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    90 Minutes Each Week Could Reduce Burnout, Errors

    By Jennifer Huddleston, staff writer    

    A recent study involving anesthesia residents at the Yale School of Medicine in New Haven, Connecticut, revealed that just 90 minutes a week could reduce burnout, a condition often associated with increased medical errors.

    A Mayo Clinic study published in September 2008 found that physicians who believe they made a major medical error in the preceding three months are not only more likely to report symptoms of burnout, but also more likely to make an error in the next three months.
    [1]  In its report, “To Err Is Human: Building a Safer Health System,” the Institute of Medicine reported that 44,000 to 98,000 patients die annually in hospitals as a result of preventable medical errors.

    According to an article in the June 2009 edition of Anesthesiology News, anesthesia residents who participated in a novel wellness program as part of the Yale study showed reduced levels of anxiety and stress as well as increased social support when compared to other residents who participated in the study but were not involved in the wellness program.

    The study, led by principal investigator Haleh Saadat, M.D., assistant professor of anesthesiology at Yale, and Alison A. Considine, M.D., M.P.H., pediatric anesthesia fellow at Yale, involved a total of 58 students divided into three groups: one that participated in a 16-week wellness program that lasted for 90 minutes each week, one that received 90 minutes each week for 16 weeks to do as they wished and a control group that did not receive any scheduled free time during the 16-week study and instead continued normal clinical duties.

    The wellness program focused on coping with work and family stress, including improving social networks, using effective problem-solving and communication skills, managing stress and minimizing the use of avoidance techniques like overeating or alcohol abuse.

    Researchers found that at the end of the 16-week study, the residents who participated in the wellness group used more problem-solving skills, sought more social support and used fewer avoidance-coping tactics than the residents in the other two groups. The residents in the wellness group also reported decreased alcohol consumption, less anxiety and more social support from co-workers after the study.

    The effects of burnout are many, ranging from stress, fatigue, emotional exhaustion and poor work performance to suicide, depression, anxiety, alcoholism and drug abuse. Studies have shown that compared to the general population, physicians typically have a higher rate of depression, substance abuse anxiety and suicide, many of which may be brought on by burnout. Further, studies have estimated that rates of physician burnout range anywhere between 25 and 70 percent and that this burnout begins during residency.

    While a 2004 study found that resident burnout varied by specialty, the difference was not statistically significant.
    [6]  The Yale study focused only on anesthesia residents, but its findings could likely help reduce the incidence of burnout among residents in all specialties and among physicians who have completed their residencies.

    “I think it’s very important that someone is looking at what’s happening to our residents,” said Mehernoor F. Watcha, M.D., attending anesthesiologist at Texas Children’s Hospital and Baylor College of Medicine in Houston, Texas. “I think we should also look at a second group of people. This is the group of physicians who are accustomed to 80-hour workweeks during their residency and then become faculty, where the ACGME [Accreditation Council for Graduate Medical Education] rules no longer apply. My guess is there is a large amount of burnout in this group as well, from working for more than 80 hours a week.”

    [1] Mayo Clinic. “Physician Burnout Associated with Increase in Perceived Medical Errors.” ScienceDaily. Sept. 8, 2006.
    [2] Vlessides, Michael. “In Just 90 Minutes a Week, Residents Able to Fight Burnout.” Anesthesiology News, Volume 35:6. June 2009.
    [3]  Ibid.
    [4]  Ibid.
    [5] Eckleberry-Hunt, Jodie, et al. “An Exploratory Study of Resident Burnout and Wellness.” Academic Medicine. Volume 84, Number 2. February 2009.
    [6] Martini, Shahm, et al. “Burnout Comparison Among Residents in Different Medical Specialties.” Academic Psychiatry. Volume 28:3. Fall 2004.
    [7] Vlessides, Michael. “In Just 90 Minutes a Week, Residents Able to Fight Burnout.” Anesthesiology News, Volume 35:6. June 2009.

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