Changing the “Working While Sick” Culture: Promoting Fitness for Duty in Health Care

The recent Ebola outbreak has drawn attention to the threat of spreading communicable disease between patients and health care workers. However, other infectious diseases are much more prevalent: for instance, a disease like influenza represents a more common cause of morbidity and mortality among patients in the United States and is more likely to be transmitted between patients and health care workers. The risk of health care workers infecting patients is real because many health care workers tend to continue working when they are ill, a finding documented in the report by Szymczak and colleagues¹ in the September 2015 issue of JAMA Pediatrics. Based on a survey of 536 clinicians, Szymczak et al found 83% reportedly continued to work even while they were ill. More than half (55.6%) reported that they continued working while having acute onset of significant respiratory symptoms, as did 30% with diarrhea and 16% with fevers.¹ Prior studies have described this phenomenon, dubbed “presenteeism,” in which health care workers report to work despite feeling ill or not well rested.²