The U.S. health care industry annually spends nearly $1 billion on turnover among primary care physicians (PCP), according to a new study by the American Medical Association (AMA)—but experts say that figure could be even higher post-pandemic amid the "Great Resignation."
For the study, AMA estimated excess health care expenditures that could be attributed to PCP turnover using published data for Medicare patients, calculated estimates for non-Medicare patients, and the AMA Physician Masterfile database.
In the analysis, AMA used published data from a cross-sectional survey of U.S. physicians conducted between Oct. 12, 2017, and March 15, 2018. The survey gave researchers a measurement of PCP burnout for each specialty and evaluated their intention to leave their current practice in the next two years.
To estimate excess expenditures tied to PCP turnover due to burnout, researchers used a conservative estimate from the literature for actual PCP turnover based on their intention to leave.
According to the study, turnover of PCPs results in around $979 million in excess health care expenditures for public and private payers every year, with $260 million tied to PCP burnout-related turnover. The analysis used a pre-pandemic turnover estimate to assume that 11,339 PCPs turn over annually. From that total annual estimate, the study approximated that burnout-related turnover impacted 3,006 PCPs.
Similarly, a recent survey by The Physicians Foundation found that burnout rates among physicians overall have increased during the Covid-19 pandemic. In the survey, 61% of physicians reported experiencing feelings of burnout in 2021, compared to just 40% in 2018—and those figures were even higher among female physicians.
To mitigate physician burnout and improve patient care overall, AMA said changes in health care need to prioritize physician well-being, which could ultimately lead to lower turnover, fewer medical errors, higher quality care, lower malpractice claims, more clinical hours, and decreased costs for patients.
"Turnover of primary care physicians is costly to public and private payers, yet there is an opportunity to decrease unnecessary health care expenditures by reducing burnout-related turnover," said Christine Sinsky, the study's lead author and AMA VP of professional satisfaction. "Physician burnout is preventable and payers, health care organizations and others have a vested interest in making meaningful changes to reduce physician burnout." (Lagasse, Healthcare Finance News, 3/1; Christ, Modern Healthcare, 3/1; Sinsky et al., Mayo Clinic Proceedings, 2/26)
By Eliza Dailey
Covid-19 has shined the spotlight on what we’ve known for a while: our physician workforce is highly discontented and burned out.
And as Dr. Sinsky writes, there are real consequences. In my team’s current research on the topic, one statistic is particularly alarming to us: 54% of physicians say that the pandemic has changed their employment plans. But when we dug into the data further, we found that about half of the physician workforce has considered switching employers for the past five years—even before the pandemic. While physician burnout and discontent remain high, it hasn’t necessarily translated into more turnover. (We’re publishing more on our analysis later this month so stay tuned!)
That leads us to the current question my team is exploring: If the problem hasn’t changed, what’s different about physician turnover today?
One important shift is in our perception of turnover and its consequences. There’s a reason most executives think physician turnover is higher today—even if it actually isn’t. Over the past two years, we’ve seen the consequences of burnout and turnover firsthand: strain on our health care system, a workforce crisis, and as Dr. Sinsky writes, excess spending. I’m glad to see that workforce concerns are topping executive agendas this year, because we shouldn’t simply accept that half of our physicians are unhappy in their jobs.
I’ve included some helpful links on this topic below. And if you're interested in more, we’re publishing more in the coming months. Stay tuned!
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