question: Do doctors get sick more often because of exposure to germs, or do they get sick less often because that exposure leads to a strong immune system?
comment: I’m not a doctor, but I do work in healthcare. I rarely get sick, and I suspect it’s due to 2 things: 1) exposure/immunity 2) hand washing/masking/PPE. Anecdotally, new employees tend to get sick more frequently, until they develop immunity to the *local* everyday sicknesses. In healthcare, “safe practices” are drilled into our heads, so we’re less likely to be exposed to uncommon illnesses (that being said, I was recently tested for TB because I was exposed at work). For example, a family member is considerably more likely to catch c. Diff from an infected person than a healthcare worker is, because the healthcare worker is going to be wearing gloves and a disposable gown when in contact with the patient and will thoroughly wash their hands after having contact. Edited for spelling and grammar.
passages: In the United States, Medical Laboratory Scientists can be certified and employed in infection control. These professionals monitor and report infectious disease findings to help limit iatrogenic and nosocomial infections. They may also educate other healthcare workers about such problems and ways to minimize them.
   Infectious diseases risks from contaminated clothing etc. can increase significantly under certain conditions, e.g., in healthcare situations in hospitals, care homes and the domestic setting where someone has diarrhoea, vomiting, or a skin or wound infection. It increases in circumstances where someone has reduced immunity to infection.
   Section::::History.:Medical specialists.
  
  The medical treatment of infectious diseases falls into the medical field of Infectious Disease and in some cases the study of propagation pertains to the field of Epidemiology. Generally, infections are initially diagnosed by primary care physicians or internal medicine specialists. For example, an "uncomplicated" pneumonia will generally be treated by the internist or the pulmonologist (lung physician). The work of the infectious diseases specialist therefore entails working with both patients and general practitioners, as well as laboratory scientists, immunologists, bacteriologists and other specialists.
  
  An infectious disease team may be alerted when:
   Patients are assigned their SOI based on their specific diagnoses and procedures performed during their medical encounter, which is generally an inpatient hospital stay. Patients with higher SOI (e.g. major or extreme) are more likely to consume greater healthcare resources and stay longer in hospitals than patients with lower SOI in the same diagnosis-related group (DRG).
   Exposure to respiratory infectious diseases like tuberculosis (caused by "Mycobacterium tuberculosis") and influenza can be reduced with the use of respirators; this exposure is a significant occupational hazard for health care professionals. Exposure to dangerous chemicals, including chemotherapy drugs, is another potential occupational risk. These drugs can cause cancer and other health conditions. Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including scabies. Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needlestick injuries or through contact with bodily fluids. This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B. In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic or the 2003 SARS outbreak, healthcare workers are at even greater risk, and were disproportionately affected in both the Ebola and SARS outbreaks. In general, appropriate personal protective equipment (PPE) is the first-line mode of protection for healthcare workers from infectious diseases. For it to be effective against highly contagious diseases, personal protective equipment must be watertight and prevent the skin and mucous membranes from contacting infectious material. Different levels of personal protective equipment created to unique standards are used in situations where the risk of infection is different. Practices such as triple gloving and multiple respirators do not provide a higher level of protection and present a burden to the worker, who is additionally at increased risk of exposure when removing the PPE. Compliance with appropriate personal protective equipment rules may be difficult in certain situations, such as tropical environment or low-resource settings. A 2016 Cochrane systematic review found low quality evidence that using more breathable fabric in PPE, double gloving, and active training reduce the risk of contamination.
   Hospitals have sanitation protocols regarding uniforms, equipment sterilization, washing, and other preventive measures. Thorough hand washing and/or use of alcohol rubs by all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infections. More careful use of antimicrobial agents, such as antibiotics, is also considered vital.
  
  Despite sanitation protocol, patients cannot be entirely isolated from infectious agents. Furthermore, patients are often prescribed antibiotics and other antimicrobial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains.
  
