Most Doctors Work While Sick, Despite Knowing It's Bad For Patients 191
An anonymous reader writes: A new survey published in JAMA Pediatrics found that 95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year." The researchers doing the survey dug into the reasons for this: first of all, given the heavy workload of most doctors, it's very difficult to find others who can take up the slack when one is recovering from an illness. Beyond that, the profession is pervaded by a culture of working through the discomfort and pain of minor maladies. According to a commentary on the research, hospital policies don't help matters — they often incentivize long hours and don't encourage ill workers to leave the premises.
Coincidentally... (Score:2)
Doctors ALWAYS know what is best for their patients /snark
Re:Coincidentally... (Score:4, Insightful)
They might. The current system does not necessarily give them incentive to _do_ what's best though. Still, modern medicine beats whatever is in second place by a long long way.
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I HAVE had a lot of experience with doctors recently (defined as the last ten years). And my impressions of the various doctors that have treated me have been universally positive.
Of course, all my doctors except my Priimary Care guy work at a University Hospital, and so, presumably, are a bit better than the average.
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I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk. Issues were either googled, or simply told to take some antibiotics and come back if it gets worse (ie the reboot). When you look at how much a modern economy spends on healthcare, I think there is room for a different health model which is a lot cheaper and more efficient.
Essentially, you are at a 1st level helpdesk. Human body or computer, there's no quick track that skips proper troubleshooting, and proper troubleshooting sometimes takes time. Trouble is that there is no tier 2 helpdesk that isn't dedicated to a specific field, which they will send you to once they determine what it is. From there, if they can figure out the specific issue, you can go to a tier 3 helpdesk of a specialist. Patients, like users might try and skip the tier 1 helpdesk, but chances are, the tie
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Not all modern medicine is the same and IMHO, it is in decline in the U.S.
In the U.S. we have the most expensive healthcare by far, but the result is among the worst in the 1st world. It's rapidly approaching the point where we could replace doctors entirely with an expert system that walks the diagnostic tests then prescribes the most expensive drug at the end of the tree. Clinical diagnosis is dead.
Re:Coincidentally... (Score:5, Insightful)
Doctors are paid per service, they take the time off they don't get paid.
If they have a small practice then it is their whole staff that won't work that day so it is also 2 - 4 more people missing work. And those don't get paid nearly as well as the Doctor so they will really hurt.
Re:Coincidentally... (Score:5, Funny)
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Where do you think the doctor contracted the thing(s) making them sick?
How many of us work in an environment full of sick people?
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How many of us work in an environment full of sick people?
Those many of us who benefit from sick people?
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Actually,
I am a medical doctor, and work in a government owned hospital. That makes me kind of a civil servant. I get paid per month, not per patient/treatment.
I completely recognize my colleagues and myself in this report. One doesn't call in sick, unless one has 39,5C fever or isn't capable of driving the car to work.
Financial interest has nothing to with this, your remark reflects your utter ignorance for the matter and lacks any form of humour.
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I am a medical doctor, and work in a government owned hospital. That makes me kind of a civil servant. I get paid per month, not per patient/treatment.
I completely recognize my colleagues and myself in this report. One doesn't call in sick, unless one has 39,5C fever or isn't capable of driving the car to work.
Financial interest has nothing to with this, your remark reflects your utter ignorance for the matter and lacks any form of humour.
Are you claiming there are no doctors who get paid per visit or per service offered? Because unless that is the case, your remarks reflect your utter ignorance for the matter.
Even for you and your colleague who never calls in sick, I doubt there are no financial interests at play. Do you have a limited number of sick days? Do you have to take vacation days after those sick days are exhausted? Are you compensated at the year's end for unused sick days? Are your sick days and vacation days all combined into a
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Off course there are hospitals and doctors over here that are being paid by the patient/treatment. But, like i said, the same work ethos applies to those who are not financially inclined to come. That indicates that the financial interest is not the (main) reason for this behaviour. I see this in all civil servant doctors as well.
We are talking single / couple of days sick leave here, having the flu, headache or diarrhoea. not long term illnesses / disability.
