Physician burnout is at least equally responsible for medical errors as unsafe medical workplace conditions, if not more so, according to a study 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.”

The study was published online July 9 in the Mayo Clinic Proceedings. Shanafelt, who is also a professor of hematology and the Jeanie and Stew Ritchie Professor, is the senior author. Daniel Tawfik, MD, an instructor in pediatric critical care medicine at Stanford, is the lead author.

A national epidemic

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 questionnaire to assess work unit safety.