“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.”