Is it ok to take a mental health day off from residency?

[hallowmann]

With all due respect, the child care options described vary wildly depending on where you are. I can absolutely say that if my child was sick and my spouse couldn't take care of her, we'd struggle to find someone on short notice, especially when even some of the respite care options in my area have limitations on age, illness, and get full. I'm fortunate enough to have a spouse that is flexible, but I don't delude myself into thinking that everyone is as lucky as I am.

What exactly do you think causes burn out if you claim it can be prevented by a single resident being "proactive in developing strategies to help avoid it"? I'd love to hear your proactively developed strategies to help avoid dealing with hostile patients, malignant attendings, 30+ hour shifts, etc.

Its the same process of blaming the individual for their "lack of resilience" instead of the pressure cooker that placed them at risk. Its like blaming the narcotic addict for being hooked on painkillers when they were injured on the job, had to keep working due to a lack of finances, and were given a bunch of long-term opioids by their doc for their chronic pain (so that they could physically keep working). Yeah, if only that guy had more will power, right? Not money in his bank account, a better job with disability/workman's comp, a better education, or a more responsible doc...

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[mvenus929]

Should programs strive to make things available to residents in these situations? Of course. But sitting around waiting for a program to solve your problem for you isn't the right answer either. Which is part of what annoys me about these discussions about burnout. We can agree that burnout is a problem, but avoiding it requires the individual to be proactive in developing strategies to help avoid it. These efforts should be facilitated and promoted by the program, but expecting it to happen without any individual effort is fairly entitled.

I actually disagree with this. Our health system did a burnout survey of all staff. The attendings in my division are significantly more burned out than the rest of the attendings in the system. A huge part of that is that they feel they have no power. Decisions are made at an administrative level (both hospital wide and for our division) and then handed down to the division without input or discussion. They’re also being pushed to see more patients, to take on additional clinics, all the while they turn out research and educate.

Yes, some of them intentionally work too hard-they take on additional shifts and don’t have a good work life balance. Those individuals need to make some personal changes to avoid burnout. But there are also those who have a fulfilling home life, and love taking care of patients, but are sick of coming to work because of all the administrative stuff they are forced to do that doesn’t seem to have any benefit to themselves or the patients.

 

[Mass Effect]

I actually disagree with this. Our health system did a burnout survey of all staff. The attendings in my division are significantly more burned out than the rest of the attendings in the system. A huge part of that is that they feel they have no power. Decisions are made at an administrative level (both hospital wide and for our division) and then handed down to the division without input or discussion. They’re also being pushed to see more patients, to take on additional clinics, all the while they turn out research and educate.

Yes, some of them intentionally work too hard-they take on additional shifts and don’t have a good work life balance. Those individuals need to make some personal changes to avoid burnout. But there are also those who have a fulfilling home life, and love taking care of patients, but are sick of coming to work because of all the administrative stuff they are forced to do that doesn’t seem to have any benefit to themselves or the patients.

And let's remember that EMR burdens is thought to be one of the main contributors to burnout and that's something most have no say in.

 

[Gastrapathy]

I’m just curious if you think you should be paid for your mental health day?

 

[calvnandhobbs68]

I’m just curious if you think you should be paid for your mental health day?

I’m curious if you think you should be paid for sick days?

 

[Gastrapathy]

I’m curious if you think you should be paid for sick days?

Sure. If you take them when you are sick. If you use them as extra vacation, then no.

 

[calvnandhobbs68]

Sure. If you take them when you are sick. If you use them as extra vacation, then no.

And how are you gonna figure that one out? Go knock on someone’s door every time they take a sick day and demand to see their diarrhea or thermometer?

There are some rare flagrant violations of “sick days”. There are some people that are truly debilitated when they take a sick day and would not be able to work reliably that day. Many of them fall into a large grey area.

 

[Gastrapathy]

I’m not going to try to catch anyone but I also wouldnt cheat just because it would be hard to catch me.

A “mental health day” is just a way to justify getting paid to skip work that sounds better than “I didn’t feel like showing up” but is actually the same thing. Abuse of sick days is something every company has to deal with but relabeling it under the guise of wellness doesn’t change anything. If “mental health day” is in your employee handbook as a justification for calling out, then sure. Otherwise, see what your boss thinks when you tell her.

 

[Mass Effect]

Sure. If you take them when you are sick. If you use them as extra vacation, then no.

I’m not going to try to catch anyone but I also wouldnt cheat just because it would be hard to catch me.

A “mental health day” is just a way to justify getting paid to skip work that sounds better than “I didn’t feel like showing up” but is actually the same thing. Abuse of sick days is something every company has to deal with but relabeling it under the guise of wellness doesn’t change anything. If “mental health day” is in your employee handbook as a justification for calling out, then sure. Otherwise, see what your boss thinks when you tell her.

