The physician shortage isn’t going anywhere

Approximately 35 percent of physician respondents indicate they are likely to leave their current roles in the next five years, of which roughly 60 percent say they are likely to leave clinical practice entirely. This upcoming shift is not just restricted to physicians nearing the traditional retirement age. Of those surveyed who say they are likely to leave, 59 percent of those aged 54 to 64 note that early retirement or leaving the care delivery workforce is their most likely next step, and 13 percent share that they would prefer to move to an administrative role within the care delivery workforce. For respondents aged under 54 who are likely to leave, 37 percent prefer early retirement or exiting the clinical workforce, and 14 percent prefer an administrative role. The high proportion of physicians considering a departure from clinical care represents not only a numerical shortfall but also a potential erosion of clinical knowledge and apprenticeship.

Turnover is likely to continue increasing as physician respondents’ interest in leaving their current positions continues to rise. In our survey, 58 percent state their desire to change jobs has grown over the past year. In our prior survey, 43 percent reported the same. Although not all of those physicians act on that desire—median turnover of employed physicians is less than 10 percent per year¹Based on Medical Group Management Association data.—physicians are also acutely aware that they have other job opportunities: 72 percent of respondents report they are approached about alternative job offers at least monthly, and 50 percent report being approached at least weekly.

When asked about factors that influence their decision to leave, physicians’ family needs are just as critical as compensation. In our survey, 69 percent of respondents flagged a desire for higher remuneration, and the same proportion selected family needs and competing life demands. Other well-being factors, such as the demanding nature, emotional toll, and physical toll of work (66 percent, 65 percent, and 61 percent, respectively), are also key determinants. Besides compensation and well-being, the other key influencers on physicians’ decisions to leave, according to our survey, include whether they are involved in decision making and whether they have sufficient staffing support (discussed in further detail below).

While long hours can lead to burnout, a lack of control over their schedules affects physician well-being even more than the absolute time spent on the job, according to the survey. Fifty-two percent of respondents who say they work more than 60 hours per week report experiencing burnout, but 66 percent of those dissatisfied with their schedules say the same. Similarly, more respondents who are unhappy about their schedules say they are likely to leave in the next year (32 percent) versus those working more than 60 hours (23 percent).

Work flexibility is a key driver of well-being, as evidenced by the correlation between schedule satisfaction and burnout.¹P value for Z test (Z = 4.52) is < 0.00001. But it can mean different things to different people, so in our survey, we asked physicians about the importance of various aspects of flexibility. A larger share of physician respondents say that flexibility over the specific days and times during the day that they work is important, compared with flexibility of work location. The majority of surveyed physicians report that the ability to take time off (87 percent) is important, while finding coverage when needed (77 percent) and the ability to work specific hours of the day (69 percent ) are next in line. On the other hand, 38 percent of physician respondents share that the ability to work remotely is important.

Involvement in decision making is a key consideration for physicians in determining whether to leave their position, with more than 60 percent of physician respondents saying they expect to at least be consulted or have a vote on major decisions. This was consistent across various types of decisions, such as patient care quality, culture, and strategic priorities, as well as across respondents employed by health systems and large physician groups. Among those surveyed, expectations of involvement are highest for patient care quality and lowest for strategic priorities.

To understand how best to provide appropriate support to physicians—the lack of which is a key influencer for leaving a job—we analyzed how physicians spend their time. Survey respondents say nearly 20 percent of their clinical time is spent on tasks that could be handed over to nonphysician staff or technology. Respondents indicate that the biggest proportion of delegable time could be entrusted to advanced practice professionals, with hospital-based physician respondents reporting the highest percentage of possible delegation to this group (42 percent).