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Social Desirability Bias in Self-rated Presenteeism Among Resident Physicians—Reply

Social Desirability Bias in Self-rated Presenteeism Among Resident Physicians—Reply In reply Dr Ting highlights a potentially important limitation of our survey of presenteeism among resident physicians1: the desire of survey respondents to report socially desirable reasons for working when ill, such as altruism toward patients and colleagues. While we agree that this bias likely exists, we believe its magnitude is small for several reasons. First, we would expect social desirability bias to exist primarily in surveys that are not conducted anonymously. Second, while residents may be more likely to report altruistic reasons for presenteeism because their attendance at the conference is known to their residency program, we believe this to be unlikely. For this to occur, residents would have to believe that the aggregated results of the survey would be seen by their program directors and would result in sanctions, despite no links to an individual resident's survey response. Third, in a national, mail-based, anonymous survey of residents in 2009, we found nearly identical rates of presenteeism.2 This provides empirical support that social desirability bias in our current survey is not large. The cited concern of health care workers about treating patients with easily transmissible illnesses also does not contradict reported altruistic motivations for presenteeism in our study. The relevant measure of altruism, it seems, is whether health care workers continue to provide care to ill patients despite concerns of becoming ill themselves. If so, it is difficult to argue that health care worker altruism toward patients is small. Ultimately, our survey of residents suggests that presenteeism is common and that altruism toward patients and colleagues is likely an important cause. The pressure on residents to report socially desirable reasons for presenteeism may lead us to overestimate the importance of altruism in promoting presenteeism, but we suspect that the size of this bias is small. Back to top Article Information Correspondence: Dr Jena, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02116 (jena@hcp.med.harvard.edu). Conflict of Interest Disclosures: None reported. References 1. Jena AB, Meltzer DO, Press VG, Arora VM. Why physicians work when sick. Arch Intern Med. 2012;172(14):1107-110822710803PubMedGoogle ScholarCrossref 2. Jena AB, Baldwin DC Jr, Daugherty SR, Meltzer DO, Arora VM. Presenteeism among resident physicians. JAMA. 2010;304(11):1166-116820841527PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Social Desirability Bias in Self-rated Presenteeism Among Resident Physicians—Reply

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Publisher
American Medical Association
Copyright
Copyright © 2013 American Medical Association. All Rights Reserved.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.1418
Publisher site
See Article on Publisher Site

Abstract

In reply Dr Ting highlights a potentially important limitation of our survey of presenteeism among resident physicians1: the desire of survey respondents to report socially desirable reasons for working when ill, such as altruism toward patients and colleagues. While we agree that this bias likely exists, we believe its magnitude is small for several reasons. First, we would expect social desirability bias to exist primarily in surveys that are not conducted anonymously. Second, while residents may be more likely to report altruistic reasons for presenteeism because their attendance at the conference is known to their residency program, we believe this to be unlikely. For this to occur, residents would have to believe that the aggregated results of the survey would be seen by their program directors and would result in sanctions, despite no links to an individual resident's survey response. Third, in a national, mail-based, anonymous survey of residents in 2009, we found nearly identical rates of presenteeism.2 This provides empirical support that social desirability bias in our current survey is not large. The cited concern of health care workers about treating patients with easily transmissible illnesses also does not contradict reported altruistic motivations for presenteeism in our study. The relevant measure of altruism, it seems, is whether health care workers continue to provide care to ill patients despite concerns of becoming ill themselves. If so, it is difficult to argue that health care worker altruism toward patients is small. Ultimately, our survey of residents suggests that presenteeism is common and that altruism toward patients and colleagues is likely an important cause. The pressure on residents to report socially desirable reasons for presenteeism may lead us to overestimate the importance of altruism in promoting presenteeism, but we suspect that the size of this bias is small. Back to top Article Information Correspondence: Dr Jena, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02116 (jena@hcp.med.harvard.edu). Conflict of Interest Disclosures: None reported. References 1. Jena AB, Meltzer DO, Press VG, Arora VM. Why physicians work when sick. Arch Intern Med. 2012;172(14):1107-110822710803PubMedGoogle ScholarCrossref 2. Jena AB, Baldwin DC Jr, Daugherty SR, Meltzer DO, Arora VM. Presenteeism among resident physicians. JAMA. 2010;304(11):1166-116820841527PubMedGoogle ScholarCrossref

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jan 28, 2013

Keywords: social desirability

References