I wouldn't "have" to be breaking duty hours. You can't work more than 80 hours per week per ACGME rules. In third year psychiatry, we work max 40 hours a week and have weekend call only once a month for 16 hours. So 3 weeks 40 hours and one week 56. Which means I can work technically over 120 hours moonlighting without breaking duty hours. And Im not wrong on how much Im gonna make. This month Im making over 12000+ but Im not gonna post the amount because people will freak out saying Im working too many hours.

Also, everyone this situation is real. Im not trolling. I promise. That previous post of the ratting was uncalled for. Im sorry about that. But this situation is 100% real.

Clearly, you and I have very different definitions of mental health. As a psychiatrist, I stand by my point that a mental health day qualifies as a sick day. Taking a day off because you're feeling mentally unwell is no different than taking a day off because you're feeling physically unwell. The degree to which it's debilitating can be argued for both. And yes, if he/she has sick days left, then he/she should absolutely be paid for the day.

 

[Gastrapathy]

With no diagnosis? Then basically you are saying to treat all days as vacation which is fine if it’s the same for everyone but we all know that isn’t how it works.

 

[emergentmd]

So has residency training devolved into believing mental health days are good?

What a slippery slope this is.

Who defines what a mental health day entails?
Is there a Max placed on mental health days?
Do you need a doctor's note?

Back in the days without hour restrictions, I could have used a mental health day every week. After a 36 hr call, I would have loved to have 24 hrs off to sleep in but someone had to see the patients which would have been another overworked resident.

 

[DarkHorizon]

I don’t know, I never called in sick or just took a day off other than PTO in my residency/fellowship, neither did anyone that I know. I feel like I went to a fairly benign residency and fellowship. It was just the most responsible thing to do, everyone had to carry their own weight, calling in sick would have really caused chaos.

 

[Mass Effect]

With no diagnosis? Then basically you are saying to treat all days as vacation which is fine if it’s the same for everyone but we all know that isn’t how it works.

You don't always have a diagnosis when you're feeling physically unwell. It's the same thing here.

So has residency training devolved into believing mental health days are good?

Who said they were good? Sometimes being necessary is not the same as being good.

Who defines what a mental health day entails?

The patient.

Is there a Max placed on mental health days?
Do you need a doctor's note?

The max is the sick day max since they're sick days and no, you should not need a doctor's note, unless you need one for physical ailments as well.

Back in the days without hour restrictions, I could have used a mental health day every week. After a 36 hr call, I would have loved to have 24 hrs off to sleep in but someone had to see the patients which would have been another overworked resident.

I'm sorry that your generation of docs didn't stand up for what's right, but no need to advocate for the rest of us to deal with what you did.

I don’t know, I never called in sick or just took a day off other than PTO in my residency/fellowship, neither did anyone that I know. I feel like I went to a fairly benign residency and fellowship. It was just the most responsible thing to do, everyone had to carry their own weight, calling in sick would have really caused chaos.

Calling in sick would not have "caused chaos." People would have dealt with it, just as they deal with it when a nurse calls out or a CNA calls out or anyone else taking care of patients. When multiple people in my residency class got pregnant at the same time, we didn't run around like chickens with our heads cut off. We dealt with it. I think people are so programmed to think that doctors are the be-all-end-all of the universe that if one gets sick, it'll be the collapse of the world as we know it. This isn't the case. The world will still continue to turn, just as it always has.

Don't make a habit of it, but if you need the occasional "mental health day," take it. And the above posts are proof that you need to call it a sick day since people still tend to not take it seriously.

 

[Merely]

I love that people are equating mental health day to just being lazy and wanting the day off. Again, if physicians have this sentiment and misconceived conception of mental illness no wonder there’s a suicide epidemic...

 

[VA Hopeful Dr]

I love that people are equating mental health day to just being lazy and wanting the day off. Again, if physicians have this sentiment and misconceived conception of mental illness no wonder there’s a suicide epidemic...

The problem is that sometimes that's exactly what they are

 

[emergentmd]

My residency didn't have any PTO days or sick days. Didn't exist. If you called in too much, you were dealt with swiftly by the upper levels/attending.

So how many Sick days do residents get? Do they roll over or disappear if not used?

If there are set number of sick days, Can I save them then call in sick for a week while taking a vacation?

If no one can define being sick, or what a mental health day is (what is this anyhow) then why can't I just call in sick and go to vegas for a week?

I get if you got a bad bug and you will be back tomorrow. But does one mental health day really fix mental health issues? If one day is all someone needs to fix their mental health issues, then I call BS to this and call it lazy.

