Depressed Doctors Are Associated With More Medical Errors
It is increasingly evident that physician well-being is essential to patient safety
When I had surgery earlier this year, I placed my very life in the hands of my surgeon, my anesthesiologist, my nurses, and everyone else who took care of me. I trusted that they would do their very best to avoid making a mistake, whether in the surgery itself, the medications administered to me, or the postoperative care. The trust I gave to them is the very same trust given to me by my patients admitted to my intensive care unit.
Because of this trust placed in me, patient safety is at the center of everything I do. It influences the procedures I perform or not perform, the treatments I administer or decline to administer, and the courses of action I recommend or not recommend. According to a study in 2016 by researchers at Johns Hopkins, it was estimated the medical errors account for over 250,000 deaths in the U.S., making it the third leading cause of death. So, ensuring ours patients are safe from harm in the hospital is a very big deal.
This is why healthcare systems and organizations have robust processes in place to prevent medical errors, such as medication alerts in the electronic medical record, hard stops in the amount of medication that can be given through an IV pump, and active surveillance by every member of the healthcare team. It is time, energy, and resources well-spent.
What is becoming increasingly evident is that, as important as these processes are to patient safety, physician well-being is just as critical as well. It is well-recognized that physician burnout is a major health crisis, now being characterized as a “syndrome” by the World Health Organization. Not only has it led to physician suicide, but it has also been shown to cause fragmented and suboptimal patient care.
Less recognized is the effect of depression on physicians. In research published last month, more than 21,000 physicians were studied to see if depressive symptoms were associated with medical errors. The findings were stark: among physicians who exhibits symptoms of depression, there was nearly double the risk of medical errors.
The effect of depressive symptoms were consistent among both practicing physicians and those in training. What’s more, the effect of depressive symptoms caused a vicious cycle: not only did depression among physicians lead to medical errors, but the commission of those medical errors led to depression among physicians as well.
The findings of this study are a clarion call to all healthcare organizations to invest more resources into taking care of those physicians who exhibit symptoms of depression. This disease is easily identifiable and have well-established clinical criteria. Further, depression is both treatable and preventable. Moreover, studies have demonstrated that few physicians with depression seek treatment, and there are relatively few organizational interventions aimed at reducing symptoms of depression in physicians. This needs to change.
In fact, the study authors endorsed, and their study findings reinforced, the call to add physician well-being to the Institute of Healthcare Improvement’s “Triple Aim” of (1) enhancing the patient experience of care, (2) improving the health of populations, and (3) reducing the per capita cost of health care. I cannot be in more emphatic agreement.
Making sure that I don’t choose the wrong drug, or the wrong dose, or the wrong patient is critical to keeping my patients safe in the hospital. It is part and parcel of what I do as a physician. It is just as important to make sure that the doctors taking care of those patients are also well. The very lives of patients is at stake.
The opinions expressed in this piece are my own and are not associated with my employer or those institutions with which I am affiliated.