HOSPITAL OVERLOAD: Doctors overworked, patient care suffering - KMSP-TV

HOSPITAL OVERLOAD: Doctors overworked, patient care suffering

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A new survey published Monday in the Journal of the American Medical Association shows American doctors are overworked, and patient care is suffering as a result.

"For resident physicians, workload so heavy as to result in physician fatigue is associated with increased medical errors and has led to the implementation of work-hour restrictions," the study said. "For nurses, a recent cross-sectional analysis showed a significant association between patient mortality and low staffing."

The study, conducted by Johns Hopkins University, anonymously surveyed 506 physicians, who all work exclusively in hospitals. Notable findings in the survey include:

  • 40 percent reported having too many patients to safely take care of each month.
  • 36 percent reported that patient overloads occur once a week.
  • 25 percent reported their workload is a barrier to thoroughly discussing treatment options with patients and their families.
  • More than 20 percent said they ordered unnecessary procedures for patients, because they didn't have enough time for a thorough evaluation.
  • More than one in five reported their workload likely contributed to patient transfers, patient complications or death.

Lead author Henry J. Michtalik, MD, MPH, MHS, of Johns Hopkins University in Baltimore, stressed that each doctor and hospital system is different, and that this survey is just the first step in assessing how workload is affecting care.

Only 14 states, including Minnesota, have enacted laws or regulations to address nurse staffing.

"I think most outpatient physicians feel they don't have enough time also," said Dr. Aaron Friedman, dean of the University of Minnesota's medical school.

Friedman was not surprised by the study, but he said staffing is only one piece of a complex puzzle -- such as varied payment methods and more acutely sick people now. 

According to Friedman, as patients have become sicker, the system has not adjusted to allow a team approach to share the workload -- and that's partly because of the way insurance companies pay.

"I get paid as a doctor for my time with you, but your insurance company doesn't pay for us having this other person spend time with you," he explained.

Furthermore, Friedman says state laws designed to protect can often get in the way.

"If I gave you, as a pharmacist, a responsibility to do certain things, you may not be legally allowed to do those even though you could," Friedman said.

While Friedman believes having more doctors and a variety of other health care professionals on staff would help, he said the most crucial goal is to create a system that allows health care providers to function as an efficient team. 

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