Hope modifies the association between burnout and self-perceived medical errors among practising physicians: implications for person-centered medicine

Abstract

Rationale, aims and objectives: Hope is an important resource that influences an individual’s ability to cope with stressful situations. The objective of this study is to evaluate the association of medical errors with burnout and hope among practising physicians using validated metrics.Method: Participants were physicians who had already completed residency training and were working in hospital settings (N=1054). Surveys included self-assessment of medical errors and validated Burnout Scale (depersonalization [DP] and emotional exhaustion [EE]) and Herth Hope Index. Frequency of self-perceived medical errors was recorded as the principal outcome measure.Results: A total of 716 errors were reported in 1054 physician-years. We observed a significant association between the burnout EE, DP domain score and reporting an error; compared with the lowest tertile category, IRRs of self-perceived medical errors of physicians in the highest category were 1.40 (95%CI, 1.16–1.68) and 1.37 (95%CI, 1.15–1.63) respectively, for EE and DP. We did not find a significant association between the hope score and self-perceived medical errors. In stratified analysis by hope score, among physicians with a low hope score, those who experienced higher burnout reported higher incidence of errors; physicians with high hope scores did not report high incidences of errors, even if they experienced high burnout.Conclusions: Self-perceived medical errors exhibited a strong association with physicians’ personal wellbeing: burnout was strongly associated with self-perceived errors. However, this association was modified when physicians felt hope. These results have immediate implications for the practice of person-centered medicine. In order to practise PCM effectively, the health of the person of the doctor is as important as the health of the person of the patient.