America has the flu

[Rapunzel]

Wait a second, Angie, your husband is an oncologist - right? Isn't it kind of bad to have oncology residents with illnesses around patients undergoing chemo and radiation because their immune systems are lowered??

You know, I can see a radiology program behaving this way - or a pathology program. They have incredibly limited patient contact for the most part so they're really just going to pass on any illness to other radiologists or pathologists. But, to have a surgeon or an oncologist or an obstetrician or ANYTHING peds related be FORCED by their program to expose their at-risk patients to serious complications is ridiculously irresponsible - and it IS malpractice.

Since there are so many "ethical" rules that places like the AMA impose upon physicians are there any regarding the ethics of a program forcing their patients to be exposed to an ill physician?

DH got sent home for a week for what was an unusual eye infection (he had to get an MRI to rule out a few other nasty things). I think the only thing that kept him out of there was that it looked incredibly gross. My eyes would water just looking at him. If I saw someone looking like that try to lay a hand on me....I'd go running out the door.

I agree that it is really horrible and perhaps unethical to subject patients to the illnesses of the resident or attending treating them. There should be a study on infectious disease trasmitted to the patient via the physician. That necktie study was pretty interesting!

[Sheherezade]

Isn't it kind of bad to have oncology residents with illnesses around patients undergoing chemo and radiation because their immune systems are lowered??

Ya think?!!? But I suppose *not* treating the patients at all is also a bad thing. (Or making them wait until you get better--after they've gotten worse.)

I think a lawsuit or two would be interesting. Lawsuits do seem to influence the practice of medicine. I think the problem is that it is hard to prove that someone acquired said illness from said person.... particularly in a hospital setting when the patient has been in contact with so many people in each day. Of course, there is also the issue that hospitals might become understaffed quickly if an illness infected everyone. I know that the few times that something bad has been going around (during training - not now) several of the residents/staff were down at once. (And IV'd up!) And there is that problem that you are usually infectious before you show symptoms.

Of course now, DH would probably be able to call in sick or cancel cases if he was very ill. His cancer patients probably wouldn't like getting their surgery pushed back every time he got the sniffles though, and his practice always books solid 2 mos in advance so rescheduling becomes an issue.

I just read The Devil Wears Prada and was struck that the horrible behavior described comically within was actually pretty typical for some of DHs training experiences. It just didn't seem so outrageous. Clearly, I've been twisted by this experience. Maybe someone should write The Devil Wears Prada Scrubs.

[Vanquisher]

Unethical as it may be, it still goes on. Just as the 80 hour rule is so well adhered to , physicians are obviously encouraged not to work when they are sick. Right.

Residents definitely put in their own IVs here. Dh has been really sick a few times and sounded horrible. He's gone to work with me saying, "Maybe they will feel sorry for you and send you home?" My thinking was that surely patients wouldn't want to be exposed to a doctor who looks and sounds like ass. Apparently this is not a conflict with the ability for residents to work though, as he has yet to be sent home early for feeling like crap.

Heaven forbid a senior resident or attending do a little extra work when someone should clearly not be at work. Dh did have to take call once when another doctor had to wait for the results of his Hepatitis test before he could do surgery (he had a needle stick). Lovely.

Angie, I agree that too fine a test would throw the whole system out of whack and could also create other consequences for patients.

I think the general advice for the normal working population is that if you have a temp over a certain degree and/or vomiting or diarhhea stay at home. It seems like there is an article in the paper about this at the start of the flu season -- when to stay home and when to go to work. Handwashing and careful coughing and sneezing goes a long way.