Healthgrades for Professionals

7 Reasons Doctors Are Leaving Medicine

  • Doctor resting head in hand with stress, worry or burnout
    Why are physicians leaving practices or contemplating quitting?
    Increasing numbers of unhappy doctors are leaving their practices or considering leaving soon, surveys show. About 8% of doctors—representing about 16,000 practices—shut down in 2020 due to COVID-19’s impact on business, with 4% planning to close in 2021, according to the nonprofit Physicians Foundation.

    The pandemic has caused stress, financial loss, and other problems for doctors, but physician dissatisfaction with the profession has been a problem for years. A 2018 survey found 54% were considering retiring in the next five years (including 30% of those under 50). Why? What are the primary factors causing so many doctors to want to quit?
  • Serious, overworked, very sad male health care worker
    1. Burnout and COVID-19 stress
    About 60% of doctors surveyed this spring by Physicians Foundation say they are burned out, up from 40% in pre-pandemic 2018. Female doctors report even higher rates of burnout (68%, compared to 57% for men). In a Medscape 2021 survey, critical care and infectious disease now are among the top most burned-out specialties. COVID-19-related stressors include lack of personal protective gear, difficult conditions, long hours, and emotional trauma from seeing patients die. About 4% of doctors said they’ve quit their practices due to burnout, 1% have attempted suicide, and 13% have felt suicidal. However, 79% of respondents say they were burned out even before COVID.
  • Frustrated young woman talking with her doctor
    2. Increased verbal abuse and bullying by patients
    Some doctors report being cyberbullied, harassed or threatened when they try to counter misinformation about vaccination or other COVID-19 issues. Harry Severance, MD, adjunct assistant professor at Duke University School of Medicine, often speaks to doctors about career options. He says a physician recently confided that the verbal abuse he'd been receiving from patients had him contemplating quitting medicine. "When patients seem to turn on their doctors and accuse them of not operating in their best interest, that's a strong motivating force for leaving clinical practice altogether," Dr. Severance says. "For unhappy physicians already on the fence, this is a final straw."
  • Overworked healthcare worker stressed at home
    3. Insufficient income
    The pandemic has resulted in many doctors losing money. About 72% say their incomes dropped in 2020, with 41% seeing patient volumes decrease 26% or more. Most doctors expect to be paid less in 2021 as well. Yet even before the pandemic, some doctors—especially in less lucrative specialties or in low-paying residencies—struggled to pay such expenses as student loan debt (average: $241,600, with 25% exceeding $300,000) and malpractice premiums (as much $100,000 to $200,000 annually). Insufficient pay was cited by 32% of doctors as a burnout cause in Medscape's 2021 survey.
  • Male doctor in hospital corridor
    4. Long hours and lack of family time
    The average doctor works 53.4 hours per week and may have 24/7 or weekend on-call periods. A University of Michigan survey found that nearly 40% of female doctors chose to go part-time or quit entirely six years after completing medical training, citing family conflicts as the reason. (Less than 5% of male doctors do the same.) In Medscape's 2021 physician burnout report, work-life balance was a top concern, cited by 42% of female doctors and 48% of males, while "too many work hours" was cited by 37% of physicians overall. More female doctors also expressed concern over parenthood/work conflicts (17%) than did males (6%).
  • Side view of female nurse making medical report in computer at clinic
    5. Dealing with EHRs
    Electronic health records (EHRs) have been the bane of many doctors' existence in recent years, especially older physicians, with survey after survey citing them as difficult to use and interfering with doctor-patient interaction. This is especially true if a physician doesn't have a scribe and must input data into a computer during office visits, rather than maintaining eye contact. One study finds doctors spend two hours on EHR record-keeping for every single hour in clinical contact with patients. EHR dissatisfaction has been linked to higher burnout scores, and burnout can lead doctors to leave clinical practice or quit medicine altogether.
  • Unseen doctor with stethoscope writing on clipboard
    6. Too much bureaucracy
    It's not just EHRs that doctors perceive as taking them away from patients. "Too many bureaucratic tasks" was by far the highest-rated reason for physician burnout in Medscape's 2021 survey, with 58% of doctors citing it. Physicians spend nearly 25% of their time on nonclinical paperwork, a 2016 report found. They must deal with insurance companies, document compliance with various governmental regulations, and track quality data, among many other administrative chores. Doctors who go into medicine to work directly with patients can find such duties joyless and frustrating.
  • African American doctor looking at stacks of charts
    7. Lack of independence
    The majority of doctors today no longer work for themselves. As of fall 2020, 50.2% of 3,500 physicians who responded to an American Medical Association survey said they were employees, up from 47.4% in 2018 (and compared to 72% in private practice in 1988). Increasingly, doctors work for larger group practices, many of which today are owned by profit-driven private-equity firms. Doctors may be assigned larger caseloads than they feel is optimal and told how to treat patients by administrators focused on the bottom line, critics charge. Some physicians may choose to quit medicine rather than reduce quality of care.
7 Reasons Doctors Are Leaving Medicine | Healthgrades for Professionals

