This study examines the relationship between vacation behaviors and burnout among US physicians. A cross-sectional survey of 3024 US physicians was conducted from November 20, 2020, to March 23, 2021, with data analysis completed from March to July 2023. The main outcomes measured were burnout (using the Maslach Burnout Index) and professional fulfillment (using the Stanford Professional Fulfillment Index). Key findings include: - 59.6% of respondents took 15 or fewer vacation days in the last year, with 19.9% taking 5 or fewer. - 70.4% of respondents performed patient care-related tasks on vacation, with 33.1% working 30 minutes or more on a typical vacation day. - 49.1% of physicians reported having full electronic health record (EHR) inbox coverage while on vacation. - Concerns about finding someone to cover clinical responsibilities and financial concerns were associated with decreased likelihood of taking more than 3 weeks of vacation per year. - Taking more than 3 weeks of vacation per year and having full EHR inbox coverage while on vacation were associated with lower rates of burnout. - Spending 30 minutes or more on patient-related work on a typical vacation day was associated with higher rates of burnout. The study suggests that system-level efforts to ensure physicians take adequate vacation and have coverage for clinical responsibilities, including full EHR inbox coverage, may reduce physician burnout.This study examines the relationship between vacation behaviors and burnout among US physicians. A cross-sectional survey of 3024 US physicians was conducted from November 20, 2020, to March 23, 2021, with data analysis completed from March to July 2023. The main outcomes measured were burnout (using the Maslach Burnout Index) and professional fulfillment (using the Stanford Professional Fulfillment Index). Key findings include: - 59.6% of respondents took 15 or fewer vacation days in the last year, with 19.9% taking 5 or fewer. - 70.4% of respondents performed patient care-related tasks on vacation, with 33.1% working 30 minutes or more on a typical vacation day. - 49.1% of physicians reported having full electronic health record (EHR) inbox coverage while on vacation. - Concerns about finding someone to cover clinical responsibilities and financial concerns were associated with decreased likelihood of taking more than 3 weeks of vacation per year. - Taking more than 3 weeks of vacation per year and having full EHR inbox coverage while on vacation were associated with lower rates of burnout. - Spending 30 minutes or more on patient-related work on a typical vacation day was associated with higher rates of burnout. The study suggests that system-level efforts to ensure physicians take adequate vacation and have coverage for clinical responsibilities, including full EHR inbox coverage, may reduce physician burnout.