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Opinion EDITORIAL Primum Non Nocere Jeffrey R. Starke, MD; Mary Anne Jackson, MD For centuries, a guiding principle for health care workers system. Across the United States, many children’s hospitals em- (HCWs) has been primum non nocere, or first do no harm. Al- ploy virtually all clinicians and stress clinical productivity as though this adage has been applied mostly to therapeutic in- the main factor in supporting HCW pay and incentives. Re- terventions, it also infers that view of free-text responses of participants in this study con- HCWs should not spread in- firmed that they felt pressured by the need to produce work- Related article page 815 fections to their patients, es- relative value units. Szymczak et al also identified as an issue pecially the most vulnerable the absence of an effective sick relief system that has suffi- patients. However, HCWs do exactly that when they work with cient flexibility to “staff up” during high rates of HCW illness. patients while ill themselves with contagious infections. A Sick relief systems and policies need to be clear regarding when plethora of evidence suggests that HCWs can transmit a vari- HCWs should stay away from work, how patient coverage will ety
JAMA Pediatrics – American Medical Association
Published: Sep 1, 2015
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