Professional burnout and other forms of occupational distress among physicians has important personal and professional consequences. These consequences can erode patient safety and quality of care and come at a substantial cost to healthcare organizations and society at large. 

a. Professional Consequences:

1. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358-367. doi:10.7326/0003-4819-136-5-200203050-00008

2. West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071-1078. doi:10.1001/jama.296.9.1071

3. Windover AK, Martinez K, Mercer MB, Neuendorf K, Boissy A, Rothberg MB. Correlates and Outcomes of Physician Burnout Within a Large Academic Medical Center. JAMA Intern Med. 2018;178(6):856-858. doi:10.1001/jamainternmed.2018.0019

4. Dyrbye LN, West CP, Hunderfund AL, et al. Relationship Between Burnout, Professional Behaviors, and Cost-Conscious Attitudes Among US Physicians. J Gen Intern Med. 2020;35(5):1465-1476. doi:10.1007/s11606-019-05376-x

5. Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Nurse staffing, burnout, and health care-associated infection [published correction appears in Am J Infect Control. 2012 Sep;40(7):680]. Am J Infect Control. 2012;40(6):486-490. doi:10.1016/j.ajic.2012.02.029

6. Welp A, Meier LL, Manser T. Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol. 2015;5:1573. Published 2015 Jan 22. doi:10.3389/fpsyg.2014.01573

7. Hamidi MS, Bohman B, Sandborg C, et al. Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study. BMC Health Serv Res. 2018;18(1):851. Published 2018 Nov 27. doi:10.1186/s12913-018-3663-z

8. Halbesleben JR, Rathert C. Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Health Care Manage Rev. 2008;33(1):29-39. doi:10.1097/01.HMR.0000304493.87898.72

b. Personal Consequences

1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385. doi:10.1001/archinternmed.2012.3199

2. Oreskovich MR, Shanafelt T, Dyrbye LN, et al. The prevalence of substance use disorders in American physicians. Am J Addict. 2015;24(1):30-38. doi:10.1111/ajad.12173

3. Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334-341. doi:10.7326/0003-4819-149-5-200809020-00008

4. Shanafelt TD, Balch CM, Dyrbye L, et al. Special report: suicidal ideation among American surgeons. Arch Surg. 2011;146(1):54-62. doi:10.1001/archsurg.2010.292

5. Center C, Davis M, Detre T, et al. Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003;289(23):3161-3166. doi:10.1001/jama.289.23.3161

6. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306(9):952-960. doi:10.1001/jama.2011.1247

7. Balch CM, Oreskovich MR, Dyrbye LN, et al. Personal consequences of malpractice lawsuits on American surgeons. J Am Coll Surg. 2011;213(5):657-667. doi:10.1016/j.jamcollsurg.2011.08.005

8. Ahola K, Väänänen A, Koskinen A, Kouvonen A, Shirom A. Burnout as a predictor of all-cause mortality among industrial employees: a 10-year prospective register-linkage study. J Psychosom Res. 2010;69(1):51-57. doi:10.1016/j.jpsychores.2010.01.002

C. Impact of work on relationships

[need citations]

D. Physician suicide

[need citations]