 

[Mass Effect]

The problem is that sometimes that's exactly what they are

As are sick days. Should we get rid of them altogether?

My residency didn't have any PTO days or sick days. Didn't exist. If you called in too much, you were dealt with swiftly by the upper levels/attending

You trained at a time when medicine was malignant. Your experience should not be passed down.

So how many Sick days do residents get? Do they roll over or disappear if not used?

Depends on the program. Yes, at some programs they do roll over. At some, it's use them or lose them. At some, you get paid for unused sick days.

If there are set number of sick days, Can I save them then call in sick for a week while taking a vacation?

I mean, you can, but if you get caught, you'll be terminated.

If no one can define being sick, or what a mental health day is (what is this anyhow) then why can't I just call in sick and go to vegas for a week?

The desire of wanting to hold on to their job is what prevents most from doing this.

I get if you got a bad bug and you will be back tomorrow. But does one mental health day really fix mental health issues? If one day is all someone needs to fix their mental health issues, then I call BS to this and call it lazy

And I would suggest you don't really understand mental wellness. As a psychiatrist, I can tell you that one day can help someone with mental health issues. And the argument that it can't is as silly as telling someone they shouldn't take a sick day for the flu because the flu won't get better in one day.

 

[emergentmd]

I will own that I will never understand mental health or if one day off will fix things b/c I never had an issue with this.

If you say that someone could be fired for taking a week off and going to vegas, how can you prove they didn't go to vegas for a Mental health week?

If my program gave me 7 mental health/sick days off and I didn't use it, why would I be stupid enough to not take it? I would gladly take a week off and stay home "sick" or go to the beach somewhere for a mental health week.

This just seems fraught with abuse. All it takes is one or two residents to take a week off for "mental health" for the rest of the residents to do the same.

I have never missed a day of work in my life. If one of my residents took all 7 dys off in the year and I had to pick up the slack (yes someone has to see the patients and it will not be the attending first) I sure as heck would take my 7 days off too. I would be dumb to show up for work when people are taking their full sick days.

We were paid about $700/wk, why in the world would I go to work for 80-100 hrs for the week for $700?

 

[Mass Effect]

I will own that I will never understand mental health or if one day off will fix things b/c I never had an issue with this.

If you say that someone could be fired for taking a week off and going to vegas, how can you prove they didn't go to vegas for a Mental health week?

If my program gave me 7 mental health/sick days off and I didn't use it, why would I be stupid enough to not take it? I would gladly take a week off and stay home "sick" or go to the beach somewhere for a mental health week.

This just seems fraught with abuse. All it takes is one or two residents to take a week off for "mental health" for the rest of the residents to do the same.

I have never missed a day of work in my life. If one of my residents took all 7 dys off in the year and I had to pick up the slack (yes someone has to see the patients and it will not be the attending first) I sure as heck would take my 7 days off too. I would be dumb to show up for work when people are taking their full sick days.

We were paid about $700/wk, why in the world would I go to work for 80-100 hrs for the week for $700?

So this is the issue I have with a lot of my fellow physicians. If people worked non-doctor jobs prior to med school, they would know that most full-time professional jobs offer sick days. They trust people to be adults. Do some take advantage of it? Yes. Do they get caught? Some do and those are usually the ones who get fired. But that is no reason not to offer sick days. The majority of professions have figured that out. Why can't medicine?

We had 14 days we could use per year for sick days. It rolled over. Throughout all 4 years of residency, I used 3 days. With the exception of my classmates who took maternity leave, the rest of my class used the same or less. It's called adulting. We were able to do it.

Also, most business places ask for a doctor's note if you're out for more than 2 or 3 days, so your week in Vegas is unlikely to come to fruition.

 

[calvnandhobbs68]

I don't understand the outrage going on in this thread...

Have you guys really not known people who had some pretty soft "sick" days at times? Yeah, it's a little annoying but nobody is up in arms about it. You can abuse sick days pretty easily already...and there are people that do but the majority of people don't. That's why sick days generally work out okay.

I don't even know why this is really a debate. We shouldn't even be talking about "mental health days". Just take a sick day if you feel like you're really not gonna be able to function well if you came into work that day, for any particular reason. Everyone has different individual thresholds for this. Thresholds should likely be higher if you're on a rotation where someone will have to cover for you than one where someone will not. People's bodies and minds get sick though, for a variety of reasons. No matter what you take a sick day for, its very unlikely anyone is going to seriously question you unless you're taking multiple days in a row.

What OP is asking is more of "can you guys all make me feel better by telling me it's okay to take a mental health day". This is more of a question of validation. It's like saying "hey guys is it okay for me to take a sick day cause I have a cold?". Some people might say "sure", some people might say "you're either working in the hospital or admitted to it". You're unlikely to get a true consensus. It's like the person above who was bitching about the one resident not having emergency backup childcare for his/her child and had to take a day off....

