Some people are highly motivated to come to work and believe what they do matters; some people don't think they're work is important and show up for the paycheck. Both of those groups show up in just about any profession, and somewhat alarmingly, health care is no exception.

Researchers at Ben-Gurion University of the Negev in Israel, along with others at Johns Hopkins University, found that 16 percent of public health workers they surveyed said they wouldn't come in for work during a flu pandemic. The more than 1,800 health workers surveyed came from Minnesota, Ohio and West Virginia, and the scientists just published the study in the journal PLoS One.

With health officials warning that swine flu could continue to spread, the idea that one in six health workers wouldn't respond to the call has the researchers up in arms, and clamoring to figure out how to change the attitude problem. The study respondents who said that they were both confident they'd know what do to in an emergency situation and concerned about the dangers of the pandemic were 31 times more likely to say they'd show up than those who said neither. So that gives researchers a place to start—making sure health workers know exactly what they're supposed to do during an emergency so they don't have this crisis of confidence about going to work.

Perhaps these confidence-building interventions will bring down that 16 percent figure. Perhaps in a true emergency some of those stay-at-homers would feel the call of duty and that would overcome their fear or unwillingness to respond. But the upshot of the study is that you can't count on 100 percent participation, even in fields like health care where we assume the workers to have a certain level of altruism. And at the same time hospitals are ensuring that they workers know what to do during a pandemic, they also need to plan on how to cope if not everyone shows up.