Next time you see your family physician or a hospital doctor, be extra kind and patient—they could be on the verge of burning out, a new study warns.

About 10% of internal medicine doctors in the U.S. report a high level of burnout, researchers reported in the Annals of Internal Medicine.

Further, doctors in the West are at significantly higher risk for burnout compared to those in other U.S. regions, researchers found.

“Understanding burnout in this population that provides general medical care is particularly relevant given the projected shortage of approximately 40,000 primary care physicians within the next decade,” concluded the research team led by Dr. Nathan Houchens, a clinical associate professor of internal medicine at the University of Michigan Medical School.

For the new study, researchers surveyed 629 internal medicine docs found through a national database maintained by the American Medical Association. About half of the doctors provide primary care, and the other half work in hospitals.

Researchers found that around 10% of the doctors had the three signs of burnout—emotional exhaustion, a sense of detachment and a feeling that their efforts don’t make a difference.

Burnout risk was similar among doctors working at community medical centers, Veterans Affairs facilities and academic hospitals, results show.

Similarly, there were no significant differences in burnout risk between primary care or hospital doctors, or between doctors working in inpatient or outpatient settings, researchers found.

However, about 15% of doctors in the West suffered from burnout, significantly higher than those in the Northeast (9%), Midwest (9%) or South (7%), researchers found.

“Burnout remains prevalent among internal medicine physicians and does not seem to correlate to specific practice contexts,” researchers concluded. “Future research should explore systemic interventions that target common, important burnout drivers for internal medicine physicians.”

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