# Do you have a limited number of sick days?
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They're American? It's another sign of the "you're not allowed to be human" treatment that lots of American workers get. Even people who get sick time are discouraged from taking it, lest it reflect badly on their performance. If they'd also not get paid for that day, hell yeah they're going to drag their sorry asses to work and give everyone in the office the plague, because, you know, it's much better for 5 people to work at half capacity than give 1 person the day off to recover. Lazy shiftless assho
Re: Coincidentally... (Score:2)
Career issues (Score:2)
As a physician... (Score:5, Interesting)
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I hope if you are going in sick to work you are taking extra care to protect the patients from your illness. Such as wearing a mask and just a bit more complete washing.
Re:As a physician... (Score:5, Interesting)
I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.
Also as an employee as opposed to a fee for service type physician, there is still the drive to work as to not pass your work onto other physicians. Its part of the mentality of "I can work through anything" similar to why you hear about surgeons working for 30+hrs straight.
Re:As a physician... (Score:4, Insightful)
I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.
Whereupon you'll transmit it to another patient. Selection bias much?
I submit Parent as Poster Child for the problem.
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I really don't want a surgeon who's been up for 29 hours doing any procedure on me.
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Fine. And, since chances are good that that surgeon will be the only one available in many parts of the world, you will die for lack of a life saving procedure.
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This is from the article:
See that? Philadelphia. I'm pretty sure there is more than one surgeon available in Philadelphia. This is not some field hos
Re:As a physician... (Score:4, Interesting)
Cry me a river. The reason why physicians have to work so hard is because the AMA deliberately keeps the supply of doctors small, and deliberately ensures that health care can only be dispensed by their overpaid members. Hospitals and insurance agencies have their own rent seeking arrangements. And half the time, patients come out sicker than they go into the hospital.
Physicians are a necessary evil. Some of them even have good intentions going into the profession. Don't expect any admiration simply for your job title or your self-inflicted working hours. Oh, and your conduct sounds irresponsible.
Osteopathic Physicians (Score:3)
FYI, but you may be interested to know that the AMA does not have quite the monopoly on producing new physicians that you think.
There is actually a second source of physicians in the U.S., the American Osteopathic Association. Just after the civil war, Osteopathic Physicians [wikipedia.org] (who carry the D.O. degree instead of M.D.) split off from mainstream medicine. While initially a fringe movement focused on Osteopathic Manipulation practices, over time it eventually evolved into a full-fledged "second track" for pr
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Plus, you can't bill from bed.
Re:As a physician... (Score:5, Insightful)
I would rather work harder and longer hours today than have to take off a day myself (and possibly come in a day or two when I am recovering myself).
I know of NO ONE in my office that doesn't think people should stay home when we are sick.
Of course, it helps that I work for a law firm that is more concerned with obeying the law than most work places.
I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.
It is truly a shame that hospital management is so penny-wise/pound foolish as not to insist on generous sick time.
Close, but not quite (Score:2)
Not exactly. The 'miracle' of American worker productivity is that most of us are now doing our work and the work of the poor sap that got laid-off during the Sub-Prime Pyramid Recession. Now, we're all too terrified to call in sick lest we be tagged as lazy or disposable. So we all work sick, because we need the health insurance (
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I know of NO ONE in my office that doesn't think people should stay home when we are sick.
Same in my office, yet people still come in sick (despite everyone pleading with them to go home) because they want to show everyone else what a hard worker they are.
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I can tell you that as just an office worker, I get PISSED when my co-worker comes in with a cough, I know I will end up getting it.
People will still feel guilty calling in sick when capable of working.
I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.
It is truly a shame that hospital management is so penny-wise/pound foolish as not to insist on generous sick time.
I think it's more than complaining, management needs to actively encourage people who are mildly sick to take the day off and to actively sell it as being good for the company. Otherwise people will feel like they're shirking their duty.
I think my current organization is particularly bad in this regard as they pay only 50% for sick days, so if people are remotely capable of working they'll come in so they don't take the hit.
Re:As a physician... (Score:5, Insightful)
There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.
The corporatists have done a number on your head. Resist it.
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There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.
The corporatists have done a number on your head. Resist it.
If I'm sick, I stay home. No sense in passing what I have to the rest of my coworkers. The reality is that it's actually best for the company if I do. Which would they rather happen, one worker stays home for a couple of days to recover or that person goes to work and they lose productivity from 10 others that then get sick...
