Doctors: if you’re sick, don’t go to work.

The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.

In a recent column, the New York Times’ Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:

Hacking, febrile or racked with the sequelae of chronic illnesses, doctors who are sick have continued for generations to see their patients. Although published reports for over a decade have linked patient illnesses like the flu, whooping cough and resistant bacterial infections to sick health care workers, as many as 80 percent of physicians continue to work through their own ailments, even though they would have excused patients in the same condition.

In today’s age of H1N1 influenza and other assorted public health worries, presenteeism is being looked at. Interestingly,

researchers in the business world have begun to question this assumption. Instead of focusing on problems incurred by absenteeism, these researchers have analyzed the impact of what’s been called presenteeism, or working despite being ill. And it turns out, at least in early studies, that those employees who choose to go to work sick are expensive. Presenteeism costs companies more than $150 billion a year in lost worker productivity.

And nowhere is the impact of presenteeism more profound than in the hospital.

Dr. Chen cites a recent study from the Journal of General Internal Medicine describing a norovirus outbreak in a nursing home spread despite stricter infection control measures.

As the lead author states,

“People probably felt they were showing up at work out of empathy for their patients and out of the kindness of their hearts … But they weren’t thinking about the risks.”

Indeed.

This is going to require a culture shift in medical training. During residency, you literally would have to be dying in order to call in sick. Not only to “be there” for your patients, but also not to impose on your colleagues.

That mentality has to stop. Unrestricted paid leave and mandatory time off for sick workers need to happen now.

Doctors are doing more harm than good by coming to work sick.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.