The cost of physician burnout to the U.S. economy amounts to approximately $4.6 billion annually, according to a cost-consequence analysis.

“What was interesting to me was that the magnitude of the estimated cost associated with burnout, both at an organizational level and at the national level, was quite substantial,” said Dr. Joel Goh from National University of Singapore and Harvard Business School, in Boston.

“I think that this provides both physicians and leaders of healthcare organizations another data points about the scale of the problem of physician burnout,” he told Reuters Health by email.

About 54 percent of physicians report at least one symptom of burnout, nearly twice the rate of the general U.S. working population, Dr. Goh and colleagues note in Annals of Internal Medicine. But few studies have attempted to quantify the economic impact, they add.

Dr. Goh and colleagues developed a cost-consequence model to estimate the annual burnout-attributable costs for the United States, as well as for a hypothetical 1,000-physician organization whose distribution of age and specialty segments matched the national averages.

In the base-case model, approximately $4.6 billion a year resulted from physician turnover and reduced productivity attributable to physician burnout.

In sensitivity analyses, the estimated annual burnout-attributable cost ranged from $2.2 billion to $6.7 billion depending upon odds ratios associating burnout with turnover.

At the organizational level, the annual cost attributable to burnout was an estimated $7,600 per physician, a cost which ranged from $4,100–$10,200 per physician in multivariate sensitivity analyses.

“There needs to first be a broader awareness of the problem of physician burnout,” Dr. Goh said. “We hope that our study, and others like it, will help to begin a more serious conversation on the topic. There are already some studies that have provided evidence about the efficacy of organizational-level and individual-level interventions to reduce the prevalence of burnout. Nonetheless, I believe that further (likely, multidisciplinary) research could be fruitful in finding even more effective and creative interventions.”

“The case for tackling physician burnout so far has typically been made on moral/ethical grounds,” he said. “Without in any way diminishing the importance of these moral considerations, our study provides another perspective into why burnout prevention and mitigation can be worthwhile. It can also make good business sense.”

Dr. Edward M. Ellison from The Permanente Federation and Southern California Permanente Medical Group, Pasadena, California, who wrote an accompanying editorial, told Reuters Health by email, “The drivers of burnout are multifactorial and, therefore, the solutions must be as well. It’s not appropriate to tell physicians that if they would just do a better job practicing wellness that they will be okay.”

“Of course, we all have to take ownership of making those changes that support healthier living—stress management, sleep, exercise, healthier food choices, staying connected to the people and things that bring us joy and connection, and the joy of practice,” he said. “But just as importantly, we must address and change the systemic burdens and barriers that weigh so heavily on physicians. From the added documentation and clerical burdens of the electronic health record to lack of flexibility and autonomy in many practices to the stigma associated with seeking help when you are struggling. As some of my colleagues say, ‘don’t tell me to just eat plants and meditate.’ While self-care is important and proven to improve health, the stressors are much more complex and require system and cultural solutions as well.”

Dr. Ellison offered this message to physicians: “Be kind to yourself. Practice the same generosity of spirit for yourself that you do for others. Get involved in the conversation about burnout, resilience, and wellness. If you are struggling, reach out. It’s a sign of courage. If you see a colleague struggling, reach out. We must all be there for each other and establish a community and culture where the wellness of those who provide care matters and is supported.”

Dr. Colin P. West from Mayo Clinic, in Rochester, Minnesota, who studies physician burnout, told Reuters Health by email, “Sadly, I think very little in these important results is surprising. What is most interesting is that physician burnout is a substantial drain on our health care system, with billions of dollars of associated costs, essentially none of which are included in any institution’s annual budgeting process.”

“Our health care institutions and system as a whole need to step up and invest in healthier working and learning environments for all of our health care professionals,” he said. “This is not just the moral thing to do; it is also the fiscally responsible thing to do. There is ample evidence that interventions can help, and investment in implementation and further research into improved organizational approaches is justified by these results.”

“Burnout is a weight holding our health care system back from optimal performance for our patients and for all of our health care professionals,” Dr. West said. “The results of this study can likely be extended to some degree to nurses and other medical team members, so the total cost of burnout in medicine each year is staggering.”