"Go to school. You'll be fine," or "If I miss work, I'll be fired." These are common misconceptions most of us have learned throughout life. Why is it so difficult for us to stay home when ill?

The reasons are different for each of us. For the general public, one reason is more than 40 million American workers get no paid sick leave. They have to work when ill or take unpaid sick days, which can lead to financial hardship, or even dismissal.

But what about healthcare professionals? When clinicians work with symptoms of infection, they can put patients and colleagues at risk.

Many physicians and advanced practice clinicians have reported to work while being sick despite recognizing this could put patients at risk, according to a small survey published online by JAMA Pediatrics. Even though nearly every medical practitioner in a recent survey acknowledged the potential risk for patients, more than three-quarters of all respondents said they have worked while they were sick.

Researchers wanted to know more about why healthcare professionals work while sick, so they surveyed doctors, nurse practitioners, physician assistants, nurse anesthetists and midwives. A team of researchers, led by Julia Szymczak of the Children's Hospital of Philadelphia, received anonymous responses from more than 500 healthcare professionals.

The physicians cited concerns ranging from continuity of care and letting patients down to staffing concerns and fears of professional ostracism.

The vast majority of those surveyed (95 percent) believed working while sick put their patients at risk. Still, 83 percent admitted to working while sick at least once in the past year, and 9 percent said they worked while sick at least five times. They said they worked with symptoms like diarrhea, fever and significant respiratory issues.

And why do they work when sick?

  • 99 percent didn't want to let their colleagues down
  • 95 percent had concerns about staffing
  • 92.5 percent didn't want to disappoint their patients
  • 64 percent were worried about being ostracized by their colleagues
  • 64 percent were concerned about continuity of care

The study was limited in several ways because it was anonymous, so researchers couldn't assess bias or which job title a responder might have, in order to compare groups. Those who answered the survey (only a little more than half who were asked to participate) might have different opinions than the nonresponders.

Additionally, the survey was conducted at only one hospital, and the patients were children, which may affect the doctors' perceptions of their roles.

That said, previous surveys have found similar results among different doctors and other locations, showing internal pressures in the medical community to work despite illness.