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Is Your Doctor Stressed? Depressed Doctors Are Dangerous!

Is your doctor stressed out, burned out or overwhelmed? Many MDs are beleaguered by a dysfunctional health care system. Depressed doctors are riskier.
Male doctor terrified looking at medical reports over gray background

Most patients have no way of assessing the mental state of their physician, but it could have a significant impact on safety. A systematic review published in JAMA Network Open (Nov. 27, 2019) analyzed data from 11 studies. Over 20,000 physicians were included in this meta-analysis. Depressed doctors pose a threat. The investigators found an association between physician depressive symptoms and medical errors.

Why You Should Care About Depressed Doctors:

The authors of this study point out that:

“Medical errors are a major source of patient harm. Studies estimate that, in the United States, as many as 98, 000 to 251, 000 hospitalized patients die each year as result of a preventable adverse event.”

That’s “just” in hospitals. How many errors occur in nursing homes, clinics and doctors’ offices?

The investigators go on to point out that:

“Depressive symptoms are highly prevalent among physicians, and several studies have investigated the associations between physician depressive symptoms and medical errors.”

When depressed doctors make diagnoses, prescribe drugs or initiate treatment, you may be at increased risk.

Doctor Burnout Is Dangerous to Your health!

Other research has revealed that when doctors are burned out and under emotional distress, patient care can be jeopardized. Depressed doctors don’t often seek treatment, and the organizations that employ them don’t provide much support for dealing with depression or burnout.

How common is physician burnout? Far more common than you might realize.

Here is a “systematic review” (Diseases of the Colon and Rectum, June, 2017): 

“All US medical students, physicians in training, and practicing physicians are at significant risk of burnout. Its prevalence now exceeds 50%. Burnout is the unintended net result of multiple, highly disruptive changes in society at large, the medical profession, and the healthcare system. Both individual and organizational strategies have been only partially successful in mitigating burnout and in developing resiliency and well-being among physicians.”

An article in JAMA (Sept. 18, 2018)  reviewed all the available research on physician burnout at that time.

The results are all over the map.

“This systematic review of 182 studies involving 109 628 physicians in 45 countries demonstrated remarkable variability in published prevalence estimates of burnout, with estimates of overall burnout ranging from 0% to 80.5%.”

In some studies “emotional exhaustion, depersonalization, and low personal accomplishment” prevalence ranged as high as 90%.

Depressed Doctors and Medical Errors:

When doctors are burned out and emotionally distressed, they are more likely to make mistakes (JAMA Internal Medicine, Oct. 1, 2018):

“This systematic review and meta-analysis provides robust quantitative evidence that physician burnout is associated with suboptimal patient care in the process of health care service delivery. We found that physicians with burnout are twice as likely to be involved in patient safety incidents, twice as likely to deliver suboptimal care to patients owing to low professionalism, and 3 times more likely to receive low satisfaction ratings from patients.

“We found that physician burnout is associated with a reduced efficiency of health care systems to deliver high-quality, safe care to patients. Preventable adverse events cost several billions of dollars to health care systems every year. Physician burnout therefore is costly for health care organizations and undermines a fundamental societal need for the receipt of safe care.”

What Can You Do About Depressed Doctors?

Patients should care about their doctors’ well-being. Not only is compassion for their physicians appropriate, it could have an impact on their own health. Perhaps it is time for patients to ask their doctors how they are feeling. Although many physicians are reluctant to talk about their own well being or seek help for depression, patients have every right to know if they are being treated by depressed doctors.

Here is a link to our book, Top Screwups. It provides crucial questions to ask health professionals so you can avoid medical mistakes.

Share your own thoughts about depressed doctors and medical errors in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Citations
  • Pereira-Lima, K, et al, "Association Between Physician Depressive Symptoms and Medical Errors A Systematic Review and Meta-analysis." JAMA Network Open, Nov. 27, 2019. doi:10.1001/jamanetworkopen.2019.16097
  • Rotenstein, L.S., et al, "Prevalence of Burnout Among Physicians A Systematic Review." JAMA, Sept. 18, 2018. doi: 10.1001/jama.2018.12777
  • Panagioti, M., et al, "Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction A Systematic Review and Meta-analysis." JAMA Internal Medicine, Oct. 2018. doi: 10.1001/jamainternmed.2018.3713
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At the beginning of each primary (& some specialists) care visit, I’m asked to fill out a screening checklist that includes a number of questions related to stress, depression, substance use. Maybe I should ask the doc to do one as well; then we can exchange the information. Might be fair as well as helpful to both parties.

