I am confident that most of you, whether a radiology resident or an attending, have felt sick at one time or another. And, most likely, you were unsure about coming to work. This decision can become incredibly complex.
Here are some of the issues. Is there adequate coverage? How sick are you? Are you going to be seeing patients for that day? Are you going to be sitting down in isolation for most of the day? Are your reads or your procedures going to be compromised by your illness? What is the group's culture about taking a sick day? How will it affect your colleagues if you do not show up? Will it prevent you from being promoted? Unfortunately, these difficult questions compound when you cannot think clearly due to illness.
Even more confusing, most of the articles that I have read regarding physicians and sickness are not written directly for the Radiologist. Radiologists are a bit different than other hospital or outpatient physicians. Depending upon the day, the rotation, or job description we may or may not have direct patient contact. So, we have to have to think about the question of missing a day of work differently than other physicians.
What about the literature regarding sickness for the general physician? Many articles say not to come to work if you are a sick physician. (1,2) And others are more indeterminate. (3,4) However, the body of research is sparse about whether the ill physician, let alone a Radiologist, should come to work. In this post, I will try to address the most common issues that may sway your decision one way or the other.
How sick are you?
As all of you know, there are multiple levels of sickness. If you are delirious, have difficulty speaking, or are unable to sit for more than a few seconds at a time, you may want to reconsider coming to work. But rarely, is the decision so simple as that.
Most of the time, you may think you have a common cold. You may have a cough or a slight fever or feel a little tired. So, we have to make a judgment if the illness is going to compromise patient care. Or, is it going to be contagious to others? If that is the case, then, by all means, call out sick. But many times that is simply not the case.
Can someone else do your job?
Let's assume that you are not that sick and have the ability to reasonably function. You may be the only radiology resident or attending on call for the weekend that can perform a certain procedure or read a particular type of case. And, you may not have a simple replacement or backup. In this situation, someone that can read cases is obviously much better than no one. In fact, you may have the potential to prevent significant morbidity and even mortality of your patients.
On the other hand, let's say it is during the week and you have adequate coverage. Well then, other members of the practice can easily take up the slack. That is an entirely different situation.
Is the schedule flexible?
At some institutions, you can easily cancel patients/imaging studies for the day, either to leave early or cancel the day entirely. At other practices and hospitals, you really cannot control the patient workflow. If you are at center with a rigid workflow and cannot obtain adequate coverage, this can be a good reason for the Radiologist with a cold to come to work.
Are you in direct patient contact?
Some days you may be on a rotation where you are just grinding out plain films and are in isolation from other members from your practice. You can simply bring wipes and wash your hands frequently. Or on other days, you may be directly involved in complex procedures and patient interviews. If you have lots of direct patient contact with a good chance of getting other personnel or patients sick, the pendulum should swing toward staying home. Obviously, the decision to come to work greatly depends upon the day's circumstances.
What is the corporate culture?
Some practices, especially larger academic and private practices, really discourage its employees from coming to work if they are sick. Other smaller practices may not have the luxury of adequate coverage and may need a warm body present at all times. These practices may not be so forgiving. In fact, if you are on a partnership track, not showing up can prevent you from becoming a partner. You may be perceived as having a "poor work ethic." Unfortunately, this factor can come into play when you make that final decision whether to show up at work.
In sickness or in health: The bottom line!
To be dogmatic about either always staying home or going to work when sick is not realistic in today's radiology practices. It actually may be worse for patient care, if you don't show up to work a little sick. On the other hand, sometimes it really pays to stay home. The final decision needs to rest on a logical assessment of the circumstances of your health, the day's events, and the corporate culture of the practice. If compromised and unsure, we can also always ask our friend, spouse, or significant other for his/her opinion. With the help of others and a little bit of practical logic, it is possible to make a reasonable decision!
Barry Julius, MD, is a board-certified radiologist at St. Barnabas Medical Center. He is the developer of an [educational website](http://www.radsresident.com). He is a 2018–19 Doximity Author.
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