For background, I haven't taken a sick day in 4 years of residency. Obviously my threshold for taking a sick day is pretty high. That doesn't mean that my personal value system is the only or right answer...or that I know exactly what is going on in everyone else's life that would cause them to take a sick day.

 

[calvnandhobbs68]

My residency didn't have any PTO days or sick days. Didn't exist. If you called in too much, you were dealt with swiftly by the upper levels/attending.

So how many Sick days do residents get? Do they roll over or disappear if not used?

If there are set number of sick days, Can I save them then call in sick for a week while taking a vacation?

If no one can define being sick, or what a mental health day is (what is this anyhow) then why can't I just call in sick and go to vegas for a week?

I get if you got a bad bug and you will be back tomorrow. But does one mental health day really fix mental health issues? If one day is all someone needs to fix their mental health issues, then I call BS to this and call it lazy.

what an EM thing to say.

And also what? If someone had a IBD flare and had to take a day or two off for that would you say that was "BS" because their chronic disease couldn't have resolved in just a day or two?

 

[Wordead]

Must be nice. I've never heard of someone calling off in my program. We must be superhuman.

I totally remember that one time my attending cancelled their clinic and rescheduled 40 patients.

 

[VA Hopeful Dr]

As are sick days. Should we get rid of them altogether?

If I took a sick day on a rotation that mattered, I had to prove it (most jobs require a doctor's note as you mention later).

If it's an elective month, do whatever you want.

 

[Mass Effect]

Must be nice. I've never heard of someone calling off in my program. We must be superhuman.

I totally remember that one time my attending cancelled their clinic and rescheduled 40 patients.

Your attending had 40 patients scheduled and the shocker was him/her calling out?

 

[Raryn]

You don't always have a diagnosis when you're feeling physically unwell. It's the same thing here.



Who said they were good? Sometimes being necessary is not the same as being good.



The patient.



The max is the sick day max since they're sick days and no, you should not need a doctor's note, unless you need one for physical ailments as well.



I'm sorry that your generation of docs didn't stand up for what's right, but no need to advocate for the rest of us to deal with what you did.



Calling in sick would not have "caused chaos." People would have dealt with it, just as they deal with it when a nurse calls out or a CNA calls out or anyone else taking care of patients. When multiple people in my residency class got pregnant at the same time, we didn't run around like chickens with our heads cut off. We dealt with it. I think people are so programmed to think that doctors are the be-all-end-all of the universe that if one gets sick, it'll be the collapse of the world as we know it. This isn't the case. The world will still continue to turn, just as it always has.

Don't make a habit of it, but if you need the occasional "mental health day," take it. And the above posts are proof that you need to call it a sick day since people still tend to not take it seriously.

My god.

My residency program had sick days and it had vacation days.

Days off are of course great for the mental health - that's why everyone always used their full vacation days.

Sick days OTOH were reserved for days you were unable or unsafe to work. Everyone had their own threshold for using them - but no one I know of (outside of maternity leave) came close to using the full amount we had, which was like 13 or 14 of them each year (without rollover). Other residents saw when someone used them more freely - and we made note of it. Not that we did anything about it. I personally called in sick legitimately twice in five years of training, plus I did it a few extra times as a PGY3 because my program didn't give us enough interview time (though all of this was done only on rotations that didn't require coverage -and the fake calling in sick was with the tacit understanding of our chief residents, who agreed we didn't have enough interview time but weren't in a position to change the policy).

Using sick days as extra vacation days for your mental health is not "OK" - that is not the purpose of the sick days and abusing them is breaching your contract with your employer and involves pushing work from you onto your peers and attendings.

Now as an attending I just have a unified pool of PTO. If I take a day for a sick day or a doctors appointment or whatever, I have less PTO I can use for vacation. It's much less vulnerable to abuse.

 

[Merely]

If I took a sick day on a rotation that mattered, I had to prove it (most jobs require a doctor's note as you mention later).

If it's an elective month, do whatever you want.

You have to prove vomiting? You have to prove a fever? How does one prove those things? You’ve never been too sick to go to work but not needing to go to doctor?

 

[dpmd]

You have to prove vomiting? You have to prove a fever? How does one prove those things? You’ve never been too sick to go to work but not needing to go to doctor?

