S8E06 - When Illness Disrupts the Diary: How OTs Manage Sick Leave in Practice

When sickness hits, how OTs and business owners keep care moving

Nasty bugs, surprise migraines, sick kids, even the occasional adult case of chickenpox – illness has a way of arriving exactly when the diary is full. For Occupational Therapists, being unwell rarely affects just one person. It impacts appointments, client safety, rescheduling, team capacity and the financial stability of a service.

In allied health, illness is never just personal. It sits at the intersection of duty of care, workforce sustainability and if you’re a business owner, the realities of running a practice. When a clinician can’t work, the ripple effect is immediate and often far larger than a single cancelled appointment.

When illness disrupts more than your day

Many OTs recognise the instinct to keep going when they’re sick. A sore throat, a lingering cold or exhaustion after a busy conference might normally be something you push through because the week is full and people are relying on you.

That mindset often develops early in a career. When you’re building a caseload or working as a sole trader, the pressure to maintain appointments can feel intense. Cancelling sessions means lost income, disappointed families and a backlog of work waiting when you return.

Duty of care when you’re unwell

Over the past few years, the profession has shifted its thinking about illness. Previously, many clinicians worked through symptoms as long as they could physically manage the session. Now the focus is much more firmly on client safety and infection control.

One unwell therapist can quickly affect an entire caseload, especially when working with children, older adults or people with complex health needs. Illness doesn’t just affect the therapist, it can expose multiple households and potentially disrupt care for a large number of clients.

Because of this, many clinics have become much clearer about expectations. If a therapist is unwell, they stay home. If symptoms suggest something infectious, testing or isolation may be required. These decisions aren’t just about protecting the clinician, they protect the entire community around the service.

Rescheduling isn’t just moving an appointment

At first glance, cancelling a session might seem like a simple administrative task. In reality, rescheduling can be one of the most difficult parts of managing illness in our line of work.

Many clinicians operate with diaries booked weeks in advance. When a day disappears unexpectedly, there is rarely a spare slot waiting to absorb those clients. The missed appointments can create a backlog that extends well beyond the original sick day.

This challenge becomes even more complicated when sessions involve multiple professionals. Joint visits with builders, equipment suppliers or support coordinators can take weeks to organise. If the therapist becomes unwell on the day, it may take significant time to bring everyone back together again.

Telehealth can sometimes provide a temporary solution, particularly for consultation or follow-up conversations. However, most clients do not expect or request telehealth simply because a therapist is sick. In many cases the appointment simply needs to move.

The hidden cost of sick leave and cancellations

For practice owners, illness has an additional layer of complexity. When clinicians are unable to see clients, revenue disappears immediately while operating costs remain unchanged.

A single day of cancelled appointments may represent several hours of billable work. When illness affects multiple clinicians, or when winter brings repeated cancellations due to sick families, the financial impact can grow quickly.

This is one reason the true cost of professional development, conferences or training days is often underestimated. It is rarely just the cost of attending. It also includes the income that would normally be generated during that time, along with the administrative effort required to reorganise the diary.

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