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Doctor's Note: A Few Paid Sick Days Make A Big Difference

Benjamin R. Doolittle MD

May 07, 2011

It's one of the simplest and most basic instructions a pediatrician can give: "Keep your child home from school for a couple of days, until the fever subsides and her stomach settles down." Doctors say it dozens of times every week.

But for the parents of many of our young patients, that instruction isn't simple at all. In fact, it causes considerable distress because it creates a dilemma for which there are no good answers. Following the doctor's order carries a high, perhaps unmanageable, price — the loss of a paycheck and possibly a job. But not doing what the doctor ordered means your child may be sicker for longer, and infect other kids.

I have run the Yale medicine-pediatrics practice in Waterbury for six years. Every week, my colleagues and I see a few hundred patients, nearly all of them from hard-working, low-income families. Three in five of the adults we treat are paid less than $20,000 per year. They rely on Medicaid for their health care, and they get that care at clinics such as mine.

These are the workers you see every day mowing lawns, washing dishes, staffing switchboards, sweeping streets or working in nursing homes and factories. For the most part, they are paid minimum wage and have few benefits.

Most of my patients spend more than half their income on rent. Buying medications, managing co-pays, putting food on the table and paying bus fares so they can get to work all pose huge challenges.

So does staying home with a sick child.

It continually surprises me how many people don't seem to understand that. It often seems like those of us with the income, the benefits and the security to take a paid sick day when we need it take it for granted. It's often a surprise to learn that people all around us don't have that basic workplace protection.

But they don't, and that creates real hardship.

Of all people, the lawmakers who represent us in Hartford should know that. That's why the debate over paid sick days has surprised me so much. For the last few months, I have followed the conversation as legislators have considered a modest, straightforward measure that would allow workers to earn a few paid sick days to use when they are sick or when they need to stay home with a sick child. I have heard the arguments against it, and watched the debate become heated and the outcome uncertain. And I honestly don't understand.

The patients I see at my clinic, and those I have known at various ministries I have led throughout the state, are incredibly grateful for the jobs they have. More than anything, they are afraid of losing those jobs.

They aren't looking to game the system. But they need to be able to take an occasional day off if they get strep throat or stomach flu, or if they have a sick child.

I want that for them too. As a doctor, I recognize the need to quarantine a patient who is contagious — and I recognize the threat to the public health when that doesn't happen.

And as a minister at an urban church, I have seen the human side of patients' struggles. Living paycheck-to-paycheck, on minimum wage, without job security, savings, health insurance and job prospects, is a tough life.

So I say to the business lobby that is opposing the paid-sick-days bill: Treat these workers as human beings, rather than hourly commodities, and their loyalty and dedication to their jobs will increase.

And I say to lawmakers: Let's do right by the people in our state who carry the heaviest burdens. Pass Senate Bill 913 so that hard-working people in Connecticut no longer have to go to work sick, or choose between their love for a child and the harsh economic realities facing our state and our country. Let me and my colleagues in the medical community give the parents of our youngest patients the best medical advice we have, knowing that they can take that advice. Our communities will be much better off when you do.

Benjamin Doolittle, M.D., is an assistant professor and the program director at the Yale Medicine-Pediatrics Residency Program. He is also the minister of social action at South Church in New Britain.