By Annia Raja, WCI Columnist

Burnout among doctors is still high, with the most recent study from the American Medical Association showing that almost 50% of physicians report at least one symptom.

Burnout doesn’t always arrive with flashing warning signs. Instead, it often creeps in slowly, silently, and subtly. Sure, things like emotional exhaustion, cynicism, fatigue, and a reduced sense of accomplishment are often discussed about burnout. But there’s another huge consequence that rarely makes it into the conversation: the financial cost of burnout. When burnout sets in, it doesn’t just take a psychological toll. It erodes income potential, increases spending, derails long-term financial planning, and introduces risks that can lead to devastating consequences.

Burnout takes a far greater toll than just mental exhaustion. It becomes a serious financial liability for both physicians and the organizations for which they work. And when burnout spreads, it hits the balance sheet. According to the American Journal of Preventive Medicine, burnout could cost over $5 million annually for a 1,000-employee company. Poor employee retention and high turnover tend to go along with burnout, which also hits the bottom line.

In this column, I want to offer a perspective I see often in my work as a psychologist specializing in helping physicians. Addressing your burnout is not just personal self-care. It’s a financial wellness strategy.

 

Burnout Explained

We tend to wave off terms like “burnout,” believing they’re simply everyday life stresses. But the reality is that burnout is more than just feeling tired and stressed. It’s an emotional, mental, and physical exhaustion that seems to dig right down into our bones. It’s a slow erosion of the ability to function, fueled by chronic stress and unmet needs, that leaves us feeling used up and depleted.

As a therapist who works with physicians, I’ve seen how easily doctors dismiss the warning signs, mistaking them for “normal” stress or “just part of the job.” You might think it’s just another aspect of your work or the decisions you need to make. Being on call constantly, seeing 40+ patients a day, falling more and more behind on charting and admin tasks–this is normal, right? No!

Part of why burnout can be so hard to recognize is because so many physicians around you are in the same boat. It’s easy to assume this is just “how it is,” especially when colleagues brush it off, tell you to “hang in there,” or seem more interested in venting than actually finding solutions.

But let’s be honest: a lot of that advice is coming from others who are burned out themselves. It’s the blind leading the blind. And misery loves company. Some of those are older folks who built their careers during a different era when reimbursement was stronger, autonomy was higher, and the job was more respected. But what may have been sustainable then might not be now. Ignoring burnout because everyone else seems to be doing it isn’t a strategy; in fact, it can be a financial liability.

Burnout is not simply about being tired or overworked. It’s a distinct cluster of experiences that results from chronic workplace stress that has not been managed. Simply put, it’s when our ongoing coping abilities and capacities for resilience are outpaced by the influx of stressors. And it typically manifests in three key dimensions.

 

Emotional Exhaustion

You feel drained, depleted, or emotionally worn out by work. You may notice a lack of motivation or a persistent sense of dread about going to work.

 

Depersonalization (or Cynicism)

You've developed a detached, negative, and/or resentful attitude toward patients, colleagues, your role, or life in general. This often feels like you're just going through the motions or emotionally numbing yourself to get through the day.

 

Reduced Personal Accomplishment

You feel ineffective, unproductive, or as if your work no longer matters—even if you’re objectively performing well.

 

In physicians, burnout can be especially insidious because the culture of medicine often rewards self-sacrifice, stoicism, personal martyrdom, and constantly overextending oneself. The very competence that defines you becomes the mask that keeps other people (and maybe even yourself) from seeing the costs. As a result, many doctors minimize or normalize these experiences until they simply can’t go on, often reaching some crisis point.

Things don’t have to get to a crisis level to start addressing them, though. Recognizing burnout early on is essential if you want to stop it immediately, thereby reducing the risk of its far-reaching consequences, financially and otherwise.

More information here:

Which Medical Specialties Are the Most Burned Out?

