The Grapevine

Many American Doctors Overworked, Likely To Make Medical Errors Due To Burnout

Studies have shown that a majority of American doctors are overwhelmed by their workload to the point of burnout. This can not only result in poor mental health but can also increase the risk of medical errors, according to researchers from Stanford University. 

The study titled "Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors" was published in the Mayo Clinic Proceedings on July 9.

"Burnout is a reversible work-related syndrome characterized by emotional exhaustion and/or cynicism, often featuring decreased effectiveness," said lead author Dr. Daniel Tawfik, an instructor in pediatric critical care at Stanford's School of Medicine.

"Although not unique to physicians, it is particularly common in occupations like medicine that feature high levels of stress and intense interactions with people."

After the research team sent their survey to doctors (in active practice) across the United States, nearly 6,700 responded. Among these respondents, more than half (55 percent) reported symptoms of burnout. It was also found that burned-out doctors were twice as likely to make errors in medical judgment, errors in diagnosing illness, and technical mistakes during procedures.

The highest number of errors were reported by radiologists, neurosurgeons, and emergency room doctors while the lowest numbers were reported by pediatrics, psychiatrists, and anesthesiologists.

These medical errors can be responsible for 100,000 to 200,000 deaths each year in the country, according to estimations from previous studies. The latest findings could potentially help in designing prevention strategies. Tawfik believed that a "multi-pronged approach," is required to reverse the effects of widespread physician burnout.

He urged employer support to make changes in order to limit work hours, paperwork, etc. Stress levels can also be reduced with mindfulness training alongside administrative reforms. For example, certain hospitals have taken the step to hire wellness officers to look after the well-being of employees and prevent overworking.

"For every one hour a clinician spends with a patient, they spend two hours with documentation or desk work," noted Dr. Jonathan Ripp, chief wellness officer of the Mount Sinai Health System, New York City.

"We need to manage expectations, and this takes time. By making system and individual level changes, the result should be greater meaning derived from work and less burnout," he added.

The study also examined mental health, looking at depressive symptoms and contemplation of suicide. Doctors who reported medical errors were twice as likely (13 percent compared to 6 percent) to have experienced suicidal thoughts over the past year.

It was unclear whether the poor mental health was caused by the medical errors or the other way around. But Tawfik believed that it may go both ways. "It appears burnout causes errors, and that errors cause burnout. Errors can certainly lead to physician depression," he said.