This finding goes to show that even smart people are stupid even about the most basic things and that familiarity breeds contempt. I wonder how much of this has to do with the Doct
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Honestly, knowingly going in to work sick should be considered assault. It's no different than doping the food in the break room.
That would mean that a manager that somehow pressures employees to work sick would be guilty of a crime as well.
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This is why God invented labor unions, doctor.
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This is why God invented labor unions, doctor.
Except God didn't; man did.
And labor unions would not necessarily make things much better. Many nurses work for under a union, and it tends to create the "well, it's not my job to do X" mentality, because if you're in a union and you do your job but could have done X that is Jane's or Joe's job then you get penalized despite it being faster for you to do it than calling Joe or Jane to do so. It's also why it costs $19 to get an aspirin in the hospital.
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I don't think people quite understand the issue. It's not sick time. I'm one of only 2-3 neurosurgeons in a the hospital at a given time and there is so much critical work that we're all needed there at once. To have someone cover me would be problematic since they are already working 80-100 hours per week already, so they would go over the policy limits for work hours, or at the very least be very very unhappy about it.
So, because of bad management practices you would rather work yourself to death and put others in jeopardy health wise? How do you take vacations? What happens if you get hit by a bus?
If you and your peers are consistently working 80 to 100 hours a week then you guys are just plain crazy. All of you will be burned out within 2 years and end up with your own health problems. There is obviously enough work to hire more employees. If management is saying that they can't find talent, then they are probably
Re: As a physician... (Score:2)
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It must be nice to have a job where you're not essential.
So your absence for a few days would be inevitably and irrevocably devastating to your employer's business? You must be quite the rare bird.
Some employees are very valuable, and a few are so valuable that their absence is a significant inconvenience. I'm sure they're missed when they take vacations, too.
Title is stupid (Score:5, Insightful)
While it is true that there are doctors working while they themselves are not feeling well, you guys gotta understand that doctors have to face sick people ALL THE TIME, which means they have higher chance of getting infected with diseases, which means they have to spend more times feeling unwell
It is always so easy to criticize someone of doing something but why is it there is no mention of what makes that someone do that something in the first place?
Doctors always know best (Score:2)
While it is true that there are doctors working while they themselves are not feeling well, you guys gotta understand that doctors have to face sick people ALL THE TIME, which means they have higher chance of getting infected with diseases, which means they have to spend more times feeling unwell
It is always so easy to criticize someone of doing something but why is it there is no mention of what makes that someone do that something in the first place?
Because doing so implies that it's OK because it has a justification. "Hey, it's OK for doctors putting us at risk, because they have a really good reason".
This is a clear-cut example of that "needs of the many" thing. Yes, doctors encounter sickness more often then average. Yes, that probably means they get sick more often. Yes, their work is really hard.
Does the inconvenience of one doctor outweigh the inconvenience of 5 patients catching what he's got?
I once read a study where doctors refuse to use check [stuartjeannebramhall.com]
Re:Doctors always know best (Score:4, Insightful)
It is slowly happening in some areas (trauma medicine) because it's being done well and being rejected in others because it is not.
Re:Doctors always know best (Score:5, Informative)
Pilots don't want to use checklists either
Nonsense... a good pilot WANTS to use a checklist, the cockpit tends to reach the site of a crash first...
Humans are not perfect, more than once I've missed something trying to do it from memory or seen someone else do it, including high time experienced pilots.
A good training program will weed out the "I've got it, I've got it" attitude... No, no you don't... use the checklist...
Modern aircraft are too complicated to have it all perfect in your head every time, 100% of the time, in any situation. You should know your checklists and you should practice with them, but you should still pull them out and use them.
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Totally agree - many accidents have been cause by pilots not reading their checklists.
As the saying goes, "all airplanes kill stupid pilots".
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One question which comes to mind, though, is whether memory items count as checklists.
They do...
However you're supposed to know those by heart, front to back, but then you double check them from the checklist.
So an emergency response checklist might have 30 items on it, the first 6 of which are "memory items", meaning you should know them 100% perfectly.
This is done because an aircraft might have more than a dozen checklists, it is not reasonable to expect humans to memorize 100% of all of them, but for perhaps 5 of them, the first 5 or 6 items, you can expect every single pilot to know thos
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Pilots don't want to use checklists either
Bullshit. A pilot that doesn't use a checklist is going to be a dead pilot. And if he/she has passengers, they will die too. There's a reason for the checklist: So you don't kill yourself and others.
