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Study Finds Doctors Make Mistakes When Overwhelmed

Sep 23, 2009 | Parker Waichman Alonso LLP

A new study has concluded that doctors who are working when sleepy or overwhelmed are not only likelier to make medical errors, they know that their exhaustion is a contributing factor to those errors. Reuters, citing a study just reported in the Journal of the American Medical Association, said that “general distress and mental fatigue” are also factors that contribute to physician errors.

"While fatigue is important, said study lead, Dr. Colin West of the Mayo Clinic in Rochester, Minnesota, “there is this whole domain of distress beyond fatigue that also demands attention," quoted Reuters. The findings are hoped to better enable ways to reduce stress on residents, which is hoped to reduce errors, said Reuters. "I think this is going to have an impact on health care reform," West said. "We need (to put) resources into training and medicine to control work hours and maintain physician well-being," he added, said Reuters.

According to a 1999 U.S. Institute of Medicine report, said Reuters, it was estimated that between 48,000 to 98,000 Americans die annually from an array of medical errors, such as overdoses and infections, deemed preventable.

In December we wrote about this problem and noted that the Institute of Medicine was recommending that new doctors’ workloads be eased a bit, saying that young doctors—and their patients—may benefit from sleep breaks. Now, said Reuters, doctors, unions, and others have been looking to cut residents hours, traditionally at 100-to-120 hours each week and still at no less than 80 weekly hours in training hospitals, according to West and his team. The team looked at 163 medical schools and 356 residents worldwide.

The study revealed that 39 percent of the residents admitted to making “at least one major medical error” during the time under which the study was conducted and also were likelier to admit to being “sleepy, fatigued, or stressed,” said Reuters. "What we have shown in these data is that fatigue is important ... but it's only part of the issue, and previous studies have not paid much attention to the distress factors," West said, quoted Reuters. "Over the course of their training and the course of their career, everyone has made a major error. Everyone tries to be perfect, but no one is," West added.

In December, ECanadaNow noted that residents are exhausted when treating patients, which could result in “serious medical errors.” The vast majority of residents—a whopping 75 percent—reported being “burnt out” before ever reaching the 80-hour weekly limit, said ECanadaNow, which noted that even 30-hour shifts might be excessive.

According to a December Associated Press (AP) piece, regulations passed in recent years limited the amount of hours residents were allowed to work to 80 per week.  Regardless, an Institute of Medicine report entitled, “Resident Duty Hours: Enhancing Sleep, Supervision and Safety” that was cited in December, indicated that residents are still too tired and their hospitals should provide opportunities for trainees to get some rest.