Forced to work when sick

[jsr52]

Curious to hear the groups thoughts on this.

I’m supposed to moonlight tonight at the hospital I’m a fellow at on the medical service, but two days ago threw my back out at the gym. I’m bedridden at the moment and can hardly move and my back is all contorted. If I were a lay person I’d probably be in the emergency room at this point but since this happens to me every few years I know I’ll be ok with ICE and Heat...

The fun part... I told the head of he hospitalist team I can’t work tonight (about 24 hours in advance). They had no remorse and said they had no backup plan when someone is sick other then seeing if anyone else can chip in which I doubt will happen since it’s 12/30...

So I’ve found myself in a position where I’m essentially being “forced” to work with a pretty bad injury, and this isn’t even my primary employer. If I had a cold, I’d be there in a heartbeat, but not being able to move is a whole different beast.

Has anyone ever found themselves in this situation? If this wasn’t the hospital I’m a fellow at it be much easier to stand my ground and tell them I simply can’t work. Im also considering going to urgent care tommorow, so this is documented Incase working tonight worsens my injury...

[AR]

There is a general expectation that docs suck it up more than most.  That's just the way it is.

Having said that, it is foolish on their part not to have a contingency plan.  What if you got hit by a bus on the way to work?  Stuff happens.

If you can't do it, then you can't do it.

Also agree that actually seeing someone is a good idea.  Maybe they can even help get you better.

 

 

 

[jfoxcpacfp]

So, even if you are contagious...?

[q-school]

you've notified them that you can't work.  they will take care of it.  if you don't show, pretty much count on never working there again, note or no note.   or at least only getting the crap shifts.

i'm not sure about why you think the the primary employer part matters, other than you can still finish your fellowship.

many places don't have a more specific contingency plan than scrambling to find coverage, or asking the other team members working at the affected time to suck it up.  it's very specialty dependent.  even if they have a plan for one person being sick, what if two are sick?   three?

it would be much better if you could get a co fellow to cover.  even if you have to do an 'uneven' trade of two shifts for one or something.

hope you feel better.

 

 

 

 

[cgossage]

My wife has never taken a sick day in 10 years.  I don't agree with it, and I sympathize with how much physicians sacrifice.  I think if you have to miss a shift you do.  You may not be able to moonlight there again, but maybe it isn't worth moonlighting at a place that expects you to literally break your back on the job.

[VagabondMD]

q-school wrote:

you’ve notified them that you can’t work.  they will take care of it.  if you don’t show, pretty much count on never working there again, note or no note.   or at least only getting the crap shifts.

Click to expand...

It sounds like he already has the "crap shifts".

 

jsr52 wrote:

The fun part… I told the head of he hospitalist team I can’t work tonight (about 24 hours in advance). They had no remorse and said they had no backup plan when someone is sick other then seeing if anyone else can chip in which I doubt will happen since it’s 12/30…

Click to expand...

I would also make the distinction between being "sick" versus injured, as the latter is the case here.

Yes, I would agree that there is rarely a contingency plan. What would that look like? Paying someone to be available in case of illness, accident, or other emergency. Where would the money come from?

I am not sure that I would expect "remorse" from them (that should come from you), perhaps, sympathy, but now they have a problem to deal with. Usually it's a scramble to find someone to cover, as it is in this case. I doubt that the OP will burn a bridge, but it would be nice if he could assist in finding the coverage solution.

[CM]

cgossage wrote:

My wife has never taken a sick day in 10 years.

Click to expand...

.

[Dr. Mom]

From experience...Lidoderm patch will help if you truly have to suck it up.  Good luck!

[cgossage]

CM wrote:

cgossage wrote:

My wife has never taken a sick day in 10 years. 

Click to expand…

I had a four month stretch without a single day off as an intern and I developed a terrible case of the flu on one of those weekends. I worked Saturday, but my resident had to be there on Sunday anyway and he took pity on me. It was fairly easy for him to do rounds on our patients without me, so he sent me home for that half day. That’s the only time I ever missed as a physician or med student.

On the other hand, when I worked in financial services for several years I missed a couple of days. I had food poisoning on one occasion (don’t buy pre-cut cantaloupe at the grocery store: http://www.foodsafetynews.com/2012/08/cantaloupe-food-safety-101/) and stayed home. If I was working as a physician I would have gone in.

 

Click to expand...

Yep.  Totally different in finance and pretty much every other field I can think of.  My wife operated up until the day she delivered both of our kids.  I on the other hand have taken a bunch of sick time. In an office, everyone looks at you weird if you are coming in ill.  In a hospital, it seems like its expected.  I get there is a coverage issue in a hospital that may not exist in an office, but it does seem like there should be a better way of doing it that is more in line with other industries.

[Peds]

jfoxcpacfp wrote:

So, even if you are contagious…?

Click to expand...

yup.

[VagabondMD]

I have missed 5.5 days in 22 years, for illness:

1 1/2 days for the flu--my chief said I looked terrible, had a nurse take my temp, it was 103+ and he sent me home.

Four days for chicken pox--I ran into the Head of Pediatrics one night, she diagnosed me on the spot and ordered me to leave and not come back to the Hospital until the pox scabbed over. I was on the Monday evening shift, working alone, I finished my shift and did not return until the following Monday.

Yes, the culture of medicine is to "suck it up". In the long run, I do not think that it is healthy, and it is hard to do your best when you are feeling lousy. But again, what are the alternatives? Tell the patients to go home because there's not a doc to do the job? Close ERs? Cancel surgeries and procedures?

[hightower]

Not much you can do except decide if you truly can not work and if you can not, don't go in.  If I were you I'd be contacting anyone you could to see if they can cover the shift for you.  That takes the burden off your employer and solves your problem if you're successful.  You can text while you're laying in bed right?

I hope you feel better quick though.  That sucks

I have only had to call in sick once since I've been out of residency and it was when I got food poisoning and literally couldn't leave the bathroom because I was throwing up so much.  My partners had to suck it up and see my patients that day.  I hated doing that, but had no choice.  I would do the same for them though and I wouldn't dare complain.

[Hatton]

I think the culture is you work unless actively vomiting.  It may not be very healthy but that is the expectation.

[MPMD]

the problem is that there are problems with every kind of coverage system.

if you have an "on-call" doc for emergencies that can be seriously abused and over used. this tends to work better in fields like EM where bad behavior can eventually be ironed out by the person doing the schedule but can still cause difficulty. i've also had friends with young kids who really can't do the call shifts b/c it means you have to have extremely flexible and costly childcare.

if no one is on call you incentivize docs to work when sick and can create patient safety issues if one is truly unable to work.

i've worked in both systems and seen problems with both. no great answer.

when i've been too sick to work safely i don't work. there isn't any point at all in being a hero and compromising patient care. esp working at the ivory tower where sometimes half of my patient's WBC added together wouldn't equal 10 it doesn't make much sense to come in contagious.

[Dicast]

I use a salonpas patch when my back flares up. It can nurse me along for a day or so but I have had to switch shifts a couple times.

The worst call out I made was for pink eye. It is an instant patient complaint if you push thru it.