It's not a simple equation (Score:2)
Does the inconvenience of one doctor outweigh the inconvenience of 5 patients catching what he's got?
Sometimes yes. Sometimes no. And the answer depends on what he's got and what the consequences of him not showing up for work are. There are places where the doctor is the only qualified medical professional around. Should the gunshot victim have to wait a few days for the doctor to get over his bout of the sniffles before he gets help? Should patients in urgent need of care in a rural area have to wait for a week for a doctor to stop coughing when he's the only medical help within reasonable distance?
Re:Title is stupid (Score:5, Insightful)
That just seems to imply that doctors shouldn't be trained to work stupid-long immune system destroying hours, should be overstaffed (not understaffed) to allow for frequent sick days, etc. In other words, double the number of medical schools, reduce the on-call stress that hurts the immune system and reform the residency system. Maybe also get rid of the concept that doctors are so much smarter/more honorable than the poluace instead of just having a different skillset.
Medicine is pretty poorly done in, well, the US. Maybe the whole world, but I have no idea how other countries train doctors.
Reforming medicine (Score:3)
That just seems to imply that doctors shouldn't be trained to work stupid-long immune system destroying hours, should be overstaffed (not understaffed) to allow for frequent sick days, etc.
That would be nice but it cannot realistically happen without a single payer government run health care system. Since that is a political impossibility it seems unlikely to happen. Furthermore, low staffing levels are sometimes an economic or functional reality. If you work in a rural area, odds are good there is no backup. Long hours? That's not unusual in a lot of professions including programming. Given the almost limitless need for medical care I don't really see doctors ever working short hours.
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You're conflating the best individual care with the system. Imagine two countries, both with a billion people (for shits and giggles). One has up and running, I dunno, like a million doctors. The other has exactly one of those machines from Elysium that autocures someone in five minutes. Which has the best system?
Well, to those people able to get into the machine, I'm guessing they would say the Elysium-like one. But to society as a whole? The mi
What's worse? (Score:5, Informative)
"More than 95 percent believed that working while sick puts patients at risk, but 83 percent still said they had come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year."
I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk. Maybe in London (where Reuters is based) there are enough doctors working for the central government mandated health industry that sick doctors don't feel the pressure to come in. However, it looks like in Philadelphia (where the data was collected) there aren't enough doctors. I know that my medical doctor friends go to work sick, since the risks associated with someone catching a cold is much greater than the risks associated with not seeing a medical provider. In some places in rural New Mexico, you get to drive for 2+ hours to see a similar specialist. My urban Albuquerque isn't as bad, but things are still pretty backed up and doctors usually schedule months in advanced for routine things.
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Sooo, it's American doctors. This study is new, and I'm not aware of studies for countries like England and Canada that have social healthcare, but I gotta wonder if that's a factor.
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oops... http://www.cbc.ca/news/health/... [www.cbc.ca]
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Yeah, but Canadian doctors are spreading free infections.
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Just anecdotally, my ex-wife (a paediatric oncologist) considers the only real excuse for not working to be "death". Although I imagine she does actually take time off if she's infectious, because many of her patients have a weakened immune system.
I don't think it's something limited to doctors. In the States, where you have a lot of "at will" employment contracts and can be fired without reason, I'm sure that many people work when they are sick just because they are afraid to get the sack.
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I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk.
I agree, but this article just lowered the trust people have in doctors, reducing the number of people that will actually go see a doctor.
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Economic value (Score:3)
If a doctor contaminates patients, then the economic value of his work day is probably negative.
I noted the point of high workloads, but it just suggests that we need more doctors, and that subsiding would make sense.
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If a doctor contaminates patients, then the economic value of his work day is probably negative.
Not purely negative. The doctor exposes his patients to some germs and have them create the appropriate antibodies. That's immunization!
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The doctor exposes his patients to some germs and have them create the appropriate antibodies. That's immunization!
Except that the patient is likely to be already sick, and it is not the best time to introduce new germs.
Re: Economic value (Score:2)
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You clearly have a different idea of what economic value means versus hospital admins and department chairs. Look up the concept of RVU's and you'll see why coming in to work, no matter what, will continue (because it is economically incentivized). Only a TREMENDOUS amount of social change will overcome that.
