sick time as employed doc

[westcoastdoc]

Wanted to get some other opinions from fellow docs regarding the use of sick time.

I am a hospital employed physician who accrues sick time (around 1 day per month worked).  We can accrue a maximum of 22 days of sick leave.  As a surgeon, I really never use sick days.  Whenever I am sick, I usually work through it (if I can safely etc.) as I always feel bad about cancelling surgeries for my patients.  I also have one day off every 2 weeks.

Some of my colleagues often take sick days for routine doctors appointments, dental appointments and have suggested that I do the same.  I feel that I could often schedule these routine appointments on my days off.  Any other opinions on using sick time for non urgent appointments when you have a 'use it or lose it' sick time policy?

[AlexxT]

I would certainly use it for dental appointments and elective doctor appointments. It need not be an emergency to be appropriate.  In any case, it sounds like the culture considers that to be appropriate.  There's no reason for you not to take advantage of that benefit as well.

Also, be sure to  accrue the maximum.  You may need it for a severe illness or for elective or emergent surgery.  22 days of sick leave is one month off.  You could burn through that very quickly

[PhysicianOnFIRE]

Giving a physician a day of "sick time" per month is silly. It's not like we can decide last minute not to show up unless there is a true emergency. We have a full slate of appointments or surgeries that have been on the books for weeks or months.

If you can negotiate those sick days to become vacation days, even if you only get half as many, it would be worthwhile. In ten years of practice, I've taken exactly zero sick days, but I've never had a contract that encouraged it.

Best,

-PoF

 

 

[Hatton]

Most docs I think will work sick unless they are having surgery.  It sounds like the policy is a blanket one designed for all hospital employees.  I would not want to reschedule surgeries because I had a dentist appointment.  I would be infuriated if I found out my case was rescheduled for something like that.

[jhwkr542]

I've always liked the idea of getting a set number of days off for everything. I don't understand people using sick days for vacation. Especially during residency when someone had to cover for them. Not someone I want to work with when they're looking out for #1.

Re: OP, I agree that I wouldn't cancel surgeries for "sick" days. It may be routine for you, but having surgery is a big event for most people's lives. Not something I would want my surgeon cancelling just to avoid losing a sick day.

[The White Coat Investor]

There is a fairly severe culture in EM to work when sick. The reason is because the work has to be done and it has to be done that day. If you don't do it, someone else has to. So you're burning someone else's day off when you take a sick day. Thus, you have to really be sick to take a sick day. A doctor's appointment? No way. You'd be thrown out of a small democratic group if you pulled that stunt more than once. Switch shifts or schedule it before or after your shift or on a day off.

The expectation is that you'll be in the ED when you're scheduled to be in the ED. If you're not seeing patients, you'd better be a patient.

I like the idea of negotiating them into vacation days. I also think it's wise to save up your 22 days and keep them just in case.

Now, if you normally work during doctor's clinic hours, perhaps it is different. I guess I just don't like the "employee mentality" that leads people to need doctor's notes when they're sick because their employer literally doesn't believe them.

[westcoastdoc]

I too would never use sick time to add extra work for colleagues or cancel surgery. I didn't take a single sick day in residency, as not to burden my coresidents etc. Often, in practice some physicians use a little sick time scheduled way in advance to make time for non urgent appointments. Just wondering if anyone else used this in a similar fashion.

[The White Coat Investor]

westcoastdoc wrote:

I too would never use sick time to add extra work for colleagues or cancel surgery. I didn’t take a single sick day in residency, as not to burden my coresidents etc. Often, in practice some physicians use a little sick time scheduled way in advance to make time for non urgent appointments. Just wondering if anyone else used this in a similar fashion.

Click to expand...

I missed one shift in residency. I left the one the day before with an IV in my arm and was literally not out of bed (maybe to pee once) until I got up to go to my shift the following day.

One of the most annoying things to work with is laryngitis that I seem to get with a URI once or twice a year. You don't feel sick, but you can't really talk for an entire shift. By 3 or 4 hours in, the nurses, the patients, and you are all annoyed.

[childay]

OP, how are you paid?  If I take a sick day I will lose money as I am on a productivity model.  If I were paid on some other basis I might use the sick days assuming you could get paid for that day and arrange coverage etc.  I actually had to look back at my contract just now to see what it says.  I apparently accrue PTO days which can use for illness, but have no idea how many I have accrued since I have never used them..