Financial Planning: An Important Part of Beating Burnout

 

How Burnout Quietly Erodes Your Financial Foundation

 

Reduced Productivity and Earning Potential

Burned-out physicians often experience decreased efficiency. They take longer to chart, feel less focused when it counts, need more mental breaks, and avoid adding additional procedures or shifts that once felt doable. They may miss chances for bonuses, RVU-based incentives, or extra shifts when it makes sense to strategically take those opportunities. Even a 10% drop in clinical productivity can represent tens of thousands of dollars per year in lost income.

Burnout can also close the door on the longer arc of a medical career. You may feel too exhausted to pursue leadership, teaching, or entrepreneurial roles that can supplement your income, as well as side gigs like consulting, speaking, expert witnessing, etc.

 

Career Detours and Early Exit

Some physicians respond to burnout by cutting back to part-time, leaving clinical practice altogether, or retiring early. Sure, sometimes this can be the right move. But there’s a difference between making a decision like that thoughtfully and strategically vs. making it from a reactive position of burnout.

Doctors suddenly tapering down or altogether walking away from six- or seven-figure incomes without a clear plan can suffer years of financial fallout. This can be made all the worse if you leave at the peak of your earning years, which sadly is happening more and more from what I’m seeing.

 

Impaired Financial Decision Making

Burnout doesn’t just drain energy; it clouds your judgment. Doctors who are in a state of emotional and cognitive overload are more likely to make reactive financial decisions rather than intentional ones.

That might mean quitting a job without a plan, switching roles in search of greener pastures (only to encounter new regrets or what-ifs), jumping into high-risk investments out of desperation, or putting off critical financial tasks—like updating a will, reviewing insurance, or maintaining your investment accounts, etc.

Emotional exhaustion also leads to financial avoidance. Bills and important financial tasks pile up, and financial plans sit unmade and/or untouched. Budgets are ignored, and investing goals are either not made/enacted or, worse, outsourced to high-fee financial advisors who happily charge you exorbitant fees in exchange for your financial disengagement. (Important note on that topic: make sure you take The White Coat Investor’s “Fire your Financial Advisor” course! And don’t forget that even a task like completing that course requires you to have time and mental bandwidth in your life to watch it, much less put it into action.)

Even seemingly small missteps, like missing a tax deadline or forgetting to renegotiate contract terms, can compound over time. What’s often mistaken for “laziness” or “disorganization” is, in fact, a mind in survival mode, unable to prioritize, plan, or care.

Protecting your decision-making capacity is an overlooked form of wealth preservation.

 

Increased Spending as Coping

Burnout often drives what I call “escape spending,” which is using money to seek relief from the discomfort of chronic stress, emotional exhaustion, or disconnection resulting from your ongoing state of overwork. For doctors, this coping mechanism often takes on a particular shape that is fueled by both the ability to spend and the culture of medicine itself.

Doctors can engage in “work hard, spend hard” behavior: justifying frequent luxury travel, fine dining, convenience subscriptions, or high-end purchases as well-earned rewards or necessary tradeoffs for a demanding lifestyle. Repeated overnight call shifts? That last-minute trip to Bora Bora feels like the only sane response. Too burned out to cook? DoorDash becomes a daily ritual. These aren’t inherently bad choices. But when they’re driven by emotional depletion rather than intentional planning, the literal financial costs can quickly add up.

For high-income earners like doctors, the issue isn’t usually one large splurge. It’s the slow, normalized financial bleed: outsourcing everything, upgrading constantly, or using spending as a buffer against a deeper existential dissatisfaction with life. Many physicians also face peer comparison pressure (i.e., “keeping up with the Joneses”), especially in specialties with visible wealth markers (cars, homes, vacations)—all of which can further reinforce lifestyle inflation, thus increasing financial hemorrhaging.

Ultimately, these patterns can sabotage long-term goals like financial independence or early retirement, as well as lead to self-imposed “golden handcuffs” that preclude your financial ability to scale back on work if that’s what may actually be needed over the long term.

Therapy and other mental health interventions can help doctors become more aware of these spending patterns, emotional triggers, and underlying schemas, and then, from there, work to replace them with healthier, more sustainable forms of relief.

