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Vol. 39. Issue 2.
Pages 100-108 (March - April 2024)
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Vol. 39. Issue 2.
Pages 100-108 (March - April 2024)
Original article
Why do physicians go to work when they are sick? Presenteeism at different career stages
¿Por qué van los médicos a trabajar estando enfermos? Presentismo en las diferentes etapas profesionales
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O. Urbano Gonzaloa,e,f, B. Marco Gómezb,e,f, C. Pérez Álvarezb,e,f, A. Gállego Royoc,e,f,
Corresponding author
alba_gallego@hotmail.com

Corresponding author.
, I. Sebastián Sánchezd,e,f, M.P. Astier Peñad,e,f
a Department of Anaesthesiology and Resuscitation “Miguel Servet” Hospital, Health Service of Aragón, Zaragoza, Spain
b Department of Psychiatry “Royo Villanova” Hospital, Health Service of Aragón, Zaragoza, Spain
c Department of Preventive Medicine “Miguel Servet” Hospital, Health Service of Aragón, Zaragoza, Spain
d “Universitas” Primary Health Care Centre, Health Service of Aragón, Zaragoza, Spain
e “University of Zaragoza”, Spain
f Feminisation and Ethics in the Health Professions (FEPS) Research Group, H36_23D, Institute of Health Research of Aragón (IIS Aragón), Spain
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Tables (5)
Table 1. Script of semistructured interviews.
Table 2. Average age of sample by gender.
Table 3. How often have you gone to work with a health problem for which you would have taken a patient off work? By gender and career stage.
Table 4. The main reason (choose only one) why you came to work when you were ill. Distributed by gender and career stage.
Table 5. Other passages coded in the categories related to presenteeism.
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Abstract
Introduction and Objective

Physicians find it difficult to take on the role of the patient and they show unusual behaviors when ill. One of these behaviors is presenteeism, which is working while sick. The objective of this research is to analyze the factors that contribute to the phenomenon of presenteeism in Spanish physicians.

Material and methods

Mixed methodology study: one national survey through the General Council of Medical Associations website (quantitative part), 22 semistructured interviews with sick residents and practicing physicians, and three focus groups involving professionals from the occupational health services (qualitative). A bivariate analysis using parametric and non-parametric tests. The significance level was p<0.05 (95% confidence interval). Qualitative analysis using the comparative-constant method until saturation of information.

Results

Presenteeism is reported by 89.4% of doctors who responded to the survey, and it is more common among women. Contributing factors include fear of overburdening colleagues (the main reason and more common among women 58.14% vs 48.35%), self-perception of doing one's duty (the second reason and more common among men, 44.63% vs 33.14%) and economic impact and difficulty in accepting the role of a sick person. This behavior has an impact on patient safety, and is part of the hidden curriculum that also affects the training of medical professionals.

Conclusions

Presenteeism is a widespread and accepted practice among medical professionals. Although normalized, and even appreciated as a way to avoid overburdening colleagues, presenteeism has important implications for clinical ethics and patient safety.

Keywords:
Presenteeism
Sick doctor
Physicians
Patient safety
Occupational health
Resumen
Introducción y objetivo

A los médicos les cuesta asumir el papel de pacientes y muestran comportamientos anómalos cuando están enfermos. Uno de estos comportamientos es el presentismo, que consiste en trabajar mientras estás enfermo. El objetivo de esta investigación es analizar los factores que contribuyen al fenómeno del presentismo en los médicos españoles.

Material y métodos

Estudio de metodología mixta: una encuesta nacional a través de la página web del Consejo General de Colegios de Médicos (parte cuantitativa), 22 entrevistas semiestructuradas a residentes enfermos y médicos en ejercicio, y tres grupos focales en los que participaron profesionales de los servicios de salud laboral (cualitativa). Se realizó un análisis bivariante mediante pruebas paramétricas y no paramétricas. El nivel de significación fue p<0,05 (intervalo de confianza del 95%). Análisis cualitativo mediante el método comparativo/constante hasta la saturación de la información.

Resultados

El presentismo es referido por el 89,4% de los médicos que respondieron a la encuesta. Y es más frecuente en las mujeres. Entre los factores que contribuyen a ello se encuentran el miedo a sobrecargar a los colegas (principal motivo y más frecuente en las mujeres, el 58,1 frente al 48,4%), la autopercepción de cumplir con el deber (segundo motivo y más frecuente en los varones, el 44,6 frente al 33,1%), el impacto económico y la dificultad para aceptar el papel de enfermo. Este comportamiento repercute en la seguridad del paciente, y forma parte del currículo oculto que también afecta a la formación de los profesionales médicos.

Conclusiones

El presentismo es una práctica extendida y aceptada entre los profesionales de la medicina. Aunque normalizado, e incluso apreciado como una forma de evitar sobrecargar a los colegas, el presentismo tiene importantes implicaciones para la ética clínica y la seguridad del paciente.

Palabras clave:
Presentismo
Médico enfermo
Médicos
Seguridad del paciente
Salud laboral

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