You show up to work and have witnessed vomiting or chills and get sent home was the way we did it (or you get a nurse to hit you up with some zofran and an iv then you feel better enough to keep working, but that was before it became too hard to borrow a dose from the pyxis without having to enter a patient). This was fine by me as I was used to the way it is in the army which is that if you don't think you can work you have to get up extra early to go to sick call in order to get an excuse. I think the only time I called in sick in my adult life (excluding the teen years where I absolutely did occasionally just call in fake sick) was when I was postop from my thyroidectomy and had come in the day prior for the first day of the rotation but woke up really sore so took a prescribed vicodin and called in drugged. Other than that it has been being sent home by a sympatheric senior or missing work under doctor's orders.

 

[VA Hopeful Dr]

You have to prove vomiting? You have to prove a fever? How does one prove those things? You’ve never been too sick to go to work but not needing to go to doctor?

If I was on a call month, if I was sick enough to miss work I clearly needed to see a doctor. If vomiting, to get zofran. If feverish, to check for flu/strep (since fevers in adults are fairly unusual for standard viral infections).

The one call day I missed was with a CT proven kidney stone, and I tried to go back but the attending wouldn't let me (it had made it to my bladder by the time the CT was done so I felt fine).

 

[Merely]

If I was on a call month, if I was sick enough to miss work I clearly needed to see a doctor. If vomiting, to get zofran. If feverish, to check for flu/strep (since fevers in adults are fairly unusual for standard viral infections).

The one call day I missed was with a CT proven kidney stone, and I tried to go back but the attending wouldn't let me (it had made it to my bladder by the time the CT was done so I felt fine).

Lol bro residency is not that serious, they can survive a day without you..especially if you’re feverish/contagious

 

[Merely]

You show up to work and have witnessed vomiting or chills and get sent home was the way we did it (or you get a nurse to hit you up with some zofran and an iv then you feel better enough to keep working, but that was before it became too hard to borrow a dose from the pyxis without having to enter a patient). This was fine by me as I was used to the way it is in the army which is that if you don't think you can work you have to get up extra early to go to sick call in order to get an excuse. I think the only time I called in sick in my adult life (excluding the teen years where I absolutely did occasionally just call in fake sick) was when I was postop from my thyroidectomy and had come in the day prior for the first day of the rotation but woke up really sore so took a prescribed vicodin and called in drugged. Other than that it has been being sent home by a sympatheric senior or missing work under doctor's orders.

Lol..

 

[Mass Effect]

My god.

My residency program had sick days and it had vacation days.

Days off are of course great for the mental health - that's why everyone always used their full vacation days.

Sick days OTOH were reserved for days you were unable or unsafe to work. Everyone had their own threshold for using them - but no one I know of (outside of maternity leave) came close to using the full amount we had, which was like 13 or 14 of them each year (without rollover). Other residents saw when someone used them more freely - and we made note of it. Not that we did anything about it. I personally called in sick legitimately twice in five years of training, plus I did it a few extra times as a PGY3 because my program didn't give us enough interview time (though all of this was done only on rotations that didn't require coverage -and the fake calling in sick was with the tacit understanding of our chief residents, who agreed we didn't have enough interview time but weren't in a position to change the policy).

Using sick days as extra vacation days for your mental health is not "OK" - that is not the purpose of the sick days and abusing them is breaching your contract with your employer and involves pushing work from you onto your peers and attendings.

Now as an attending I just have a unified pool of PTO. If I take a day for a sick day or a doctors appointment or whatever, I have less PTO I can use for vacation. It's much less vulnerable to abuse.

Pretty sure you misunderstood the posts you're responding to. I never advocated using sick days as extra vacation days. Actually, I said that shouldn't be done and that people will get found out for doing such a thing. Mental health days ARE sick days. Being mentally unwell is equivalent to being physically unwell and anyone thinking otherwise does not understand mental wellness. If you are struggling with anxiety to the point you can't go to work, take a sick day because you are, by definition, sick. That's the point. Why you would make the leap that this thread is advocating for using sick days as vacation days for mental health is beyond me because it suggests a misunderstanding of the posts, mental wellness, or sick/vacation days.

You show up to work and have witnessed vomiting or chills and get sent home was the way we did it (or you get a nurse to hit you up with some zofran and an iv then you feel better enough to keep working, but that was before it became too hard to borrow a dose from the pyxis without having to enter a patient). This was fine by me as I was used to the way it is in the army which is that if you don't think you can work you have to get up extra early to go to sick call in order to get an excuse. I think the only time I called in sick in my adult life (excluding the teen years where I absolutely did occasionally just call in fake sick) was when I was postop from my thyroidectomy and had come in the day prior for the first day of the rotation but woke up really sore so took a prescribed vicodin and called in drugged. Other than that it has been being sent home by a sympatheric senior or missing work under doctor's orders.

