Study: Burned Out, Depressed Surgeons More Likely to Make Major Medical Mistakes

Nearly 9% of nearly 8,000 surveyed members of the American College of Surgeons said they'd made a major medical error in the last three months, and one-third attributed the mistake to a "lapse in judgment," rather than a system failure.

Reporting those errors was strongly associated with burnout and depression manifested by emotional exhaustion, depersonalization, and decline in a sense of personal accomplishment.

Those are the results from the latest in a series of reports on the mental health of America's surgeons from Charles M. Balch, MD, colleagues at Johns Hopkins University, and others at the Mayo Clinic and the Winchester Surgical Clinic. It was published yesterday in the online version of the Annals of Surgery.

"People have talked about fatigue and long working hours, but our results indicate that the dominant contributors to self-reported medical errors are burnout and depression," said Balch, a professor of surgery. "All of us need to take this into account to a greater degree than in the past. Frankly burnout and depression hadn't been on everybody's radar screen."
The study found that 40% of the surgeons who responded to the survey said they were burned out.

The authors said the findings are important because, while surgeons don't make more errors than physicians in other disciplines, "errors made by surgeons may have more severe consequences for patients due to the interventional nature of surgical practice."

"For example, reporting a major medical error in the last three months was associated with a 7-point increase ... in emotional exhaustion on the MBI (Maslach Burnout Inventory questionnaire) and roughly a doubling in the risk of screening positive for depression," the authors wrote.