Presenteeism:  A Chronic Condition Among Doctors

A recent study published in the Journal of the American Medical Association (JAMA)[1] suggests that presenteeism — showing up to work with an illness, impairment, or disability that limits productivity — has reached epidemic proportions among doctors.  The study, which surveyed residents at multiple hospitals, found that three out of five had continued working while sick.  At one hospital, 100% of residents had done so.  Half the residents noted that they simply didn’t have the time to see a doctor.

Presenteeism imposes productivity costs on any business, but in the practice of medicine, these costs can include a noticeable decline in the quality of care patients receive.  A physician suffering from an illness or disability—or distracted by severe physical pain—can make serious mistakes in judgment, which in turn can have life-threatening consequences for the patient.

Moreover, the presentee habit can become life-long.  Later in their careers, physicians may not seek medical care for chronic conditions, injuries, or disabilities, even when they are legitimately unable to work.  They may attempt to continue even the most physically and mentally demanding duties, aggravating the injury and putting patients at risk, even when they hold a disability insurance policy that could provide a safety net for their personal and professional finances.

In light of the foregoing, a change in medical culture may be in order.  Doctors should feel comfortable seeking the medical care they need, or even filing a disability insurance claim when appropriate.  Dr. Vineet Arora, Associate Professor of Medicine at University of Chicago and one of the JAMA study’s authors, argues that “Hospitals need to build systems and create a workplace culture that enables all caregivers, not just residents, to feel comfortable calling in sick.  Their colleagues and their patients will thank them.”

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