[Dru]

Outpatient employed doc here. I'm in a large office, and because of one of my roles I know every sick call. A few people use it a lot more than others. Some nearly never, and most people seem to feel if you don't need to see your own doctor then you can be at work. Can get tricky when people's kids get sick. So for us it sucks cancelling 15-25 appointments if someone calls out sick. Not as bad as a surgery, but still a huge inconvenience to the patients as well as the docs still in the office who will try to squeeze those patients onto their schedules.

In terms of scheduled appointments, our expectation is you'll go on your day off. I work full time, clinic hours, so every 6 months I use an hour or two to go to the dentist. But always scheduled way in advance so as to not cancel any appointments.

My overall feeling is unless you are truly febrile, or vomiting you can probably work Probably 85-90% of my office is that way. Unfortunately there is no system in place to penalize those who call out sick more.

[Med0000]

I think the way your colleagues are using sick time is common among all employees.

Some of my partners can't understand why our midlevels always want to leave on time, want more pay, more vacation, and more sick time. All while our reimbursement is declining. I tried to explain to them it's because there is no ownership in the group. There is no skin in the game. I also think that you think about things differently when your billing is disconnected from your pay.

[GXA]

I hear what you are saying.  Although as an employed ED physician with no sick days in our contract, we have significant disincentives to call in sick.  We don't get paid for the day and it is significantly disruptive to my partners/colleagues as someone has to come in for the shift.

One problem is the inconsistent manner in which sick call is used (some use much more than others).  As mentioned earlier, somehow rolling sick days into vacation makes a lot of sense would provide a little disincentive to calling in for something minor.

[AlexxT]

This has nothing to do with calling in sick.

I think many of the above posters are missing the distinction between scheduled time off and unscheduled.   What OP was asking about was scheduled time off.   Patients and colleagues are no more inconvenienced by a dental appointment scheduled 3 months in advance than they are by a vacation day scheduled 3 months in advance.  Neither one results in patient cancellations or unfair or unanticipated impact on colleagues.

The question here was whether it was appropriate to use accrued sick days for a dental appointment scheduled in advance, rather than using vacation days for that purpose.  Based on my personal experience, and what OP described as the normal culture in his hospital, and based on common sense, I believe that if you have the benefit of sick days, they may be used appropriately for scheduled doctor and dental appointments, as well as for elective surgery and unexpected sick days.

OP, you will probably get the definitive answer from your group's physician employee handbook or HR.

I'm not suggesting that you call in sick unexpectedly one day a month to use up your sick leave,  but failing to take advantage of benefits that are there to be used appropriately is as foolish as refusing any other benefit.  They are part of your salary.  They are meant to be used.

Among other benefits, my group provided for 3 weeks of paid paternity leave for partners. That leave would generally be scheduled in advance.  Everyone was expected to make use of that leave if they qualified for it.  No one said " I'm not taking it because I never missed a shift as a resident".   Again, this is a benefit.  It's like vacation time, but it comes out of a different account, to be used for a different purpose. If you think that it's ok to take vacation days off and get paid for them, it's also ok to take sick days off and get paid for them.   Just as with vacation days, when possible, they should be scheduled well in advance.

[wideopenspaces]

I think it's totally acceptable to schedule your sick time in advance for routine dental and doctor appts. I also use it for my son's appts as well. I only work part time so I sometimes schedule them in the afternoon once I am off work, but honestly, this is a benefit your are given, so you should use it as such and not waste your free time on this stuff. For me, it doesn't disrupt patient care because I do it months in advance and we just block out the schedule.

Some of you are super hard core! Not a single sick day in 10 years?? So far, I've used about 1 sick day/year. Guess I vomit, get a fever, am contagious more often than the rest of you! I know it's a PITA for staff to cancel all my appts, so I only do it if I truly feel like I can't really work through it.

[EH]

Agree with trying to do routine appointments on my unscheduled time. my colleagues who work full time do need to use sick leave for these appointments. I think this is perfectly reasonable and makes it acceptable for all docs to do this. That being said taking time off usually just creates more work to do later so most of the time I find it less stressful to see the dentist on my day off.
We have a very large practice and routinely tell people to go home sick which is a nice culture to be in. The biggest issue is kids illnesses and that seems to be where most of the variation is. I see the 22 days as mostly for when you are direly I'll and hopefully you never need to use them. I really don't like the tend away from having separate sick leave (then again we get 6 months of sick leave so it really is a good benefit).