26 October 2012
Burnout among doctors leads to higher suicide rates and fatal medical mistakes, the conference heard.
Minnesota professor of medicine Tait Shanafelt, director of the Mayo Clinic department of medicine program on physician well-being, said studies of physicians in the USA showed 80 per cent of residents — the US equivalent of junior doctors — experienced burnout at some point during their training and half of doctors experienced burnout at some point in their careers.
Dr Shanafelt said burnout led to doctors feeling disconnected and having ‘less altruistic beliefs and behaviours’ towards patients and society. Studies have also linked burnout and stress with the increased risk of medical mistakes, he added.
While male physicians were less likely to have chronic obstructive pulmonary disease compared to other male professionals because they were aware of the dangers of smoking, they had a much higher rate of death by suicide and accidents, Dr Shanafelt said.
Male physicians also had a much higher rate of ‘suicide ideation’ — having suicidal thoughts — than the regular population.
He cited some factors such as long working hours: 40 per cent of physicians worked more than 60 hours a week compared to just 10 per cent working such long hours among the general population. He said studies have shown that risk of burnout increased by 2 per cent for every extra hour worked in a week.
A study of more than 8,000 US surgeons, who were asked ‘are you concerned that you have made a major medical error in the last three months?’, found 9 per cent believed they had done so. Dr Shanafelt said a follow-up study found that in 14 per cent of cases the outcome of errors had been the death of a patient.
He said: ‘If you do the math, it means that around 1 to 1.5 per cent of US surgeons believe that they have made an error in the last three months that killed a patient. That’s a very sobering figure.’
Dr Shanafelt said the study also found that 6.4 per cent or 501 US surgeons had thought about committing suicide in the past 12 months.
‘I think that this is very sobering. It means that one of every 16 colleagues that I greet in the morning has thought of taking their own life in the last 12 months,’ he said.
Dr Shanafelt challenged attendees at the 2012 International Conference on Physician Health in Montreal to develop evidence-based prevention strategies to prevent burnout and promote well-being. This should be done for individuals and health systems, he said.
Stress and malpractice
He said the chief executive officers of health organisations knew that a stressed workforce was not good for productive patient care but they faced tight budgets.
‘It is our responsibility to help provide the evidence of what will work from a system point of view. Much of our work has been on the individual physician,’ he said.
One study cited, by the St Paul Fire and Marine Insurance Company, an insurance firm in Minnesota, examined whether reducing physician distress would benefit their employing organisation.
He said stress levels of all staff working across 61 hospitals were measured and high levels strongly predicted higher medical malpractice claims.
Further stages of the study found that introducing a stress reduction programme for staff at one hospital reduced malpractice claims by 50 per cent.
This was followed up by a 70 per cent reduction in malpractice claims across 22 hospitals that had introduced stress reduction, compared to a control group of 22 hospitals of similar sizes and profiles that had not.