Blog | Wednesday, October 7, 2009

QD: News Every Day--obesity, H1N1 and faking illness vs. "presenteeism"


ACP Internist's daily digest of internal medicine in the news continues with obesity programs, H1N1 updates and employees who fake calling in sick vs. those who won't when they really are.

Obesity
Schools, workplaces, food retailers and food and beverage makers are chipping in for the Healthy Weight Commitment Foundation, an effort to reduce obesity by balancing calorie consumption through physical activity. As just a few examples, food manufacturers will change product offerings, packaging, and labeling. Companies may provide exercise activities or facilities, offer weight management programs, and provide healthier foods in workplace cafeterias and vending machines. The Robert Wood Johnson Foundation, The National Business Group on Health and the University of California, Berkeley Center for Weight and Health will evaluate progress.

An internist is developing recommendations for physicians on how to guide and treat overweight patients on behalf of the STOP Obesity Alliance, a coalition of professional and labor groups, businesses, insurers and health care providers. The internist outlines his success in a case study.

H1N1 Flu
Health and Human Services Secretary Kathleen Sebelius further encouraged H1N1 vaccination, calling it "safe and secure" and adding that it's made the same way as seasonal flu vaccines.

Although H1N1 vaccination in the U.S. is slowly starting, states have ordered more than 2 million doses, mostly of nasal spray, for the first patients, according to Thomas Frieden, MD, director of the CDC. In Chicago, John Segreti, ACP Member, an infectious diseases expert at Rush University Medical Center, told Reuters his facility will distribute its first 2,000 doses to children and will wait for inactivated vaccine for health workers.

Emory University doctors licensed their interactive Web site to allow patients with potential H1N1 cases to self-screen using the same triage calculations their doctors and the CDC use. Questions about fever, symptoms and underlying health help patients determine whether they've got H1N1 flu, and what to do next--rest, call their doctor or seek immediate treatment. This site and related hot lines have been developed to keep people from flooding emergency departments. The materials, known as Strategy for Off-Site Rapid Triage (SORT) and Real-time Epidemiological Assessment for Community Health (REACH), were created and developed at Emory University. Ruth Parker, FACP, was one of the developers.

In case you missed it ...
The proportion of employees calling in sick when they're not hasn't changed among U.S. workers--at about one-third and holding--but fewer are getting fired for it, according to CareerBuilder.com as reported by Reuters. Of employers surveyed, 15% said they fired an employee for missing work without a legitimate excuse this year, compared to 18% last year.

The survey showed that most employers typically don't typically question absences (29% in 2009, 31% in 2008, 35% in 2007) and two-thirds of them let workers use sick days as "mental health days." The one-third of employers who do check on absenteeism require a doctor's note, call the person at home or have another worker call or drive by the employee's home. Employers cited stress and burnout from the recession as a reason they think employees fake illness.

The bigger fear is "presenteeism," those who show up to work no matter how sick they are. (They're also called "mucus troopers.")