Physician Burnout Responsible for Medical Errors

A recent study published in the Mayo Clinic Proceedings indicates that physician burnout is at least equally responsible for medical errors as unsafe medical workplace conditions, if not more so.

The study was led by researchers at the Stanford University School of Medicine.

“If we are trying to maximize the safety and quality of medical care, we must address the factors in the work environment that lead to burnout among our health care providers,” said Tait Shanafelt, MD, director of the Stanford WellMD Center and associate dean of the School of Medicine. “Many system-level changes have been implemented to improve safety for patients in our medical workplaces. What we find in this study is that physician burnout levels appear to be equally, if not more, important than the work unit safety score to the risk of medical errors occurring.”

Medical errors are common in the United States. Previous studies estimate these errors are responsible for 100,000 to 200,000 deaths each year. Limited research, though, has focused on how physician burnout contributes to these errors, according to the new study.

The researchers sent surveys to physicians in active practice across the United States. Of the 6,695 who responded, 3,574 — 55 percent — reported symptoms of burnout. Ten percent also reported that they had made at least one major medical error during the prior three months, a figure consistent with previous published research, the study said. The physicians were also asked to rank safety levels in the hospitals or clinics where they worked using a standardized question to assess work unit safety.

“We found that physicians with burnout had more than twice the odds of self-reported medical error, after adjusting for specialty, work hours, fatigue and work unit safety rating,” Tawfik said. “We also found that low safety grades in work units were associated with three to four times the odds of medical error.”

The study also showed that rates of medical errors actually tripled in medical work units, even those ranked as extremely safe, if physicians working on that unit had high levels of burnout. This indicates that burnout may be an even a bigger cause of medical error than a poor safety environment, Tawfik said.
“Up until just recently, the prevailing thought was that if medical errors are occurring, you need to fix the workplace safety with things like checklists and better teamwork,” Tawfik said. “This study shows that that is probably insufficient. We need a two-pronged approach to reduce medical errors that also addresses physician burnout.”