Care for our fellow humans cannot, of course, be reduced solely to figures or numbers. However, we are in the midst of a burnout epidemic in healthcare across the world and it may help us to acknowledge the seriousness of this point in time with the aid of an economic analysis.

We all hear daily of the delays in being able to see a GP, the shortage of GP’s, excessive waiting times in ED, elective surgery blowouts, record rates of nurses leaving their profession, shortages of staff – the list goes on. But often the stories seem to come so incessantly that they blur into one and go unheard.

And what of burnout? The occupational affliction that contributes, at least in part, to all of the problems above and also is related to poorer physical and psychological health (including increased suicide rates) in the person suffering. Can we assign a dollar cost to this condition?

For the sake of these calculations I have used data from the US and extrapolated some to an Australian context. Please remember that the numbers may not always be accurate in any transfer, but the themes will be similar and, of course, the exact figures are not the most most important takeaway – more that we have an urgent call to action and an opportunity to improve healthcare systems for the benefit of us all.

• There are 340,000,000 people in the USA
• It is estimated that 100,000 people in the US die each year from medical errors (Rodziewicz, Houseman, Hipskind, 2023) and that these errors occur in both inpatient and outpatient settings (Rodziewicz and Hipskind, 2018)
• It is known that doctors suffering from burnout make twice the rate of serious medical errors compared with non burnt out doctors (Shanafelt, Balch, Bechamps et al, 2010).
• Assume approximately 50% of doctors in US affected by burnout (conservative estimate – most studies indicate higher rate of burnout)
• Therefore, of the 100,000 deaths we can assume that 66,000 are made by doctors suffering with burnout, and 33,000 by doctors unaffected by burnout.
• Every US citizen has a 0.029% (roughly 3 in 10,000) chance of dying each year from a medical error, however that goes up to 0.039% (around 1 in 2500) if treated by a doctor suffering with burnout, and down to 0.018% (less than 1:5000) if you are treated by a non burnt out doctor. I guess we all want to get the doctor unaffected by burnout, huh?

Annual expenditure related to medical errors in the US is approximately $20 billion (Ahsani-Estahbanali, Doshmangir, Najafi et al, 2021) – which equates to $59/person/year just to pay for medical errors.

In Australia, if the same cost applied to medical errors/person applied, this would equate to $91 AUD, with a nationwide bill of $2.37 billion AUD for our 26 million populace.

Imagine that we could eradicate burnout in the, let’s say, 50% of Australian doctors affected. This group would make half the errors and save $788 million each year.

That’s a lot of money. Of course, it is somewhat abhorrent to think that saving money could be more motivating than reducing human suffering and death. And these calculations do not take into account the poorer teams that result from doctors with burnout, the overall reduced standard of care, nor the costs on the doctor’s own health and that of their families.

Make no mistake – we know some of the causes of burnout, and we know that certain demographics such as young doctors are more affected. It is clear that burnout can have its genesis in medical school or early career years. We know some of the organisation-level changes that can help – such as reduction of unnecessary or duplicated clerical and bureaucratic load. We know that improving teams and culture reduces burnout. We have wellbeing science that informs many of our individual interventions.

So, with all of this information at our disposal – and with significant potential fiscal saving as well as reduction of human suffering – why is it that we are not doing more to prevent, combat, and treat burnout? Why aren’t our organisations and institutions engaging with the science to reduce the precipitants of burnout? Why aren’t we prioritising how our teams function and optimising organisational culture? Why aren’t we engaging with evidence-based interventions and measurement? Does there have to be an even greater cost exacted before we address this problem?