 

Relationship Strain and Divorce

For physicians, the burnout-creating combination of long hours, emotional overload, and limited bandwidth can take a heavy toll on relationships. As burnout worsens, many doctors report becoming more irritable, withdrawn, or emotionally unavailable to their partners and children.

Medicine often requires doctors to give their best energy to patients, leaving little left for the people closest to them. Partners may feel neglected or unimportant, especially when the doctor partner seems perpetually distracted, overworked, or numb. Over time, this disconnection can turn into chronic conflict, resentment, and emotional distancing.

There’s a reason why WCI constantly emphasizes that maintaining your marriage is one of the important forms of financial asset protection. Divorce is sadly prevalent among physicians (particularly more with surgeons and female doctors), and the financial consequences of a separation, divorce, and/or custody battle can be devastatingly life-altering. Legal fees, the division of assets, alimony or child support, and the cost of establishing two separate households can dramatically derail long-term financial plans, even for high earners. And even short of divorce, ongoing relationship strain can impact collaboration on financial decisions and increase stress at home, compounding burnout further.

Protecting your mental health isn’t just good for your clinical performance; it’s a safeguard for the personal relationships and financial structures that hold the rest of your life together.

 

Risk of Errors, Liability, and Malpractice

Burnout impairs cognition, focus, and judgment. This can lead to medical errors, patient complaints, or administrative scrutiny. The reputational and financial fallout from malpractice claims can be enormous, even when you're fully insured.

While malpractice insurance covers financial losses in many cases, the fallout from claims can still be costly and career-altering. Doctors facing lawsuits often experience increased insurance premiums, damaged reputations, and restricted professional opportunities. The stress of legal proceedings can also exacerbate burnout, creating a vicious cycle.

Prioritizing your mental health as a physician is a critical part of risk management, burnout prevention, and financial protection. Staying psychologically resilient helps maintain sharp clinical decision-making, reduces errors, and ultimately protects both your patients and your livelihood.

 

Missed Wealth-Building Opportunities

Burnout can make it tough to focus on anything beyond the immediate demands of work. For doctors, this often means putting off important financial tasks like reviewing your investment portfolios, maximizing retirement contributions, setting up auto-investments, strategizing your tax planning, writing your will, reviewing your insurance, etc.

This disengagement can cause missed opportunities for compound growth, tax efficiencies, or strategic financial moves that could significantly impact your net worth over time. Even small delays in optimizing investments or saving can add up to substantial losses across a career.

Time is money. Addressing your mental health and reducing burnout is a literal investment in your financial life.

 

Why Doctors Wait Too Long to Get Help

Doctors are hardwired to push through. They’ve trained to endure long hours, tough cases, and emotional strain, all without complaining. The culture of medicine sadly reinforces the idea that you’re not allowed to show that you’re struggling, overwhelmed, or even just tired. Admitting that you’re struggling can feel like admitting weakness for so many doctors. It's no surprise that so many delay seeking help until burnout becomes a full-blown crisis or, worse, never reach out for help, no matter how bad things have gotten.

As a therapist for doctors, here are some common thoughts I hear from physicians:

  • “Everyone in medicine is exhausted; it’s just part of the job.”
  • “I don’t have time to see a therapist.”
  • “If I ask for help, people might think I can’t handle the pressure.”
  • “Therapy won’t work unless I quit my job.”
  • “No one else understands what it’s like to be a doctor.”
  • “If I slow down, my colleagues will think I’m weak or lazy.”
  • “I’m not burned out or depressed or anxious. I’m just tired.”

I have a lot of compassion for these thoughts—especially given so much of the cultural messaging that doctors absorb in their profession and even outside of it—but they come with a steep price if doctors indulge these hesitations to get help. Waiting too long not only needlessly prolongs your suffering, but it also increases the risks to your financial life. Things like career disruption, bigger snowball financial setbacks, and worsening personal consequences can be better avoided by seeking support sooner.

