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Thursday, 2 September, 1999, 17:25 GMT 18:25 UK
Patients at risk from tired doctors
juniors
Junior doctors work long hours under pressure
Heavy workloads are causing junior doctors to make potentially life-threatening mistakes on a regular basis, a study suggests.

Forgetting to answer an emergency call, cutting too deep during surgery or prescribing the wrong dosages of drugs are among the mistakes uncovered.

The findings were presented at the British Psychological Society's annual conference in Leeds as junior doctors prepare to ballot on industrial action over what they consider to be unreasonable workloads.

The mistakes were split into four categories:

  • Procedural 40%: Including one doctor who thought an emergency call to see a heart transplant patient was a dream and went back to sleep
  • Misdiagnosis 29%: In one case a doctor missed an open wound - the mistake could have led to amputation
  • Wrong prescribing 27%: Generally doctors would give a higher dose than they should
  • Surgical errors 4%: Cutting too deep during surgery and severing a nerve in one case
One in four doctors had made between five and 10 mistakes while almost a third had made 11.

Two thirds of the doctors questioned in the study blamed workload for their errors, and many said tiredness and an inability to focus on the problem in hand were the cause.

hobart
Andrew Hobart was not surprised by the finding
Junior doctors are supposed to work a maximum of 56 hours a week, but the British Medical Association says one in four junior doctors is working over this limit.

Although the study itself draws no conclusions as to why doctors make so many mistakes, Dr Andrew Hobart, head of the BMA's junior doctors committee, said there were dangers in current working conditions.

"Long hours and lack of sleep is not good for the patients or the doctors themselves," he said.

"We want to bring hours down to some sort of reasonable level so that doctors are less tired and give patients the care they deserve."

Disasters averted

Rachel Raymond, a business psychologist, carried out the research at a London teaching hospital.

She questioned 78 senior house officers - middle-ranking junior doctors who are responsible for much of the day to day work in hospitals - with an average age of 28 and two thirds of whom were men.

Most had been qualified for a relatively short period - between two and three years - although some had been working on the wards for up to 13 years.

Ms Raymond told BBC News Online that mistakes were common, but not all cases had resulted in disaster.

"There were instances that did have an adverse effect - and some had the potential to go very wrong - but some were averted," she said.

Accepting blame

Most doctors blamed themselves for the mistakes, although one in 10 blamed patients and one in five blamed the government.

A spokesman for the Department of Health said: "We are committed to tackling junior doctors' hours and working conditions, especially measures to improve rest breaks.

"We will be providing another 7,000 doctors over the next three years on top of the 2,000 recruited in the government's first years in office."

See also:

09 Mar 99 | Health
Doctor's 'tiredness' killed baby
04 Jun 99 | Health
On call: The demands on juniors
08 Jul 99 | Health
Junior doctors: We will win
20 Jul 99 | Health
Doctors suffering ill health
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