Mistakes take a significant psychological toll on physicians, and health-care facilities do not help them cope, a new study concludes.


In a survey of 3,171 physicians, 92% reported they had either “been involved with” a medical error or come close. About half said these incidents added to the emotional pressures they already dealt with on the job. The stress increased with the severity of the mistake, but it affected a third of the doctors who only had come close to making a mistake.

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The added pressure took several forms:


• 61% of the physicians reported increased anxiety over future errors.

• 44% reported loss of confidence.

• 42% reported sleep difficulties.

• 42% reported reduced job satisfaction.

• 13% reported harm to their reputation.


Led by Amy Waterman, PhD, a psychologist and assistant professor of medicine, Washington University School of Medicine, the survey included internists, pediatricians, family doctors, and surgeons in Seattle, St. Louis, and Canada (The Joint Commission Journal on Quality and Patient Safety 2007;33:467-476).


The researchers urge hospitals and other facilities to create a variety of support services both during and outside work hours.


“Critical-incident stress debriefing, telephone or in-person counseling with therapists or physicians with personal experience with medical errors, and discussion of how physician leaders coped after their own error experiences send an institutional message that seeking support after errors is not a sign of weakness,” Dr. Waterman’s  team concluded.