I work with many doctors in my therapy practice, and one particular example comes to mind. I once worked with a highly respected surgeon who didn’t reach out for help until he was seriously considering walking away from medicine altogether. What he really needed wasn’t a career change. He needed time and space to decompress, permission to be human, and support in managing the intense pressure he’d been under for years. Once he addressed the burnout, he chose to stay in medicine and also started to enjoy his work again and find deeper meaning and purpose in his day-to-day life within and outside of medicine.

His story is far from unique. According to a 2022 survey by the American Medical Association, nearly 1 in 5 physicians reported they were planning to reduce clinical hours or leave medicine entirely due to burnout. That kind of attrition has personal and financial consequences not just for doctors, but for their families, patients, and long-term goals.

Recognizing burnout as a professional risk and financial hazard rather than a personal failure is the first step toward protecting your financial future.

 

The ROI of Prioritizing Mental Health

Physicians are taught to think in terms of outcomes—and mental health is no exception. Burnout doesn’t just impact your mood. It affects your performance, earning potential, and long-term financial trajectory. Investing in your mental health can yield a surprisingly high return.

 

Improved Efficiency = Higher Income

When you’re burned out, everything takes longer—charting, decision-making, even simple tasks. Getting support can help restore mental clarity and focus, allowing you to move through your day more efficiently. That means fewer hours spent catching up and more opportunities to generate revenue without burning out further.

 

Longer Career = Bigger Nest Egg

Many physicians leave clinical practice early, not because they can’t do the work but because burnout makes it feel unsustainable. But if taking care of your mental health allows you to stay in practice even a few years longer, the compounding effect on your investments and retirement savings can be massive.

Let’s say you’re earning $300,000 per year, and you manage to stay in practice five years longer than expected because you took your mental health seriously. That’s $1.5 million in additional income, not even accounting for continued retirement contributions or compounding investment growth. The upside is huge.

 

Stronger Relationships = Less Financial Disruptions

When you're not constantly running on empty, you're more present, patient, and communicative at work and at home. This can help reduce costly relationship strain, avoid distractions that spill over into your clinical work, and improve overall life satisfaction. An investment in your mental health directly contributes to bettering your marriage and personal relationships, all of which translates to better financial outcomes.

 

Better Emotional Regulation = Lower Lifestyle Inflation

Doctors under stress can readily fall into the “I deserve this” spending trap—needlessly expensive vacations, luxury cars, mindless convenience services, and so much more. To be clear, there’s nothing wrong with enjoying your income, but when your spending becomes a coping strategy, it can quickly eat away at your finances. Addressing doctor burnout can help keep your lifestyle aligned with long-term financial goals and overall values in life.

 

Clearer Thinking = Smarter Decisions

Burnout clouds your judgment. Physicians who are in survival mode are more likely to make impulsive or avoidant choices (things like walking away from a job prematurely, ignoring financial planning, overspending just to feel better, and more). Prioritizing mental health contributes to mental clarity, thereby helping you make better, clear-eyed, strategic decisions about your money, career, and personal life.

More information here:

How My Burnout Led to Rage That Could’ve Ended My Career

Understanding Veterinarian Burnout and Mental Health

 

Practical Steps for Reducing Burnout and Prioritizing Your Mental Health

You don’t need to overhaul your entire life to start addressing burnout. Small, strategic changes that are implemented consistently can make a big difference. Think of it the same way you approach financial independence: identify your goals, implement high-yield actions, cut what’s not working, and double down on areas that give the best return on investment.

Here are some practical ways to get started.

 

#1 Know What Burnout Looks Like in You Specifically

Burnout isn’t just about being tired. If you’re feeling numb at work, irritable at home, dreading your next shift, or fantasizing about quitting medicine altogether, those are signs to which you should be paying attention.

 

#2 Reframe Therapy or Coaching as a Professional Tool—Not a Crisis Response

Getting support doesn’t mean you’re failing. It means that you’re investing in performance and longevity. Just like you’d consult a financial expert to optimize your investment strategy or an attorney for legal concerns, working with a physician therapist or coach can help you manage stress, improve clarity, and avoid costly career missteps, thereby optimizing your financial life.

