The study estimated excess health care expenditures attributable to primary care physician turnover using published data for Medicare patients, calculated estimates for non-Medicare patients and AMA files.

"Each instance of a physician leaving his or her current practice results in $86,336 in excess health care expenditures during the following year," the report said. "Physician burnout is therefore costly to public and private payers, who bear most of these excess costs."

There are multiple plausible reasons for increased expenditures observed when patients lose their physicians:

• Continuity between patients and physicians is important for quality of care and patient satisfaction, as well as for total costs of care.
• If care shifts to higher-cost venues, such as an emergency department instead of an ambulatory setting, costs rise.
• Finally, to the extent that patients replace primary care with non–primary care, they may receive more low-value care.

The $260 million per year from burnout is distinct from the estimated $4.6 billion attributable to burnout from reduced productivity because of vacant positions and the costs associated with replacing physicians. Collectively, these costs would translate to a nearly $5 billion increase in health care expenditures each year from burnout-related turnover. Uncounted in this estimate are additional costs related to other consequences of burnout, such as reduced patient satisfaction, lower-quality care, medical errors, associated morbidity and mortality, and increased medical malpractice claims.

"There is an opportunity to decrease unnecessary health care expenditures by reducing burnout-related turnover," said Christine Sinsky, the study's lead author and AMA vice president of professional satisfaction. "Physician burnout is preventable and payers, health care organizations and others have a vested interest in making meaningful changes to reduce physician burnout."

Although widespread, the current high levels of physician burnout are not inevitable. Interventions to improve practice efficiency, such as advanced models of team-based care with in-room support, can reduce burnout. Likewise, interventions to improve organizational culture, including interpersonal connections with colleagues and improved local leadership, can improve professional fulfillment and reduce burnout.

"Reducing physician burnout could reduce unnecessary health care expenditures," the report concluded. "Payers, health care organizations and the health care delivery system have a vested interest in making changes to reduce physician burnout."

Read more: 

• We have a physician shortage, and it's getting worse
• The health care industry's Great Resignation: What employers can do
• The disappearing primary care practice