Concomitantly, our understanding of the relationship between physician burnout, diminished performance and the development of mental and physical illness is crystalizing. Data now links burnout with diminished physician professionalism, patient outcomes, hospital economics and patient safety. Moreover, burnout appears to be a surrogate measure of distress and vulnerability among physicians. In practicing surgeons, alcohol misuse and suicidal ideation are up to 3 times that of the general population, but when burnout exists the likelihood increases 25% and 90%, respectively. Among physicians in general, when burnout is present, depressive symptoms are 170% more likely. In surgical trainees, there is alarming prevalence of distress symptoms, with a recent national survey (manuscript in preparation) showing 16% suicidal ideation, 32% moderate to severe depression, 58% high stress and 61% alcohol misuse or abuse among PGY-3s.