Depressed, Burned Out Surgeons Admit Medical Errors

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If you are scheduled for surgery, how do you know if your surgeon isn’t depressed or burned out? Could she or he commit a medical error while you are on the operating table? According to a study lead by the Mayo Clinic, nearly 9 percent of US surgeons admitted they had made a major medical error within the last three months.

Medical errors can occur in any environment in which medical care is provided, including hospitals, nursing homes, pharmacies, urgent care clinics, physicians’ offices, and care delivered at home. According to a report entitled “Dead by Mistake,” released by the Hearst Corporation in August 2009, an estimated 200,000 Americans will die in 2009 not because of an automobile accident or cancer, but because they are the victim of a preventable medical error or infection acquired while hospitalized.

Concerns about medical errors extend to all patient populations, including children. An Agency for Healthcare Research Quality report published in the Journal of the American Medical Association found that the rates of medication errors and adverse drug events for hospitalized children were similar to those for hospitalized adults. However, medical error rates associated with dangerous drug effects was three times greater in children and even higher in infants in neonatal intensive care units.

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In this new study, which appears in the online edition of Annals of Surgery, Mayo Clinic researchers, along with collaborators from Johns Hopkins and the American College of Surgeons, conducted a confidential survey among 7,905 surgeons regarding medical errors. All of the surgeons completed survey tools that measured burnout, quality of life, and symptoms of depression, and they provided information on various professional and personal characteristics.

The investigators found that 8.9 percent, or 700 surgeons, reported making a medical error that they considered to be major within the previous three months. More than 70 percent of the surgeons attributed the error to themselves and not to a systemic or organizational cause.

The investigators also found no relation between medical errors and the work environment, compensation method, number of nights on call per week, or number of hours worked. Rather, the errors were related to surgeon burnout—emotional exhaustion, depersonalization, perception of personal accomplishments—as well as depression.

Lead author Tait Shanafelt, MD, noted that “These results suggest that a surgeon’s personal mental health including burnout may have an effect on quality of care.” The authors stated that medical errors can have a negative impact on surgeons for years, and that research is needed to find ways to reduce burnout and depression among surgeons.

SOURCES:
Agency for Healthcare Research and Quality
Hearst Corporation report, “Dead by Mistake”
Mayo Clinic News, Nov. 23, 2009

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