When doctors become patients

Excerpted from page 14 of the January/February 2016 edition of AOA Focus.

When health care professionals come to work sick, they run the risk of exposing not only their co-workers to illness, but also their patients. Yet, rescheduling patients can be a burden on everyone.

Learn how doctors in various practice settings handle themselves when feeling under the weather.

1. Consider the ethical implications.
   The AOA Standards of Professional Conduct state that "the placement of the patient's interests above self-interest is referred to as fiduciary duty and is the primary ethical responsibility of all health care professionals," points out Doug Totten, O.D., chair of the AOA Ethics and Values Committee.
   
   "If you are likely to have a case of viral influenza, there really should be no question," he says. "You need to stay home and not expose your co-workers and patients to an infection. If you have another type of illness that could be a risk to a pregnant or immunocompromised patient, you also need to consider excusing yourself from patient care until you are well again."
   
   
2. Develop a notification and coverage system.
   Whether a solo or group practice, every office should have a patient notification system in place for when the doctor must stay home.
   
   "We have a great staff who can access our patient schedules remotely, and we start calls pretty early," says Abbie Rondeau, O.D., who works in a group practice near Kansas City, Missouri. "If the patient has an 8:30 a.m. appointment, they are receiving a 7 or 7:30 a.m. call to let them know the doctor will be out and to see if they can reschedule."
   
   Because Dr. Rondeau is one of four optometrists in the practice, "a lot of times I can call on my partners for a little assistance when I'm feeling sick. They can see an extra patient or two for the ones who are not able to reschedule."
   
   
3. Communicate with patients about your health.
   "I think it's important to be honest," says Troy Bedinghaus, O.D., a solo practitioner in Florida. If he's not feeling 100%, "I'll let patients know because I am a hand-shaker, and I won't shake hands if I don't feel well."
   
   Dr. Totten notes, "If an optometrist feels he or she could possibly compromise the general health of a patient, a staff member should inform the patient of the situation and offer the option of keeping the scheduled encounter or rescheduling to another time when the provider is not ill."
   
   
4. Take extra precautions if you are feeling a little under the weather.
   "If I feel like I am coming down with a cold, I'll have my scribe and technicians help me fit contact lenses so I will not have to touch them," Dr. Bedinghaus says.
   
   Dr. Totten adds that "a provider who is sick could consider wearing a surgical mask or similar protection when working in the office or in direct contact with patients. Even though the appearance of a mask might be a different look to your established patients, they generally appreciate efforts made to protect their well-being."