What we found: Physician discontent and turnover aren't new

As we dug into the data, we found longstanding trends that just continued during Covid-19. Physician desire to change employment isn't new; the pandemic spotlighted an existing issue. Since 2012, about half of physicians, ranging anywhere from 44% to 51%, have considered a career change, such as retiring early, switching employers, or leaving medicine.[1]

Given these historical trends, the 54% data point from 2021 that we originally found doesn't seem too far out of left field—even with Covid-19 potentially driving these changes.[2] Over a similar time period, annual physician turnover has remained constant at 6-7%—even in 2020 when the pandemic began. [3]

What we predict: We won't see a spike in physician turnover

Based on our analysis, we project that these existing trends will continue. Namely, doctors will continue to be disengaged and unhappy in their jobs but not turn over at significantly higher rates than before. Ultimately, these trends highlight that physician turnover has been resistant to changing market dynamics in recent years, perhaps even a pandemic.

Recovery: It's time for the physician workforce to heal

It's also important to note that considering a career change and turning over are not directly correlated. In fact, recent data shows that the gap is quite large. Between July and August 2021, 15% of health care workers considered leaving the industry, but only 6% actually did. And this data is from the larger workforce, not just physicians, who are even less likely to make these changes.

What we'll be watching: 2021 turnover data and market shifts

The elephant in our analysis is that physician turnover data for 2021 hasn't been published yet. However, we've heard anecdotally on our research interviews that while there are some pockets of high turnover, there haven't been significant increases in physician departures across the board. We'll be keeping an eye on the market forces below that could break existing trends and lead to an increase in physician turnover.

While there are many factors that contribute to turnover, we've zeroed in on the most important ones that will tell us whether we need to adjust our projections. Importantly, there won't be a single tipping point, as these forces don't exist in isolation. You're also welcome to use this table to anticipate when your specific market might start seeing more physician turnover.

Why this still matters: 3 reasons to address physician turnover

1. There isn't slack in the system. While physician turnover hasn't skyrocketed, other clinician turnover certainly has, making the consequences more dire. Even physician turnover hovering around 6-7% can strain a health care system with no room to give. At the very least, executives must work to keep physician turnover within its current range or risk making the problem much (much) worse.
2. Executives can address the drivers of physician discontent. While the pandemic has spotlighted the problem, Covid-19 alone did not cause it. According to recent surveys, bureaucratic tasks continue to be the primary driver of burnout. And the majority of physicians point to their experience as a physician, more than Covid-19, as the cause of their burnout. These are things that executives have direct control over and can fix. Don't use the pandemic as an excuse.
3. We finally have consensus that workforce matters. For the first time in 20 years, staffing concerns are topping executive agendas. While physician turnover and discontent aren't new, now is an important moment to make long overdue changes while you have the buy-in. We shouldn't simply accept that half of our physicians are unhappy in their jobs.

End notes

[1] The Physicians Foundation Surveys of America’s Physicians: Practice Patterns and Perspectives from 2012, 2014, 2016, 2018; The question posed in each survey was: "In the next one to three years, do you plan to (check all that apply): 1) continue as I am, 2) cut back on hours, 3) retire, 4) switch to a cash/concierge practice, 5) work locum tenens, 6) cut back on patients seen, 7) seek a non-clinical job within healthcare, 8) seek employment with a hospital, 9) work part-time".

[2] Data from the Jackson Physician Search’s 2021 Physician Retention Survey; The question posed in the survey was: "Physicians, has Covid-19 changed your employment plans? If yes, which of the following are you most seriously considering?" 54% responded yes. The options listed were "early retirement" (21%), "leaving to work for a new healthcare employer" (50%), “leaving the practice of medicine entirely but working in a different environment," (15%), and "other" (14%).

[3] Median physician turnover data from the Association for Advancing Physician and Provider Recruitment (AAPPR)’s 2021 Annual Report: AAPPR In-House Physician and Provider Recruitment Benchmarking Report.

Listen to the Radio Advisory episode

The physician landscape has changed a lot, especially over the past couple of years. In this episode of Radio Advisory, host Rachel Woods sits down with Advisory Board's Sarah Hostetter and Prianca Pai to get a look at what the physician landscape looks like right now and offer a new way to view physicians.