New Research Reveals Rising Physician Attrition Puts Healthcare Workforce at Risk
A study published in the Annals of Internal Medicine shows increasing rates of doctors leaving clinical practice across all specialties and regions.
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More physicians are walking away from clinical practice, and the trend is accelerating across every region of the United States, according to groundbreaking research published today in the Annals of Internal Medicine. The study warns that, without intervention, Americans may face growing difficulties accessing medical care in the coming years.
The nationwide study from researchers at the University of California, San Francisco (UCSF), Yale School of Medicine, and UCLA tracked more than 712,000 physicians who provided care to Medicare patients over a nine-year period. They found that the rate of doctors leaving clinical practice jumped from 3.5% in 2013 to 4.9% in 2019—a 40% increase that affects patients’ ability to see a doctor when they need one.
Why This Matters: A Looming Healthcare Crisis
The United States is already facing a predicted shortage of 13,500 to 86,000 physicians by 2036. This includes up to 40,000 fewer primary care doctors—the physicians most Americans rely on for routine care—as well as shortages in surgical specialties and other critical areas. The rising attrition rates documented in this study mean these shortages will likely be even worse than projected, affecting patients’ access to care across all specialty types.
“Physician attrition is rising, overall, and across multiple groups of physicians and geographic regions. Specific groups, including female physicians, physicians practicing in rural areas, and those in psychiatry, ob-gyn, and primary care specialties, have a greater risk of attrition. Given a projected physician shortage, these findings have important implications for the sustainability of healthcare delivery and the physician workforce.”
Lead author for the study
Assistant Clinical Professor, Division of Clinical Informatics and Digital Transformation (DoC-IT)
The study represents one of the most comprehensive examinations of physician workforce dynamics to date. Unlike previous studies that measured physicians’ intentions to leave, this research tracked actual departures from clinical practice, providing concrete evidence of a worsening trend that affects healthcare access for all Americans.
Who’s Most Affected
The study revealed disparities in which doctors are leaving practice and critical trends:
- Female physicians are leaving at significantly higher rates than their male colleagues—44% more likely in the study period.
- Rural communities are hit hardest, with physicians in these areas 19% more likely to leave practice, compounding existing healthcare access challenges in underserved areas.
- Attrition rates increased across all specialties, with psychiatry (7.4% to 10.1%) and obstetrics/gynecology (6.1% to 10.7%) experiencing the steepest rises.
- Doctors caring for the most vulnerable patients, including those who are older, sicker, or enrolled in both Medicare and Medicaid, are more likely to leave practice.
These statistics translate into real-world challenges for patients: longer wait times for appointments, difficulty finding doctors who accept new patients, and reduced access to specialty care, particularly in rural areas and for people who rely on Medicare and Medicaid.
A Path Forward
The research identified factors that health systems and policymakers could potentially address. The study suggests that targeted interventions for at-risk groups—particularly female physicians, rural practitioners, and those in high-stress specialties—could help stem the tide of doctors leaving practice. For example, physicians caring for the most medically complex and vulnerable patient populations may benefit from additional supports, including robust care teams and enhanced resources.
The research was conducted using data from the Centers for Medicare & Medicaid Services and included physicians across all clinical settings nationwide. The study was funded by the Physicians Foundation.
Authors: Lisa S. Rotenstein, MD, MBA, MSc; Zili He, MS; James Dziura, PhD; Yusuke Tsugawa, MD, PhD; Arjun K. Venkatesh, MD, MBA, MHS; Edward R. Melnick, MD, MHS; and Cameron J. Gettel, MD, MHS