This kind of BS is why the rest of us are now subjected to hours of "wellness" modules. No, you don't come in to work with vomiting and chills. I don't know of a single hospital whose occ health team wouldn't tell you to stay home because you're putting all patients and colleagues at risk by dragged yourself in in such a condition. I understand the martyr mentality, but there comes a point where you're not a martyr but a liability. If you're sick, stay home. You are not God. The world will not end in your absence.

I also must admit the one time I saw a doc come in when he was this sick, I couldn't help thinking what a narcissist he was. He couldn't wait to tell everyone how sick he was and how he still came in because "patients would die otherwise." To this day, that's what I remember when I hear of docs coming in when they're so sick and contagious.

 

[dpmd]

Pretty sure you misunderstood the posts you're responding to. I never advocated using sick days as extra vacation days. Actually, I said that shouldn't be done and that people will get found out for doing such a thing. Mental health days ARE sick days. Being mentally unwell is equivalent to being physically unwell and anyone thinking otherwise does not understand mental wellness. If you are struggling with anxiety to the point you can't go to work, take a sick day because you are, by definition, sick. That's the point. Why you would make the leap that this thread is advocating for using sick days as vacation days for mental health is beyond me because it suggests a misunderstanding of the posts, mental wellness, or sick/vacation days.



This kind of BS is why the rest of us are now subjected to hours of "wellness" modules. No, you don't come in to work with vomiting and chills. I don't know of a single hospital whose occ health team wouldn't tell you to stay home because you're putting all patients and colleagues at risk by dragged yourself in in such a condition. I understand the martyr mentality, but there comes a point where you're not a martyr but a liability. If you're sick, stay home. You are not God. The world will not end in your absence.

I also must admit the one time I saw a doc come in when he was this sick, I couldn't help thinking what a narcissist he was. He couldn't wait to tell everyone how sick he was and how he still came in because "patients would die otherwise." To this day, that's what I remember when I hear of docs coming in when they're so sick and contagious.

It is like you have no concept of handwashing and manners of contagion for these illnesses. Also, it seems like all of you folks with your wellness modules and calling in sick for every sniffle and what not are the ones whose mental health is so tenuous that you need days off. If you act like a completely replaceable cog in the machine no wonder you get burned out.

 

[Mass Effect]

It is like you have no concept of handwashing and manners of contagion for these illnesses. Also, it seems like all of you folks with your wellness modules and calling in sick for every sniffle and what not are the ones whose mental health is so tenuous that you need days off. If you act like a completely replaceable cog in the machine no wonder you get burned out.

It's called realizing medicine is a job and that my health and personal well-being comes first. That's how you protect against burnout, not dragging yourself to work with a 102 degree fever, vomit, and diarrhea, because you're too scared to tell people you're sick. Handwashing doesn't rid the hospital of your snot and vomit. When you're on the elevator and you're sneezing and coughing and punching buttons, you ARE contagious, just as you are when you're seeing patients in that condition. Unless you're wearing a mask and gloves, you are contagious, no matter how many times you wash your hands.

 

[dpmd]

It's called realizing medicine is a job and that my health and personal well-being comes first. That's how you protect against burnout, not dragging yourself to work with a 102 degree fever, vomit, and diarrhea, because you're too scared to tell people you're sick. Handwashing doesn't rid the hospital of your snot and vomit. When you're on the elevator and you're sneezing and coughing and punching buttons, you ARE contagious, just as you are when you're seeing patients in that condition. Unless you're wearing a mask and gloves, you are contagious, no matter how many times you wash your hands.

With proper hand hygiene and proper precautions (I am assuming you aren't vomiting onto patients and that you are using a mask if you are coughing and sneezing a ton, but perhaps that requires specifying) you aren't more of a risk than anybody else visiting the hospital during cold and flu season (in fact less so because those ****ers are probably not washing or sanitizing after they touch their mouth and nose). Sure it is a job, and sure if you are feeling so poorly you can't work you shouldn't have to but I can't imagine how disappointing it must be to feel you are unimportant in this job. I was an important part of my team in residency and therefore was willing to suck it up when a little sick and know that if I was really sick my team would make it work for me to be out because they felt the same and weren't willing to use any little excuse to call out. Now that I am in private practice I can't just decide I want a day off. People get rescheduled if I don't come in so I don't do it lightly. I can however plan my schedule such that I get as much time off as I decide I want in advance. And if I spend the night before call puking and feel cruddy the next day I can try to see if a colleague can cover for me or I can power through it. If I did it all the time they would be much less likely to be willing though so it isn't something that gets abused.

