Physician burnout leads to medical mistakes, patient death

Medical error is a leading cause of death in the United States—and physician burnout and poor well-being are playing roles, according to a recent study published in Mayo Clinic Proceedings.

“This study suggests that burnout, poor well-being, and low work unit safety grades are independently associated with increased odds of recent perceived major medical errors among US physicians,” Daniel S. Tawfik, MD, MS, fellow physician at Pediatric Critical Care Medicine at Stanford University and lead author of the study, and colleagues wrote.

Among U.S. physicians, more than half reported symptoms of burnout in a survey, while 45 percent reported excessive fatigue. The suicide rate for this group is three to five times higher than the general population, at 6.5 percent, the study found.

The study looked at responses from more than 6,500 physicians who answered 60 survey questions using standardized survey tools to measure burnout and well-being. Of this group, 691 (10.5 percent) reported a self-perceived major medical error in the previous three months, with 4.5 percent of mistakes resulting in patient death.

Physicians who reported errors had a higher prevalence of overall burnout. Physicians who reported errors also had a higher prevalence of suicide ideation, the study found.

“Although less common than burnout, symptoms of depression and suicidality were also strongly associated with perceived medical errors in our physician cohort,” Tawfik et al. wrote.

Even minimal increases in overall symptoms of burnout, such as those with low exhaustion/depersonalization, were affiliated with an impact on quality of care delivery, the study found.

Poor safety climate also contributed to feelings of burnout, though approximately 80 percent of physicians graded the safety of their work area as excellent or very good. Efforts to boost physician well-being and reduce errors should therefore be tied to work area safety improvements.

“This phenomenon highlights that both a systems-based approach to improve work unit safety and a system approach to reduce burnout and improve well-being of health care workers are necessary to reduce errors and optimize safety/quality of care,” Tawfik et al. wrote.