English summary: Physicians work even while sick

Background

Physicians often report to work even though they are ill and should take sick leave. In Finland, doctors employed in public health care are entitled to paid sick days. Hence, one would expect them to stay at home while ill. The aim of this study was, firstly, to find out how many physicians had ever worked while they were ill and secondly, to find out how many of them had done so during the past year. We also investigated the kind of symptoms they had had and the reasons they had had for working while sick.

Methods

A cross-sectional survey in public health care was carried out in the Tampere University Hospital catchment area, Finland. The response rate was 65%, the collected data consisting of answers from 463 primary health care (PHC) physicians and 780 hospital physicians.

Results

The majority of the respondents (89%) had at some time worked in a condition for which they would have granted sick leave to a patient. The corresponding proportion during the past year was 65%. Whereas the hospital physicians’ risk of having ever “worked through” illness was 1, for the PHC physicians the risk was 3.13 (with a 95 % confidence interval of 1.96-5.01). For the past year the corresponding figures were 1 and 2.39 (1.84-3.11), respectively. Respiratory infection was the most common disorder reported, but more serious illnesses were also mentioned. The most commonly reported reason for continuing at work was the opinion that it is not appropriate for doctors to take sick leave.

Conclusions

Nearly all doctors had at some time worked despite being ill and two thirds had done so during the past year. This is a common phenomenon in health care, and reflects physicians’ commitment to their work. The doctors who work even though they are ill may constitute a danger to their patients as well as to themselves. Health care organisations should have strategies for dealing with doctors’ illnesses.