Doctors who feel burned out or overwhelmed by the demands of work are less likely to view their work with patients as a "calling" that has meaning, according to a recent study.

Burnout - characterized by emotional exhaustion, a loss of a sense of self-identity and a reduced sense of accomplishment - can happen in any occupation, the researchers write in the Mayo Clinic Proceedings.

Burnout among doctors has been linked to lower patient satisfaction, more medical errors and higher healthcare costs, the researchers write.

"If physicians only view their occupation as a job, that has implications over time in terms of their commitment to their patients," said senior author Dr. Audiey Kao, vice president of ethics at the American Medical Association (AMA).

"That's why we were interested in looking at work identity or physician's sense of calling and what may undermine or support that notion," Kao told Reuters Health by email.

To determine how burnout may be linked to doctors' view of medicine as a meaningful calling, the study team surveyed over 2,000 U.S. doctors across all specialties.

The doctors, recruited from an AMA database, completed mail-in surveys between October 2014 and May 2015.

Participants rated their level of burnout on a scale of 1 to 5, with scores of 1 and 2 indicating no symptoms of burnout. The doctors also answered true/false questions assessing whether they viewed medicine as a calling, for example, whether they had a strong desire to commit their lives to doing this work.

The responses to the questions about medicine as a calling varied widely. Over 93 percent of doctors found their work rewarding, while only 44 percent said they would continue their work without pay if they didn't need the money.

Doctors who were more burned out were more likely to answer "false" to questions about whether they viewed their work as a calling.

For example, among doctors with no burnout symptoms who enjoyed their work, 93 percent said they would choose their work life again, while less than a third of doctors in the most burned-out category said the same.

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Doctors with the highest degree of burnout had much lower odds of calling their work rewarding, one of the most important things in their lives and agreeing that it was making the world a better place.

Burned out doctors were also less likely to enjoy talking about their work with others and to say they would choose the same work life again or continue with their current work even if they were not paid.

"Some researchers in the field have described burnout as an experience of dislocation between what people are doing versus what they aspired to do," Dr. John Yoon, assistant professor of medicine at the University of Chicago, said by email.

Yoon's own research suggests that burned out doctors are more likely to work in environments that they feel are driven by profits.

"The healthcare workplace is changing quite dramatically, for better and for worse, and so the changes affect how doctors view their work every day and therefore their work identity," Kao noted.

One common change is that doctors are increasingly overwhelmed with paperwork, which may affect their perception of their work, Kao said.

"Everyone, including doctors, wants to be doing work that contributes to some greater good beyond themselves - work that feels authentic to who they are without compromising their integrity," said Yoon, who was not involved in the study.

"Having physicians who view their work as a sense of calling is not only important for physicians but as important if not more important for the patients they care for," Kao said.