About The Author

Lorna Collier has been reporting on health topics—especially mental health and women’s health—as well as technology and education for more than 25 years. Her work has appeared in the AARP Bulletin, Chicago Tribune, U.S. News, CNN.com, the APA’s Monitor on Psychology, and many others. She’s a member of the American Society of Journalists and Authors and the Association of Health Care Journalists.
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  2. ‘Death by 1000 Cuts’: Medscape National Physician Burnout & Suicide Report 2021. Medscape. https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456
  3. 2020 Survey of America’s Physicians: The COVID-19 Impact Edition. The Physicians Foundation. https://physiciansfoundation.org/wp-content/uploads/2020/08/20-1278-Merritt-Hawkins-2020-Physicians-Foundation-Survey.6.pdf
  4. 2021 Survey of America’s Physicians COVID-19 Impact Edition: A Year Later. The Physicians Foundation. https://physiciansfoundation.org/wp-content/uploads/2021/08/2021-Survey-Of-Americas-Physicians-Covid-19-Impact-Edition-A-Year-Later.pdf
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  6. Medscape Physician Compensation Report 2020. Medscape. https://www.medscape.com/slideshow/2020-compensation-overview-6012684#18
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  8. Why women leave medicine. Association of American Medical Colleges. https://www.aamc.org/news-insights/why-women-leave-medicine
  9. Physicians' departure from private practice has accelerated since 2018, AMA says. Fierce Healthcare. https://www.fiercehealthcare.com/practices/physicians-departure-from-private-practice-has-accelerated-since-2018-ama-says
  10. What is the average medical school debt? Bankrate. https://www.bankrate.com/loans/student-loans/average-medical-school-debt/
  11. Average Medical Student Debt. Education Data. https://educationdata.org/average-medical-school-debt
  12. Medscape Residents Salary & Debt Report 2021. Medscape. https://www.medscape.com/slideshow/2021-residents-salary-debt-report-6014074#3
  13. New research links hard-to-use EHRs and physician burnout. American Medical Association. https://www.ama-assn.org/practice-management/digital/new-research-links-hard-use-ehrs-and-physician-burnout
  14. Shanafelt TD, Boone S, Tan L, et al. Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012;172(18):1377–1385. doi:10.1001/archinternmed.2012.3199
  15. Physicians report that organizational and technology changes are among the biggest burnout factors. Athena Health. https://www.athenahealth.com/knowledge-hub/clinical-trends/physicians-report-organizational-technology-changes-among-biggest-burnout-factors
  16. Private equity firms now control many hospitals, ERs and nursing homes. Is it good for health care? NBC News. https://www.nbcnews.com/health/health-care/private-equity-firms-now-control-many-hospitals-ers-nursing-homes-n1203161
  17. Private Equity Is Ruining American Healthcare — Physicians, patients lose when PE takes over; it's time to take medicine back. MedPage Today. https://www.medpagetoday.com/opinion/second-opinions/93615
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