National Academy of Medicine

Addressing Burnout, Depression, and Suicidal Ideation in the Osteopathic Profession: An Approach That Spans the Physician Life Cycle

By Robert G. G. Piccinini, Kenya D. McRae, John W. Becher, Anna Z. Hayden, Caleb B. Hentges, Angela Kalcec, Pooja Kinkhabwala, Vanessa W. Halvorsen, Adrienne White-Faines, and David Escobar
March 24, 2017 | Discussion Paper

TW: suicide

If you are suicidal and need emergency help, call 911 immediately or 1-800-273-8255 if in the United States. If you are in another country, find a 24/7 hotline at

Burnout, depression, and suicidal ideation are key areas of concern because of the consequences they can have on physicians as well as the patients for whom they care. The level of burnout in the medical profession has increased at an alarming rate in the past decade. Statistics reveal that about 54 percent of all physicians are burnt out (30–40 percent of employed physicians and 55–60 percent of self-employed physicians.) Students, interns, and residents also factor into the equation as reports indicate they experience burnout at a rate of 20–40 percent. According to the International Classification of Diseases, Tenth Edition (ICD-10), burnout is defined as “a state of vital exhaustion.” It manifests as emotional exhaustion that affects a person’s passion for work; ability to relate to others; sense of accomplishment or purpose; judgment; productivity; emotions; and overall health.

Depression is an illness that is characterized by signs and symptoms that can affect a person’s emotions, thoughts, and actions. Similar to burnout, depression has increased in the medical profession. It is most commonly studied in medical students and residents. The prevalence of depression among resident physicians is approximately 29 percent.

Suicidal ideation is an alteration of one’s thought process in which ending his or her life is the preferred avenue to seeking other options to cope with stressors at the time. Approximately 300–400 physicians commit suicide every year. Figure 1 illustrates the incidence in suicide among white male physicians, but more importantly, it highlights that suicidal ideation is not merely an issue for students and residents, but is also a concern across a physician’s life cycle—and an even higher concern among physicians toward the end of their careers.

Together, burnout, depression, and suicidal ideation (or simply, physician wellness) are multifactorial issues that include physicians’ socioeconomic strains and presumptive factors of lifestyle, loss of autonomy in the workplace, and ever-changing demands of regulations. These factors can pose a heavy burden on physicians at different stages of their careers (e.g., student, resident, practicing physician, and retired physician).


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Suggested Citation

Piccinini, R. G. G., K. D. McRae, J. W. Becher, A. Z. Hayden, C. B. Hentges, A. Kalcec, P. Kinkhabwala, V. W. Halvorsen, A. White-Faines, and D. Escobar. 2017. Addressing Burnout, Depression, and Suicidal Ideation in the Osteopathic Profession: An Approach That Spans the Physician Life Cycle. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201703f


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.