Check out this thread...
http://forums.studentdoctor.ne... [studentdoctor.net]
Yes, I'm a physician in real life and yes, this mentality disgusts me.
Re: Economic value (Score:2)
Economic value is more robust than that (Score:2)
If a doctor contaminates patients, then the economic value of his work day is probably negative.
Unless he has a case of ebola that is unlikely to be true. Doctors and medical staff work around sick people all day. It is a virtual certainty that they will regularly transmit pathogens no matter how careful they are. Fortunately most people have robust immune systems so the system still works. Or would you rather that entire medical offices close every time someone gets a case of the sniffles?
I noted the point of high workloads, but it just suggests that we need more doctors, and that subsiding would make sense.
Training of doctors is already subsidized. It's primarily paid for through Medicare and the Department of He
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Fortunately most people have robust immune systems so the system still works
We are talking about sick people, right? Or perhaps you believe people waste their time waiting to see the doctor just for the fun?
Engineer Solution (Score:2)
Prioritize the patient queue based on similar symptoms.
Triage (Score:2)
Prioritize the patient queue based on similar symptoms.
It's called triage [wikipedia.org] and I assure you that medical people are well aware of it. Particularly in ERs.
This is true. (Score:2)
does it matter? (Score:3, Interesting)
Doctors' offices and hospitals are full of people who carry infections. You already have a high chance (probably around 30%) of coming out with an additional disease to the one you went in with, both from transmission from other patients, and through medical error. One more sick person (the doctor himself) hardly makes a difference.
You need crappier doctors (Score:5, Interesting)
Seriously, if there aren't enough doctors it doesn't matter how good they are, enjoy waiting a month to get emergency* treatment from an overworked doctor who's only going to spend 5 minutes with you. If you drastically reduce the requirements for becoming a doctor, then you'll get prompt treatment from a well-rested doctor who can afford to spend a good long while with you and still charge you less. Sure, they'll make some mistakes... but so do current doctors. Requiring less training might actually reduce the number of mistakes. Especially if the mistakes were of the class of waiting too long due to busy schedules, patients avoiding the hassle, doctors going to work sick/tired, or any of the various effects of not enough doctors.
* there's some conditions that are serious enough that you ought to receive immediate treatment, but don't officially qualify as emergencies.
Lowering standards is a dumb idea (Score:2)
If you drastically reduce the requirements for becoming a doctor, then you'll get prompt treatment from a well-rested doctor who can afford to spend a good long while with you and still charge you less. Sure, they'll make some mistakes... but so do current doctors.
And you'll get a lot of shitty doctors, drive up medical costs, drive up liability costs and hurt a lot of people in the process. Increasing the number of doctors is fine but lowering standards to do it is a DUMB idea. A better idea is to make working as a doctor more appealing so that you attract more good people to the profession. There are plenty of people who are smart enough to be doctors but who simply don't want the (often) horrid lifestyle that comes with it. This can be done without admitting a
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The requirements are so high because of AMA lobbying: they keep them that way, limit medical schools, and make sure that patients must see physicians even for problems that could be addressed by nurses or pharmacists.
What kinds of problems are those? As far as I know, patients can see nurses for minor problems that can be addressed by nurses (specifically nurse practitioners [wikipedia.org]). The clinics in pharmacies and supermarkets (e.g., CVS Minute Clinic [cvs.com], Walgreen's Healthcare Clinic [walgreens.com], The Little Clinic [thelittleclinic.com], Rediclinic [rediclinic.com]) are generally staffed by nurse practitioners and physician assistants.
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Correct, and medical associations generally have been trying to limit expansion, for example trying to limit NPs to operating only under a doctor's supervision.
So in other words... (Score:3)
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Exactly like every single other profession? Seriously. Name one job which doesn't encourage you to go in to work even when you are sick.
Uh... every job I've ever had for the past forty years. Management at every place I've ever worked has been far more likely to berate an employee for showing up with symptoms than for taking sick days.
It's expected (Score:5, Insightful)
This is the work ethic that is pounded into residents and interns.
You MUST work, regardless of sleep deprivation, personal trauma, or contagious illness.
(That is why I became an engineer, rather than a doctor like my father and my grandfather.)
