Stressed-out ER doctors not only burn out, they make more patient care mistakes

Doctor and nurses wheeling patient in gurney through hospital corridor
A new study finds that ER physicians who reported the most mistakes at the end of their shifts had the highest biomarkers for stress. (Getty/Sam Edwards)

The stress of caring for patients in the emergency room takes its toll on doctors, and a new study shows that it also is a danger to patients.

The more stress an ER physician experiences, the more likely he or she is to make a mistake, according to a new study published by BMJ Open.

Researchers from Michigan State University were able to determine the levels of stress that ER doctors were under by taking blood and saliva samples from 28 physicians who work at the Detroit Medical Centre, a level 1 trauma center, before and after their shifts to check their biological stress markers. After the shifts were over, they asked the doctors—who were either first-year, second-year or third-year residents—about the number of critically ill patients and trauma victims they treated and whether they made errors or experienced a “near miss,” an act of omission that could have harmed the patient.

The key finding: The physicians who reported the most near misses had the highest biomarkers for stress.

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“Stress among physicians is not just perception,” lead author Bengt Arnetz, M.D., Ph.D., chair of the MSU College of Human Medicine’s Department of Family Medicine, said in a study announcement. “It has a biological effect and that biological effect might impact the well-being of patients.”

It not only poses a danger to patients, however. Stress can also have a negative effect on the cardiovascular health of physicians. “Very few emergency physicians work past 50,” he said. “They burn out.”

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Arnetz surmised that some of the stress was self-induced because the residents were unsure of their own medical skills and may be afraid to ask a supervising physician for help. He said further research is needed to determine whether near misses caused by stress leads to poorer patient outcomes and how organizations can help ER doctors reduce stress.