Also, he said, no mechanism is in place to deal with distress and fatigue among older practicing doctors, who make up the bulk of physicians. "We have not regulated the group that is most sensitive to sleep deprivation," he said. "We have no rules for the 65- or 70-year-old practitioner."
Regulating the hours residents can work in training is "a good start," he said, "but eventually, we are going need to regulate everybody's hours in medicine to increase the safety."
In another report in the same issue of JAMA, doctors who participated in a program that included meditation, self-awareness exercises and stories of "meaningful clinical experiences" improved their well-being, had more empathy toward patients and were less "emotionally exhausted" or burned out, the researchers found.
The study demonstrated that primary care physicians participating in a continuing medical education program that focused on self-awareness experienced improved personal well-being, including burnout and improved mood, the researchers wrote.
"They also experienced positive changes in empathy and psychosocial beliefs, both indicators of a patient-centered orientation to medical care," they said. Such changes are associated with positive patient associations, such as taking a patient's experience of illness into account and promoting patients' participation in care, the study concluded.
The U.S. Agency for Healthcare Research and Quality has more on safer health care.
SOURCES: Colin P. West, M.D., Ph.D., internist, Mayo Clinic, Rochester, Minn.; David J. Birnbach, M.D., M.P.H., professor and vice provost, University of Miami, associate dean and director, UM-Jackson Memorial Hospital, Center for Patient Safety, Miller School of Medicine, Miami; Sept. 23/30, 2009, Journal of
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