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A new study confirms what some may already suspect: Many doctors in residency programs suffer from depression. Disturbingly, it also finds that these residents are more prone to make medication errors. A team led by Children's Hospital Boston pediatric hospitalist Amy Fahrenkopf, MD, MPH, used questionnaires to screen 123 pediatric residents at Children's, Lucile Packard Children's Hospital and Children's National Medical Center. Three quarters of the residents were diagnosed with "burnout," defined as emotional exhaustion and detachment in response to chronic occupational stress. About 20 percent had clinical depression—twice the rate of the general U.S population.
Medication errors (errors in requesting, writing instructions for or giving medication) were tracked for one month on hospital floors. The total medication error rate was below 1 percent, but residents with depression made 6.2 times more errors than non-depressed colleagues. Burnout alone wasn't linked to higher error rates.
Most medication errors were minor or caught by hospital safety nets, but Fahrenkopf believes there is potential for patient harm, especially if depressed physicians are also making diagnostic errors and others that are harder to catch and correct.
Sadly, most depressed residents seemed unaware of their condition. "It's considered expected for residents to be miserable, so it's hard to see when unhappiness has crossed the line into illness," Fahrenkopf says. In response to these findings and others, the Boston Combined Residency Program is taking several steps to address residents' mental health—for their sake and for patients'.
The study was published online February 8 in the British Medical Journal.
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It sounds like the setup for a joke: a see-through fish named Casper? It's true: A new zebrafish created by Richard White, MD, PhD, and colleagues in the Stem Cell Program did set up a recent joke by Jay Leno on The Tonight Show—about "invisible" servings at Red Lobster.
All kidding aside, Casper's transparent skin is highly useful to science, allowing researchers a direct view inside the fish's body as events unfold. Viewing Casper under a microscope, White has been able to watch the spread of a melanoma tumor, even seeing individual cells metastasize—something that had never been observed, so readily and in real time, in a living animal. White has also watched blood stem cells migrate, embed in the marrow and build blood after a bone marrow transplant. Observing this process may help researchers understand why marrow transplants sometimes don't "take." In the future, Casper may allow scientists to directly view the effects of treatments aimed at rebuilding patients' blood systems more quickly.
Casper was created by mating two existing zebrafish breeds: roy orbison, which lacks reflective pigment, and nacre, which lacks black pigment. You can read the rest of its story in the February 7 issue of Cell Stem Cell.
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This month, Children's is launching a new 28-page magazine about its research program. Called Vector, it will come out twice a year and will showcase basic, translational and clinical research at Children's for an audience of donors, funding agencies, industry, investors, the media and the research community.
The first issue is dedicated to the memory of Judah Folkman, MD, and features several projects inspired by his vision. Other features highlight the work of Frances Jensen, MD, in identifying new epilepsy targets, and Pedro del Nido, MD, in developing tools for beating-heart surgery. Each issue will also carry an opinion piece, a profile, briefs on recently published studies and a section called "Things to Watch," covering innovative emerging work. An online Vector is also underway. Check it out at childrenshospital.org/vector. |
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