More than four in 10 U.S. physicians said they were emotionally exhausted or felt a high degree of cynicism, or "depersonalization," toward their patients, said researchers whose findings appeared in the Archives of Internal Medicine.

"The high rate of burnout has consequences not only for the individual physicians, but also for the patients they are caring for," said Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, who led the research.

Previous studies have shown that burned-out doctors are more prone to thinking about suicide and to making medical errors than their peers, Shanafelt added.

The survey included nearly 7,300 doctors who filled in questionnaires about their work-life balance in 2011.

Thirty-eight percent had high emotional exhaustion scores, which is akin to losing enthusiasm for their job, according to Shanafelt. Thirty percent had high depersonalization scores, which translates into viewing patients more like objects than human beings, and 46 percent had at least one of the two symptoms.

Burnout was most common among doctors at the "frontline of care," such as those working in emergency rooms or in family medicine. Dermatologists and preventive care specialists were less affected.

The researchers compared physicians with a random sample of 3,400 employed people who were not doctors. Based on a modified version of the original questionnaire, 38 percent of the doctors had burnout symptoms against 28 percent of the rest.

"The study advances our knowledge by, for the first time, comparing to the general population and showing that physicians are at higher risk of burnout," said James Wright, chief surgeon at The Hospital for Sick Children in Toronto.

"It's very clear that when physicians are becoming burned-out it begins to affect their relationships with other healthcare workers and with patient families."

The new results come with some uncertainty, because only about a quarter of the doctors who received an invitation to participate completed the survey.

It's not clear why burnout strikes so many doctors, Shanafelt said, noting that excessive workloads are only part of the equation. Other possible reasons include too much paperwork, loss of professional autonomy and a higher patient load to make up for declining reimbursement rates.

"There is a sense that the volume of patients that need to be seen is increasing and it's taking away some of the time needed to build a relationship and give the best care possible," Shanafelt said. "That starts to build cynicism, I think." SOURCE: bit.ly/KEPNSw

(Reporting from New York by Frederik Joelving at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)

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