The U.S. surgeon general has issued an advisory saying Americans have a moral obligation to address long standing, crisis-level burnout, exhaustion and moral distress in health care.

Such advisories are reserved for urgent public health concerns.

The paper says stress and early retirement threaten public health infrastructure and will make routine checkups, emergency care and medical procedures harder to get.

They will also leave the U.S. ill-prepared for future emergencies.

Scottsdale-based ER doctor John Shufeldt leads Tribal Health, a company that provides medical staff to indigenous communities nationwide. He praised the advisory, saying, "It's about time."

"I'm really impressed that they went to this level and this depth of their analysis. And I think their recommendations and concerns are directly on point," he said.

Shufeldt added that he's worried about his colleagues' mental and physical wellbeing amid rising workloads.

"Nurses have it worse. So I think it's just this feeling of carrying this rock up this hill, and the rock just keeps getting bigger," he said.

He also said hospitals also lack the means to care for some patients.

"I work in hospitals now that will have patients with behavioral health in the emergency department for more than 24 hours because there's no hospital that will accept them. And there's no behavioral health services at the hospital," said Shufeldt.

But mental health concerns aren't limited to patients. Shufeldt worries medicine's high suicide rate is driven in part by a culture of resilience that punishes efforts to seek help.

"If you call a psychiatrist, and you ask for help, or they put you on medication, you have to report that to your state medical board. And once you do, if you apply for hospital privileges, there'll be comments on your mental health," he said. "No one wants to report that, because it's an unending list of questions that you have to answer if you do. And so we're reticent to ask for help one because that's generally not our culture."

Among other things, the paper recommends offering paid leave, providing living wages, reassessing workloads, equipment and staffing, offering family-friendly policies like child care, and reducing administrative burdens.