Physician turnover more complex than just burnout, study finds

By Susan Vogel for Healthcare Dive

Dive Brief:

• Physicians’ decisions to leave their practices is a complex choice “with multiple interdependent factors,” and is not solely impacted by burnout, pay or frustrations with electronic health records, according to a new qualitative study published in ​​the Journal of the American Board of Family Medicine.
• The study, which interviewed physicians who left their ambulatory care practices between 2018 and 2021, found that they were motivated to increase time off, have more flexibility or receive higher earnings. However, other departing physicians reported higher compensation would not have persuaded them to stay.
• Physician practices can better retain clinicians by addressing risk factors for departure including workflow distribution across team members and ensuring adequate staffing, the report said.

Dive Insight:

Physician turnover has risen steadily over the past decade, with attrition rates rising 43% between 2010 and 2018 from 5.3% to 7.6%, according to a study published in July.

The COVID-19 pandemic further increased turnover, with over 71,000 physicians exiting the industry between 2021 and 2022, according to a report from Definitive Healthcare. Exiting physicians often sought retirement early, burned out of the profession or struggling to adapt to providing care via telehealth. The study also linked EHR burden to physician burnout and turnover.

However, the ABJM study found that burnout and EHR burden wasn’t the primary motivator for physicians exiting their practices. In fact, many physicians who left their jobs didn’t leave the industry. Fifty-four percent of the physicians who left their ambulatory practices departed for new positions, pointing to the importance of local leadership and culture in retention.

Physicians included in the study were driven to leave their current practices by a number of factors, including isolation, the corporatization of medicine, the pandemic and inbox burden, difficult patients, volume and intensity of work, and advancement opportunities.

The study recommended increasing opportunities for physician recognition, development and advancement, as well as distributing responsibilities across team members and ensuring adequate staffing across disciplines and roles. 

In addition, though no providers listed the EHR as their primary reason for departing, the study suggests that the EHR could be optimized and providers could receive more technical support to diminish documentation burden.