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Does the mental health and well-being of your doctor affect the care you receive? A new study says yes – burnout, fatigue and depression can affect major medical errors.
Medical errors contribute to an estimated 100,000 to 200,000 deaths a year, according to the Institute of Medicine. Burnout – defined as emotional exhaustion or depersonalization – occurs in more than half of the doctors, according to the study.
Researchers interviewed physicians across the country to understand the relationship between burnout and major medical errors in their careers.
Their findings, published in Mayo Clinic Proceedings, suggest burnout, alone, plays a big role in mistakes. Other independent factors influencing errors include perceived workplace safety, physician fatigue, and the mental health of physicians.
Researchers from the Stanford University School of Medicine anonymously surveyed more than 6,600 active physicians. They were asked to complete standardized questionnaires about their level of burnout, their well-being, their fatigue and their symptoms of depression. In addition, physicians were asked to rate the safety of their workplace and to comment on any major medical errors they may have made.
STOCK PHOTO / Getty Images Fifty-five percent of the doctors reported symptoms of exhaustion, 33 percent had high levels of fatigue and 6.5 percent had thoughts of committing suicide over the past year. According to the study, doctors have 3 to 5 times the suicide rate of the general public.
Medical errors are more than twice as frequent if a doctor has signs of exhaustion and 38% more likely to have signs of fatigue. This was consistent even in workplaces with different levels of security.
"A physician suffering from burnout in a work unit with a safety rating of A has similar error rates to those of an unexcused physician in a unit with levels of much lower security, "senior author, Dr. Daniel Tawfik, MD, MS instructor of Pediatrics and Critical Care at Stanford University, told ABC News.
PHOTO STOCK / Getty Images He also explained that the number of reported errors seemed directly related to the level of burnout.
"We looked at burnout on a scale – even with changes of one point on the scale, we could detect an increased likelihood of reporting medical errors," he said. he says. "It's not just the doctors at the extreme who are responsible for all the mistakes."
The study also examined the symptoms of depression, including suicidal thoughts. Physicians reporting medical errors are more than twice as likely to have had suicidal thoughts in the last year – 13% compared to 6%. If depression leads to medical errors or medical errors leads to symptoms of depression is still fuzzy, but it seems to go both ways.
"It seems that burnout is causing mistakes, and that mistakes are causing burnout.Mistakes can certainly lead to depression among physicians," said Dr. Tawfik.
Is there any hope of using this information to help patients receive better care – and help doctors too?
[Traduction] "Much of this problem is related to the complexity of the American health care system," said Dr. Jonathan Ripp, Senior Associate Dean of Wellness and Resilience at Mount Sinai Hospital. Sinaï Health System's Wellness Officer in New York, told ABC News.
The Mount Sinai Health System is part of a handful of hospitals that have appointed a "wellness agent" tasked with tackling the burnout of doctors.
STOCK PHOTO / Getty Images Paperwork and electronic questions add to the stress of doctors, too, Ripp said. System-related issues include "the inefficiency of the electronic health record, the complexity of the documentary requirements required by the CMS, and the responsibility of the physician to perform the tasks best performed through team-based care," said Mr. Ripp.
"Every hour that a clinician spends with a patient," he added, "they spend two hours with documents or office work."
Many hospitals now have wellness programs for physicians, which focus on remedies like mindfulness. While useful, these solutions can act as a "dressing" when larger system problems are at stake, Ripp said.
"We have to manage expectations, and that takes time," he said, "by making systematic and individual changes, the result should be a greater meaning derived from work and less of a difference. exhaustion."
The researchers hope to study what can be done to solve this problem as a follow-up. They are beginning to evaluate the resilience tools that can be used by physicians and are trying to better understand the organizational causes of burnout.
Dr. Michael MacIntyre, M.D., is a psychiatry resident working in the ABC News Medical Unit.
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