While I was working as a staff member at a medical association, one of the doctors on our board was always angry, rude and condescending. This went on for years. Then one day he suddenly began saying nice things to people and seemed happy. And it lasted. Wondering what prompted the change, I came up with several thoughts: Did he quit alcohol? Did he start taking antidepressants or start/stop some other medication? This was years ago, when doctors would not have been quite as stressed as they would be now.

Perhaps not as significant as errors from MDs, but a number of years ago our family dentist (when we had 3 school-age children) left his practice. The dentist who took over the practice had the difficult task of explaining why so many cavities were now “found” in our family. The explanation was the depression of our first dentist. The results were the repair, discomfort, and expense of proper dental care by the new dentist. There was really no way to know about the problem while it was happening. Lesson learned. Sometimes no news (your teeth are just fine) is not good news. Lesson learned.

My doctor was exceptional, caring, wise and always displayed his sense of humor. But one day he came across as extremely rude and dismissive. I chose to use humor to soften the situation, and questioned if he was in a bad mood. He exploded in a rage which seemed to last forever and ended by saying if I didn’t like his moods I could find another doctor. I did.

Re article on stressed out doctors, I suggest you evaluate the literature and run some material on stressed out nurses. Nursing is inherently one of the most stressful professions with heavy responsibility. This is a critical issue.

How are you supposed to know, or find out if your MD is depressed ? I realize that question won’t be answered, but still had to ask. Lol. Although, I went to an MD once, and it was very obvious she had some sort of mental problem, could have been depression, but more like, aggression. She was just very angry, and condescending. Maybe it was due to stress, but depression you can’t detect, by looking or even talking to someone, most of the time. She shouldn’t be working around people, and certainly not as a Dr. seeing patients. It was very unsettling to be treated by a professional that way. Needless to say, I didn’t return. I would say, go with your gut feelings, because most of the time, you can trust them.

My family recently observed that nurse managers contribute to physician burnout when they repeatedly overrode doctors’ orders for financial reasons.

My brother was hospitalized for near-fatal cardiac problems and a crushed vertebrae sustained when he fell during the event. It was less than 30 days since his previous admission, and the nurse managers wanted him out of hospital FAST. They tried to override doctors orders in order to discharge him directly from the ED. Brother was admitted but it set off a doctor vs. nurse manager fight for the next 5 days over inpatient/obversation status, treatment decisions and discharge. Unfortunately doctors (and brother) lost the fight.

No wonder they are burned out.

Bernie Siegel, cancer surgeon at Yale, and author of “Love, Medicine and Miracles” a few years back, says he learns most of what he practices in his work from nurses and social workers. He also says, “Hug your doctor. He needs it.”

Doctors and patients alike are angry and depressed with the state of our “health care” system except, of course, for the corporate owners of this non-health care system.

Doctors need patients, and patients need doctors and I’ve wondered why the doctors don’t just leave the corporate system and go off on their own. Large employers, like state benefits systems, must be enlisted to stop the insanity. They started it with the advent of HMOs and “preventive care” mantra that has turned out to mean, basically,”We will fill you with prescription drugs and then let you die while you wait for an appointment.”

The big money makers–cancer & heart care centers–seem to be the part of the current system that actually works. Hmmm! Maybe that’s by design: first they neglect, then they prescribe, then they deny horrible side effects & prescribe more potent drugs, then they make you wait months for appointments or send you to urgent or emergency “care” where you will, again, wait for several hours. Eventually you will end up with cancer or heart issues for which they will charge exhorbitantly unconscionable amounts of money–and that’s for those fortunate folks with good insurance. The rest of us get the message: just die.

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