  Section::::Prevention.:Sterilization.
   The CAP outpatient mortality rate is less than one percent, with fever typically responding to the first two days of therapy and other symptoms in the first week. However, X-rays may remain abnormal for at least a month. Hospitalized patients have an average mortality rate of 12 percent, with the rate rising to 40 percent for patients with bloodstream infections or requiring intensive care. Factors increasing mortality are identical to those indicating hospitalization.
   Medical hygiene pertains to the hygiene practices that prevents or minimizes disease and the spreading of disease in relation to administering medical care to those who are infected or who are more "at risk" of infection in the home. Across the world, governments are increasingly under pressure to fund the level of healthcare that people expect. Care of increasing numbers of patients in the community, including at home is one answer, but can be fatally undermined by inadequate infection control in the home. Increasingly, all of these "at-risk" groups are cared for at home by a carer who may be a household member who thus requires a good knowledge of hygiene. People with reduced immunity to infection, who are looked after at home, make up an increasing proportion of the population (currently up to 20%). The largest proportion are the elderly who have co-morbidities, which reduce their immunity to infection. It also includes the very young, patients discharged from hospital, taking immuno-suppressive drugs or using invasive systems, etc. For patients discharged from hospital, or being treated at home special "medical hygiene" (see above) procedures may need to be performed for them e.g. catheter or dressing replacement, which puts them at higher risk of infection.
   Improving patient hand washing has also been shown to reduce the rate of nosocomial infection. Patients who are bed-bound often do not have as much access to clean their hands at mealtimes or after touching surfaces or handling waste such as tissues. By reinforcing the importance of handwashing and providing santizing gel or wipes within reach of the bed, nurses were directly able to reduce infection rates. A study published in 2017 demonstrated this by improving patient education on both proper hand-washing procedure and important times to use sanitizer and successfully reduced the rate of enterococci and "S. aureus".
   Meggs departed from academic physics to pursue medicine afterward, and achieved a Doctorate of Medicine from the University of Miami in 1979. He then completed an Internal Medicine residency at Rochester General Hospital in 1982. Meggs then served as a Medical Staff Fellow at the National Institute of Allergy and Infectious Disease at the National Institutes of Health from 1982-1985. He obtained board certification in Emergency Medicine in 1988. While his career path has been varied, Meggs' main contributions to medicine have been in the arenas of Emergency Medicine and Medical Toxicology. Since 1991, Meggs has been affiliated with the Emergency Department at Vidant Medical Center, in Greenville, North Carolina, which is the flagship teaching hospital for the Brody School of Medicine at East Carolina University. During his first few years with the PCMH Emergency Department, Meggs successfully completed a fellowship in Medical Toxicology at the New York City Poison Center and Department of Emergency Medicine, Bellevue Hospital Center, affiliated with New York University. He currently serves as professor and chief of the Toxicology Department of the ECU Emergency Medicine Residency program.
   William Latimer
  
  William W. Latimer is an infectious disease epidemiologist. He is the founding dean of the City University of New York, Lehman College School of Health Sciences, Human Services and Nursing in the Bronx, New York; Extraordinary Professor of Psychology, School of Humanities at the University of Pretoria, Pretoria, South Africa; and Producer and Host of "Public Health Minute", a radio show aired on public radio stations throughout the US.
  
  Section::::Early life and education.
   The ease with which one can be replaced on the job also affects levels of presenteeism. Specifically, if one feels that he or she cannot be replaced, that individual is more prone to attend work while sick. Doctors are often examined in this regard. For example, Jena et al. studied residents in training and noted high rates of presenteeism, which they concluded were the result of feeling irreplaceable. Further extending the examination of the medical field, McKevitt, Morgan, Dundas, and Holland studied hundreds of healthcare professionals and found that more than 80 percent of respondents had worked while ill. Individuals listed some of the reasons they had not taken sick days, and many cited the fact that they felt large pressure to work. In some cases, general practitioners did not want to burden their partners, and many felt a strong commitment to the job that prevented them from taking sick leave.
   Specialists in infectious diseases can practice both in hospitals (inpatient) and clinics (outpatient). In hospitals, specialists in infectious diseases help ensure the timely diagnosis and treatment of acute infections by recommending the appropriate diagnostic tests to identify the source of the infection and by recommending appropriate antibiotics to treat infection. For certain types of infections, involvement of an specialists in infectious diseases may improve patient outcomes. In clinics, specialists in infectious diseases can provide long-term care to patients with chronic infections such as HIV. A
  
  Section::::History.
   Contact transmission is divided into two subgroups: direct-contact transmission and indirect-contact transmission.
  
  Section::::Prevention.
  