On the therapy side, there are psychologists like myself who specialize in working with physicians. My practice offers confidential, targeted therapy support for doctors dealing with burnout, decision fatigue, the emotional weight of practicing medicine, and so much more. There’s no need to explain the minutiae of practicing medicine, because the clinicians in my practice and I already get it based on both professional and personal experience (my husband is a physician).

If you're looking for physician coaching, there are physician-specific options that focus on burnout prevention and leadership skills or databases for physician coaches hosted by professional associations like the AAFP, which offer structured support for physicians navigating work-life balance and career transitions.

Whether you’re looking to stay in medicine long-term or just want to feel more like yourself again, therapy and coaching are high ROI tools that help protect your mental health and your income, career, relationships, and financial stability.

 

#3 Audit Your Time and Energy

If you track your spending to build wealth, you should track your time and energy to protect it. Burnout often comes from constantly spending those resources on low-yield tasks. Start by identifying where your time and mental bandwidth are going each week. What drains you? What’s actually worth it? You can’t optimize what you don’t measure.

Just like you’d rebalance your portfolio, start reallocating your time and energy toward the things that give you the highest return: rest, meaningful work, relationships, and your long-term goals. Start treating your time and energy like limited capital. Budget it wisely. And remember: this isn’t about being perfect; it’s about being intentional.

 

#4 Set (and Enforce) Better Boundaries

Physicians are notoriously bad at saying no. But every time you say yes to something that doesn’t matter, you’re saying no to something that does. That includes your time, energy, and often your money.

Physicians are trained to constantly be available to everyone (patients, administrators, colleagues), but that habit comes at a cost if it’s not reined in by you. Feeling needed can be addicting for many physicians, a habit that can lead to being overextended personally and professionally.

Start small. Stop checking your EMR after hours. Block time for a real lunch. Say no to one nonessential committee. If you wouldn’t let a bad investment drain your portfolio year after year, don’t let poor boundaries drain your time and mental health. You’re the only one who can draw the line.

 

#5 Create a Plan Before You Quit

If you’re on the edge of walking away from medicine altogether, don’t make a reactive decision. Quitting without a plan can solve one problem and create dozens more new ones, especially if your finances, insurance, or identity are tied to your job.

Burnout can cloud your judgment and push you toward all-or-nothing thinking. That’s not the time to make high-stakes decisions. Talk to someone first, be it a colleague, therapist, coach, or anyone else trusted. Run the numbers. Look at your options: can you go part-time, take a leave, switch departments, or negotiate changes? You may still need to pivot, but doing it strategically beats burning it all down and starting from scratch.

You may still decide to leave, and that’s OK. Just make sure it’s a strategic decision, not a reaction to an unsustainable situation. Your career is an asset. Treat it like one.

 

#6 Stay Connected

Isolation fuels burnout. Whether it’s a colleague you trust, a professional peer group, or a therapist, regular connection helps keep your perspective grounded and your stress manageable. Remember that you don’t need to wait until you’re in crisis to prioritize your mental health. Just like investing, the earlier you start, the better the compounding returns.

More information here:

What Emergency Docs Can Do to Beat Burnout

What We Can Learn About Work-Life Balance and Retirement from the French

 

Mental Health Is a Financial Strategy

For physicians, financial security and mental well-being are deeply intertwined. Burnout can derail your income, damage your relationships, and throw your entire financial plan off course. Ignoring it comes with real costs: lost productivity, impulsive decisions, early retirement, and avoidable mistakes that compound over time.
Doctors spend years learning how to protect other people’s health. It's worth spending a little time and energy protecting your own, especially when your career, financial goals, and overall quality of life depend on it.

Investing in your mental health is one of the highest-yield, lowest-risk decisions you can make. Not only will it make your day-to-day life better, but it may just keep your career—and your financial plan—intact for years to come.

Taking care of your mental health isn’t self-indulgent. It’s smart risk management. It’s career preservation. And for many doctors, it’s the difference between burning out early and building a life (and nest egg) that actually helps you thrive both personally and financially.

Have you ever felt burnout? What signs or symptoms appeared to let you know? How did you deal with those symptoms? Did you seek professional help? Did it work?