 

[Mass Effect]

With proper hand hygiene and proper precautions (I am assuming you aren't vomiting onto patients and that you are using a mask if you are coughing and sneezing a ton, but perhaps that requires specifying) you aren't more of a risk than anybody else visiting the hospital during cold and flu season (in fact less so because those ****ers are probably not washing or sanitizing after they touch their mouth and nose). Sure it is a job, and sure if you are feeling so poorly you can't work you shouldn't have to but I can't imagine how disappointing it must be to feel you are unimportant in this job. I was an important part of my team in residency and therefore was willing to suck it up when a little sick and know that if I was really sick my team would make it work for me to be out because they felt the same and weren't willing to use any little excuse to call out. Now that I am in private practice I can't just decide I want a day off. People get rescheduled if I don't come in so I don't do it lightly. I can however plan my schedule such that I get as much time off as I decide I want in advance. And if I spend the night before call puking and feel cruddy the next day I can try to see if a colleague can cover for me or I can power through it. If I did it all the time they would be much less likely to be willing though so it isn't something that gets abused.

Of course it shouldn't get abused. No one said otherwise. I said myself that I took 3 sick days in 4 years of residency. Clearly I wasn't abusing it. But if you're sick, you're sick. One would assume you're sick to the point of missing work once every year or year and a half, so when it happens, stay home. Don't come to work while you're actively vomiting. When I go to see my own doctor, the last thing I want is for her to have just vomited in the bathroom just prior to my visit. Proper hand hygiene is a joke.

 

[emergentmd]

To compare residency to most other jobs is starting with a false premise.

In residency on my surgical call months, there are 3 teams. Each team with an R1, R2, etc.... If you call in sick either the other teams R1 or the R2 picks up your patients which makes them have to come in 1-2 hrs earlier to round on your 10-15 patients.

In most other jobs, if you don't show up then you do the work tomorrow. A better comparison is if you had a major project due tomorrow and you called in sick which would put all the work on the rest of the team to finish up meaning they all come in early or late.

So if you call in sick or a mental health day, you better be sick and this better be one in a blue moon.

 

[Mass Effect]

A better comparison is if you had a major project due tomorrow and you called in sick which would put all the work on the rest of the team to finish up meaning they all come in early or late

Except that you have a major project due tomorrow every day for 5 years. It's incompatible with the expectation that you never take a sick day. It's like when people ask "when is the best time to start a family during residency?" And the answer is "there's never a good time. You just do it when you can." People will have to cover, but those same people know that when they're the ones who need it, you'll cover for them and you shouldn't hold them to an unrealistic standard that is impossible for most to meet. This is, at the core, one of the issues with medical training that inspires conversation about wellness, mental health, and suicide. People shouldn't be made to feel like losers because they get sick once in a while, whether the symptoms are physical or psychological.

 

[Matthew9Thirtyfive]

Lol..

That’s how it is for everyone in the military. Or the operational Navy at least. Calling out can make it difficult to accomplish the mission, so they want you to come in and have medical determine that you absolutely can’t work. Seems like it would be the same in residency where a resident calling out would mean more work for everyone else. Just speculation.

 

[Mass Effect]

That’s how it is for everyone in the military. Or the operational Navy at least. Calling out can make it difficult to accomplish the mission, so they want you to come in and have medical determine that you absolutely can’t work. Seems like it would be the same in residency where a resident calling out would mean more work for everyone else. Just speculation.

Medicine is not the military.

 

[Matthew9Thirtyfive]

Medicine is not the military.

No, but there are a lot of similarities, one of which I already listed.

 

[Mass Effect]

No, but there are a lot of similarities, one of which I already listed.

This isn't a similarity. People are allowed to take sick days in medicine without having to come in to be dismissed. They just refuse to do so.

 

[Matthew9Thirtyfive]

This isn't a similarity. People are allowed to take sick days in medicine without having to come in to be dismissed. They just refuse to do so.

You can willingly choose to ignore the similarities since they don't align with your philosophy, but that doesn't make them disappear.

 

[Mass Effect]

You can willingly choose to ignore the similarities since they don't align with your philosophy, but that doesn't make them disappear.

With all due respect, as an MS 1, please don't tell me what residency is like, just as I wouldn't tell you what the military is like.

 

[GoSpursGo]

With all due respect, as an MS 1, please don't tell me what residency is like, just as I wouldn't tell you what the military is like.

I mean, several users have posted that their program required that they get a doctor's note if they called out sick, so it's not a totally unreasonable comparison to draw. Nothing is a perfect analogy.

It really feels like everyone in this thread agrees with your underlying point that mental health and wellness are important, and you are going out of your way to argue semantics. Nobody is saying someone should come in to work with a fever or GI symptoms, and most people acknowledge there is some threshold where it would be reasonable to use a sick day for mental health reasons.

 

[VA Hopeful Dr]

With all due respect, as an MS 1, please don't tell me what residency is like, just as I wouldn't tell you what the military is like.