  Controlling nosocomial infection is to implement QA/QC measures to the health care sectors, and evidence-based management can be a feasible approach. For those with ventilator-associated or hospital-acquired pneumonia, controlling and monitoring hospital indoor air quality needs to be on agenda in management, whereas for nosocomial rotavirus infection, a hand hygiene protocol has to be enforced.
   Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such "general physicians" would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys.
   Workplace burdens arise from the acquisition of a lower respiratory tract infection, with factors such as total per person expenditures and total medical service utilisation demonstrated as greater among individuals experiencing a lower respiratory tract infection.
  
  Pan-national data collection indicates that childhood nutrition plays a significant role in determining the acquisition of a lower respiratory tract infection, with the promotion of the implementation of nutrition program, and policy guidelines in affected countries.
   Higher-level and independent jobs generally require a Ph.D. as well as several years experience as a microbiologist. This often includes time spent as a postdoctoral researcher wherein one leads research projects and prepares to transition to an independent career. Postdoctoral researchers are often evaluated largely based on their record of published academic papers, as well as recommendations from their supervisors and colleagues.
   Diagnosis of many infections requires laboratory confirmation. Since laboratory tests, especially those that depend on culture techniques, often require two or more days for completion, transmission-based precautions must be implemented while test results are pending based on the clinical presentation and likely pathogens. Use of appropriate transmission-based precautions at the time a patient develops symptoms or signs of transmissible infection, or arrives at a healthcare facility for care, reduces transmission opportunities. While it is not possible to identify prospectively all patients needing transmission-based precautions, certain clinical syndromes and conditions carry a sufficiently high risk to warrant their use empirically while confirmatory tests are pending.
   Jonathan Larmonth Meakins
  
  Jonathan Larmonth Meakins, (born January 8, 1941) is a Canadian surgeon, academic, and expert in immunobiology and surgical infections.
  
  Section::::Life.
  
  Born in Toronto, Ontario, he was the son of Jonathan Lafayette Meakins, in turn the son of Jonathan Campbell Meakins.
  
  He received a Bachelor of Science degree from McGill University and a Doctor of Medicine from the University of Western Ontario in 1966. He received a Doctor of Science from the University of Cincinnati in 1972.
   Michaels graduated from the City College of New York, and holds a Master in Public Health (MPH) and PhD from Columbia University, in New York City. Before joining the faculty at the George Washington University, he taught at the CUNY School of Medicine at the City University of New York and at the Albert Einstein College of Medicine.
  
  Section::::Career.
   Section::::Syndromic and empirical use.
  
  Since the infecting agent often is not known at the time of admission to a healthcare facility, transmission-based precautions are used empirically, according to the clinical syndrome and the likely etiologic agents at the time, and then modified when the pathogen is identified or a transmissible infectious etiology is ruled out.
   William Joel Meggs
  
  William Joel Meggs (born 1942) is a board-certified internal medicine and emergency medicine physician, allergist and immunologist, and medical toxicologist with "interests in envenomations, antidotes, and environmental toxicology. Meggs currently practices in Greenville, NC, where he is a professor of Emergency Medicine and Director of the Division of Toxicology and Emeritus Warden of the Daniel Boone Dick Jail at the Brody School of Medicine at East Carolina University.
  
  Section::::Biography.
   However, the attention of most health care managers remains focused on patients rather than communities. Hospitals do not serve enrolled populations; they serve the patients who are treated in their beds and in the clinics. Consequently, the tools and perspectives of clinical epidemiology may be as or more relevant to health care managers than those drawn from population epidemiology. Managers employing epidemiology in hospitals might not conduct many community surveys. Instead, they would extract clinical information from medical records to analyze variations in outcomes, complications, and services used.
  
  Section::::Application.
   Frank Plummer
  
  Francis (Frank) Allan Plummer, (born 1952) is a Canadian scientist, academic and HIV/AIDS researcher. He is "a recognized specialist in infectious diseases whose work has influenced public health policy in Canada and abroad". He is a Professor of Medicine and Medical Microbiology at the University of Manitoba and former Scientific Director General, National Microbiology Laboratory, Public Health Agency of Canada.
  
  Section::::Honours.
   Section::::Career in medicine.:Response to contagious diseases.
  
raw_presuppositions: Doctors may get sick less often because exposure to germs leads to a strong immune system.
raw_corrections: Doctors may get sick less often not just because exposure to germs leads to a strong immune system but also because of handwashing, masking and PPE.