that sooner or later she's going to have an important day and will need me to stay home. The other day I actually thought about taking daughter to the clinics with me when she was feverish...but only for a second.

I think it will change, but not for a while.

Alexandra {{Awareness Warrior}} said...

I think a lot of it depends on what is being treated. When you wait almost a year to see someone and they call in sick for a "cold", I get mad, simply because I'm sick and I want someone to fix me! But my primary on the other hand, no big deal (well, it is, but we're not mad at the doctor, just frustrated that we'll have to go to the E.R. and pay how many hundreds of dollars because insurance will cover the E.R, but not the E.R. doctors)

I do get very upset, though, when the specialist comes in, gives you a shot of chemo and then coughs in your face. Seriously, WEAR A MASK! (I'm immune suppressed but not to the point that I have to wear a mask in a place with a few people where no one is sick, just in places with lots of people, or where someone is sick. So doctors knowing they're sick and not telling me so at least I can wear a mask is just really dumb on their part)

Okay, enough rambling, but I figured you might like to know a patients point of view, though I am quite unusual, so it's probably not most patients point of view.


Bender said...

Hope you feel better. Sick days are tough. People get sick, family/friends pass away, life happens. I'm guilty of hating on residents too. One of the pregnant interns started having contractions on a Q3 rotation, making everyone else have to take Q2. I know it's not her fault, but it seriously sucked ass.

Resident Anesthesiologist Guy (RAG) said...

Oh yeah, forgot to say I'm glad you're posting about your thoughts on residency and medicine again.

Christina said...

Hope you feel better. And, try not to feel too guilty calling off - you need to take time to get better!