Re:It's expected (Score:5, Insightful)
Medical school hours and conditions looks like a giant hazing ritual. Plenty of science shows it is dumb and make all mortal humans more error prone. Somehow the medical profession thinks they are super-human (or must act as if they are) and put their patients in increased danger from fatigue and apparently illness as well.
Listening to an NPR piece on residency some months back sounded really pathetic. The pervasive attitude was that it made you a better doc, and since everyone else went through it then I have to too. Someone needs to get through that the emperor has no clothes and this is just stupid.
In the end my experience with docs is they are all pretty darn human, and all this hazing and stupid over-work ethic does nothing more than give them a false sense that they are not.
Re:It's expected (Score:4, Informative)
Listening to an NPR piece on residency some months back sounded really pathetic. The pervasive attitude was that it made you a better doc, and since everyone else went through it then I have to too. Someone needs to get through that the emperor has no clothes and this is just stupid.
This is certainly true. Although they don't like to admit it, the medical field is full of a lot of "lore" that has never really been tested scientifically to produce better results. From the residency hazing to the whole "white-coat ceremony" weirdness, becoming a doctor still has some of the odd trappings of entering into a medieval cult or something.
The problem is that deviating from past tradition is seen as inherently risky for people who deal with "life and death," so whether it's changing training routines or questioning some standard clinical practice, it's really hard to change things... which is one of the reasons for the rise in so-called "evidence-based medicine" in recent decades. I know we all want to believe that medicine is scientifically rigorous, but there are often severe obstacles to achieving scientific rigor once a practice has caught on in the medical profession -- because refusing the "standard treatment" might be unethical, even if that treatment was adopted after uncontrolled non-randomized tests that had statistically questionable success.
I have great respect for doctors, who generally work hard and care greatly about their patients. But the profession and practice is severely broken and weighed down with bizarre (even mystical) baggage about how better doctors come from weird crap... like the hazing and long hours.
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I can't help but think that the medical system feels something like a mix between an aristocracy and a cartel.
On one hand, it seems very much a class-based system. Doctors aren't involved in a lot of hands on medical practice, they get nurses to do a lot of it. Is this a specialty based division of labor, or is it a remnant of a class system from a couple of centuries ago where doctors were likely to be members of the social elite from birth?
On the other hand, there seems to be a lot of cartel like struct
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It goes even further. Half the crap people see doctors for is stuff they could take care of at home. Sometimes enforced by silly managers that demand a doctor's note if you're out with the flu for a couple days.
Modt healthcare workers work while sick (Score:3)
Since there isn't enough staff to cover your absence.
I'm not feeling the best tonight myself
But there are only 4 aides and 2 nurses listed on the online schedule and another one of the PM crew working half the NOC shift
full staff for nights is 1 nurses and 7 aides or 1 nurse and 8 aides
It starts in med school. (Score:5, Insightful)
They study for long hours without adequate sleep so they can learn to teach their patients how to live healthy lives. Then they get abused in the residency programs and work for less than minimum wage for 80 -100 hours per week. Then they finally finish and start to practice and have to work long hours without bathroom breaks, food breaks, or just letting off steam. They're getting screwed by insurance companies and hospital administrators at every turn. I'm amazed anyone still wants to go to med school in this country.
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I'm amazed anyone still wants to go to med school in this country.
Don't worry on that count, right now the children of Indian-American immigrants are filling up the vacuum. When they realize the con job they got suckered into we will find another demographic.
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i don't know. every time my kid gets sick with something simple it's like $400 - $500 the insurance company pays for two visits. and most doctors i see drive nice cars and live in nice and expensive homes. I know there are expenses but the kid is gets around 15-30 minutes of office time for both visits and it's like $400. and the doctor is usually pretty busy the whole day.
Buddy, as an Indian-American I am drowning in a sea of doctors. Insurance companies have an invoice rate and they they actually pay something like 20cents on the dollar of the invoice amount. From that amount they pay the medical assistants, nurses, and database services to log into billing networks, liability insurance. I don't see doctors driving nicer cars than other people with Masters level education. (Not PhDs though. They end up in academics and drive Accords and Camrys. )
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Doctors/hospitals don't get the money that is billed. Insurance companies never pay the billed amount. Each transaction is negotiated between the medical office/hospital and the insurance company (think of the wasted time/ effort). Doctors in private practice still have to deal with insurance companies, unless they are doing cash only cosmetic work. Those guys deserve the money they get for putting up with the nutty patients they have to deal with.
