A vast majority of healthcare workers acknowledged that they show up to work while feeling sick, even if they know it poses a risk to their patients, according to a new survey.

Medical professionals including physicians, registered nurse practitioners, physician assistants and midwives will work while they are under the weather, according to results from a small survey published Monday in the journal JAMA Pediatrics. Researchers surveyed over 530 attending physicians and advanced practice clinicians at a hospital and found that while 95.3% said they believed working while sick puts patients at risk, 83.1% had done it at least one time in the past year.

Most respondents said they would work while sick because they didn’t want to let their coworkers down. Others cited staffing concerns, not wanting to let down their patients or fear of being “ostracized” by their peers in the hospital.

The results come from one single hospital, so the findings may not apply to other medical offices. Still, the study authors conclude that the findings show an area of improvement for medical venues to both better protect patients and prevent health care worker burnout.

“Creating a safer and more equitable system of sick leave for health care workers requires a culture change in many institutions to decrease stigma—internal and external—associated with health care works illness,” reads a corresponding editorial. “Identifying solutions to prioritize patient safety must factor in workforce demands and variability in patient census to emphasize flexibility.”

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