Generalized burnout doctor, helps to drive many medical errors

MONDAY, July 9, 2018: More than half of US doctors are burned, a new national survey suggests, and those doctors are more likely to make medical mistakes.

The survey asked nearly 6,700 doctors in clinics and hospitals about medical errors, job security and symptoms of work-related burnout, fatigue, depression and suicidal thoughts.

More than 10 percent said they had committed at least one significant medical error in the three months prior to the survey, and the researchers concluded that those who suffered from exhaustion were twice as likely to commit a medical error.

"Burnout syndrome is a reversible work-related syndrome characterized by emotional exhaustion and / or cynicism, often with diminished effectiveness," explained the study's lead author, Dr. Daniel Tawfik. He is an instructor in pediatric critical care at the Stanford University School of Medicine.

"Although not exclusive to doctors, it is particularly common in occupations such as medicine that present high levels of stress and intense interactions with people," he said. 19659002] "When a physician is experiencing exhaustion, a wide range of adverse events can occur," Tawfik noted. "In our study, the most common errors were errors in medical judgment, errors in the diagnosis of diseases and technical errors during procedures."

Other studies, he said, have highlighted the link between exhaustion and dosing or inadequate prescription of drugs; order too many or too few laboratory tests; or causing patients to fall, acquire infections or even die prematurely.

"The key finding of this study," Tawfik said, "is that both individual medical fatigue and the safety ratings of the unit of work are strongly badociated with medical errors." 19659002] According to the researchers, previous studies have linked medical errors to more than 100,000 to 200,000 patient deaths each year.

Regarding exhaustion, Tawfik noted that it is believed that approximately one-third to one-half of all American physicians suffer from the symptoms of exhaustion at any given time.

To see how workplace burnout and / or safety can affect medical errors, the team surveyed clinicians engaged in active clinical practice in 2014.

Nearly 4 percent described the safety record from your workplace as "poor" or "unsuccessful". It was found that an unsafe work environment tripled to quadruple the risk of committing a medical error.

But exhaustion was much more frequent than occupational safety problems: more than 55 percent of physicians reported burnout, a third said they suffered from excessive fatigue, and 6.5 percent said they had contemplated suicide.

In addition, exhaustion symptoms were more common among 11 percent who reported having made a recent medical error than among those who did not. The same dynamic was maintained with regard to fatigue and suicidal thoughts.

In addition, health care facilities where physician exhaustion was seen as a common problem, tripled the risk of medical error, even if the general work environment was believed to be very safe.

Tawfik said it would take a multi-pronged approach to reverse the tide of doctors' exhaustion.

Doctors, with the support of the employer, will have to prioritize taking better care of themselves, he suggested.
They also need to limit work hours, paperwork overload and excessive stress. Some of that can be achieved through training to manage stress and mindfulness, Tawfik said, along with administrative reforms designed to promote "more time with patients and greater joy in medicine."

Dr. Joshua Denson, badistant professor of clinical medicine at the Tulane University School of Medicine in New Orleans, said the causes of medical errors are "very important, but difficult to study." He was not involved with the investigation.

"But I would suggest that changes at the system level are what are needed," Denson said.
"And people are trying things, for example, some hospitals now have 'heads of welfare services', specifically to take care of the welfare of their employees, which is a completely new concept," he said.

"That's the kind of thing we need more," Denson said. "The changes that address the fact that most doctors have enormous student debt, earn much less than before, but are asked to do more than ever to work more than ever, in an environment full of information overload. very widespread issue. "

The study was published online July 9 in Mayo Clinic Proceedings .
More information

There is more about medical errors in NPR.

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