Doctors who work for hospitals are employees like everyo
universal precautions (Score:3)
>"95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms"
If they are following universal precautions, it won't matter if they are sick or not... (yes, I work in healthcare). If they don't know this, they are not doing the right things.
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If they are following universal precautions, it won't matter if they are sick or not... (yes, I work in healthcare). If they don't know this, they are not doing the right things.
The 'universal precautions' would include not coming into work when ill, wouldn't it? I mean, as far as preventing disease transmission goes, just look at how many hospital workers end up catching ebola, despite far more serious efforts to prevent it.
As a doctor, you come in with the flu or something, just like anybody else you're likely giving it to your fellow employees and customers.
Just trying to increase business.. (Score:2)
In today's competitive marketplace you need to do everything you can to generate more business.
Sometimes doctors should work when sick (Score:3, Insightful)
From a pure, selfless ethics point of view, the question is: Will humanity be better off if I go into work today or not?
Some things that may be going through doctors' heads when they decide whether to call in sick or not:
If I am sick and go in, then there's an increased chance of:
* me infecting others, and all that that implies
* me making a mistake that is worse than not being there at all
* Others perceiving me as not knowing/not following "the rules," which may impact my future career, which may negatively impact the future of the patients you would have had but won't have.
If I am sick and stay home, there's an increased chance of:
* A patient of a co-worker getting inferior care because my co-worker was covering for you
* A patient of a co-worker getting inferior care because my co-worker was tired because he covered for me in an earlier shift
* Others perceiving me as "not pulling my weight" and "wimping out," which may impact my future career, which may negatively impact the future of the patients I would have had but won't have
Similar thought patterns probably apply to most people in most careers.
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If I am sick and stay home, there's an increased chance of:
* A patient of a co-worker getting inferior care because my co-worker was covering for you
Conflict detected. They'd get superior care if you're the kind of person who would go give patients your illness.
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From a pure, selfless ethics point of view, the question is: Will humanity be better off if I go into work today or not?
Except your "pure, selfless ethics" sounds a bit too much like egotistical BS in places.
If I am sick and stay home, there's an increased chance of:
* A patient of a co-worker getting inferior care because my co-worker was covering for you
Every doctor is not "God's gift to humanity." Unless you are in the top 5% or whatever of physicians -- and most doctors obviously aren't -- this is egotistical nonsense. If you're really worried that your colleagues do crappy work, get a better job.
* A patient of a co-worker getting inferior care because my co-worker was tired because he covered for me in an earlier shift
This is a pervasive staffing issue in medicine. Except in times of war or unexpected epidemics (or if you're a true specialist with an emergency situation), there is no re
Not just Doctors (Score:2)
It seems unfair to me to pick on them. All allied health professionals are expected to work whether they are sick or not. It is just the result of the prevailing Judeo/Christian work ethic. Catholics seem to be the worst as personal sacrifice is expected by their beliefs, science be damned.
For example, one of the first things that got discarded was our previously secular hospital's very sane policy of forgiving a sick call by working an extra shift after being placed under the management of a Catholic insti
It's all about the Insurance Profits (Score:2)
When you have middlemen (Insurance Companies) and administrations working to maximize profit, all being paid by the procedure... the quality of each procedure is far less important that the quantity. We need to put health back in the drivers seat as the #1 priority... which isn't going to happen until we Nationalize health care... even then it's not guaranteed to happen.
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That is bit of an exaggeration.
In most professional environment I have worked at sick days are not frowned at. However in areas where there is less skilled labor it could get you in trouble as it is often used as excuse to get out of work.
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Re: sick days equal fired days (Score:2, Informative)
Maybe a little exaggerated, but not entirely. I work in technology, same employer for nearly 16 years, and we get PTO instead of vacation/sick time. Company policy is that you can take your PTO whenever you like for any reason (or no reason at all).
I've been dinged severely for "taking too much unplanned PTO" on performance reviews. In addition, my boss one year negatively called out a "lengthy unplanned absence", despite the fact that I was in the hospital after having a heart attack.
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plenty of available overtime" is a "positive"
It's a sign that you're not being paid enough. Despite the overwhelmingly positive public opinion that any family with a full-time worker should not be in poverty and be comfortable, it isn't true.
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