The one specific similarity he mentioned is accurate

 

[Mass Effect]

I mean, several users have posted that their program required that they get a doctor's note if they called out sick, so it's not a totally unreasonable comparison to draw. Nothing is a perfect analogy.

Unless I missed a post, only one poster said that they need a doctor's note for calling out. Others said repeated days of calling out required a doctor's note, which is reasonable. There's a difference between calling out one day and calling out 3.

It really feels like everyone in this thread agrees with your underlying point that mental health and wellness are important, and you are going out of your way to argue semantics. Nobody is saying someone should come in to work with a fever or GI symptoms

Actually, only a few posts above yours:

You show up to work and have witnessed vomiting or chills and get sent home was the way we did it

So yeah, some are suggesting you come in with GI symptoms and chills.

I'm glad the sense you're getting is opposite from what I'm getting. I don't think of it as arguing semantics, but rather, arguing why the culture needs to change and to accept that mental health is as important as physical health. I will say that I fully believe you get what I'm saying and I think you and I probably agree on the underlying point. I will also admit that I am very passionate about this topic as it's about wellness in general, which is something I care very much about. So I admit I'm over the top about it, but that's just how I am around this subject.

The one specific similarity he mentioned is accurate

Not in my experience and it seems, not in a lot of other people's either, based on this thread and the comments made.

 

[deleted480308]

I love that people are equating mental health day to just being lazy and wanting the day off. Again, if physicians have this sentiment and misconceived conception of mental illness no wonder there’s a suicide epidemic...

How many mental health days stop suicide?

 

[Vandalia]

Of course it shouldn't get abused. No one said otherwise. I said myself that I took 3 sick days in 4 years of residency. Clearly I wasn't abusing it. But if you're sick, you're sick. One would assume you're sick to the point of missing work once every year or year and a half, so when it happens, stay home. Don't come to work while you're actively vomiting. When I go to see my own doctor, the last thing I want is for her to have just vomited in the bathroom just prior to my visit. Proper hand hygiene is a joke.

Welcome to emergency medicine. While I would not say it is routine to have an attending trailing an IV pole and vomiting after every patient, it is also not exactly rare. Surprisingly, when patients are asked "Would you rather have a physician who looks like death, or die from your MI?", they generally say "I will take the physician who looks like death."

There are some specialties where you can take a week off at random and no one will really notice you are gone. There are other specialties where if you don't show up people will die. A resident (or even better a medical student) had better know the difference. If I call the on-call neurosurgeon and say "I have a patient who is herniating" and they respond with "Sorry, I am taking a mental health day"... that will not end well. In most places there are not a whole lot of neurosurgeons sitting around with nothing to do to cover for you.

While it is theoretically possible to find a replacement in EM, either you, your spouse or your child had better be in the ICU, jail, or the funeral home. Covering for people on short notice during OUR day (or night) off is not good for OUR mental health.

 

[IMreshopeful]

Welcome to emergency medicine. While I would not say it is routine to have an attending trailing an IV pole and vomiting after every patient, it is also not exactly rare. Surprisingly, when patients are asked "Would you rather have a physician who looks like death, or die from your MI?", they generally say "I will take the physician who looks like death."

There are some specialties where you can take a week off at random and no one will really notice you are gone. There are other specialties where if you don't show up people will die. A resident (or even better a medical student) had better know the difference. If I call the on-call neurosurgeon and say "I have a patient who is herniating" and they respond with "Sorry, I am taking a mental health day"... that will not end well. In most places there are not a whole lot of neurosurgeons sitting around with nothing to do to cover for you.

While it is theoretically possible to find a replacement in EM, either you, your spouse or your child had better be in the ICU, jail, or the funeral home. Covering for people on short notice during OUR day (or night) off is not good for OUR mental health.

Your attendings couldn’t see patients if you were sick as a resident? Come on. I’m in a very much life or death type of field and our attendings cover for each other and the fellows if they have something going on all the time.

Medical training instills this BS bravado in people that inflates their self importance... unless your colleagues and attendings suck (which is possible sure) you should not alone be required for operation of the hospital. For the record I don’t want a sick neurosurgeon operating on anyone I know.

 

[deleted480308]

Your attendings couldn’t see patients if you were sick as a resident? Come on. I’m in a very much life or death type of field and our attendings cover for each other and the fellows if they have something going on all the time.

Medical training instills this BS bravado in people that inflates their self importance... unless your colleagues and attendings suck (which is possible sure) you should not alone be required for operation of the hospital. For the record I don’t want a sick neurosurgeon operating on anyone I know.

Yeah, and sometimes patients transfer....I’m not morally obligated to be available 24/7