Disability Law

MedPage Today (9/22, Walsh) reported, "Internal medicine residents who report higher levels of fatigue, sleepiness, and distress are at greater risk for reporting major medical errors," according to a study in the Journal of the American Medical Association. Researchers issued questionnaires to residents who had enrolled in a "Mayo Internal Medicine Well-being Study between July 2003 and February 2009." Among the "356 participants, 139 (39 percent) reported making at least one major medical error." Of those who reported an error, "68.7 percent screened positive for depression at some point during the study." The researchers also found that "one-point increases on the fatigue and sleepiness scales were associated with 14-percent and 10-percent increased likelihoods of an error being reported during the subsequent three months."

Medscape (9/22, Barclay) added that other factors associated with subsequent error were "burnout, depersonalization, emotional exhaustion, lower personal accomplishment, a positive depression screen," and a diminished overall quality of life. The study authors concluded that "in addition to the national efforts to reduce fatigue and sleepiness, well-designed interventions to prevent, identify, and treat distress among physicians are needed." Still, they stressed that "additional research is necessary to determine the most effective strategies for accomplishing these goals."

HealthDay (9/22, Reinberg) noted that Dr. David J. Birnbach, director of the UM-Jackson Memorial Hospital Center for Patient Safety, said that although "changes in how doctors are trained are making things better for doctors and safer for patients," he is concerned that "no system exists to monitor whether they are tired or whether the hospital is complying with current regulations." Notably, in another study in the medical education-themed issue of Journal of the American Medical Association, "doctors who participated in a program that included meditation, self-awareness exercises and stories of 'meaningful clinical experiences' improved their well-being, had more empathy toward patients, and were less 'emotionally exhausted' or burned out, the researchers found."

Reuters (9/23, Fox) also covers the resident-fatigue study, pointing out that although most US hospitals have reduced the typical 100- to 120-hour resident work-weeks, most training hospitals still require at least 80 hours per week.

From the American Association for Justice news release.