Patients may not be the only sick people in the room when they go to see the doctor.

According to a study published in JAMA Pediatrics, more than 80 percent of physicians and other health care providers have worked while sick within the past year and said that they would continue to go to work even with contagious symptoms such as fever or diarrhea.

“Reasons health care workers give for working while sick include not wanting to burden colleagues with an extra workload; not believing that they are sick enough to stay home; unsupportive supervisors and colleagues; and perceiving that one’s work cannot be delegated to others,” said authors of the study, led by Julia E. Szymczak, Ph.D., of the Children’s Hospital of Philadelphia.

Of the 538 providers who participated in the study, 94 percent understood that working while sick placed their patients at risk.  Despite their understanding of the situation, 83 percent of providers worked while sick at least once in the past year and almost 10 percent reported working while sick in the past year five times or more.

Physicians face many administrative and legal obligations that result in a pressure to see a minimum number of patients per day or face penalties from either their employer, insurance companies, or government-led groups like Medicare.

While the Affordable Care Act has increased the number of insured patients, it has also increased the responsibilities of providers. Many docs feel compelled to work through their illness in order to better serve their patients.

According to the study, “some ambiguity persists around what constitutes being too sick to work, and a perception exists that sick leave is impractical for all possibly infectious symptoms, especially viral infections of the respiratory tract.”

The researchers suggest that “work duty reassignments, telework arrangements, and mask use for symptomatic health care workers are possible strategies that can be enacted to maintain productivity and continuity of care while reducing the risk for transmission.”