Daily Briefing

Why almost half of U.S. clinicians are planning to leave their jobs—and what to do about it.

Almost half of U.S. clinicians said they are planning to leave their roles within the next few years, a sentiment that has become more common amid growing burnout and dissatisfaction among the health care workforce, according to Elsevier Health's new "Clinician of the Future" report.

Staff turnover: 4 key takeaways from Advisory Board's survey of 224 hospitals

How clinicians currently feel about their role

The report, which Elsevier Health conducted in partnership with Ipsos, included a quantitative global survey, qualitative interviews, and roundtable discussions with nearly 3,000 physicians and nurses worldwide. Overall, 446 U.S. clinicians participated in the report's three phases.

Among U.S. participants, many reported increased stress from their jobs due to changes in their duties and the amount of work. Overall, 75% said the role of the doctor has changed over the last 10 years, with 63% saying it has gotten worse. Similarly, 85% said the role of the nurse has changed, and 60% said it has gotten worse.

In addition, 34% of U.S. clinicians said they work more now than they did five years ago, which has likely impacted work-life balance. In particular, 51% of doctors said they had a good work-life balance, compared with 66% of nurses.

Many clinicians also reported feeling underappreciated by both government officials and the general public for their work. Less than half of U.S. clinicians said they felt their work was fully appreciated by the general public while only 20% expressed the same sentiment when it came to government officials.

These feelings of burnout and lack of appreciation will likely influence clinician turnover rates over the next few years, the report suggests. In fact, 47% of U.S. clinicians said they are planning to leave their jobs in the next two to three years.

One clinician respondent to the survey shared, "The new stressors of having on average sicker patients, higher student debt, lower relative wages (in residency), and higher costs of living, especially in very wealthy parts of the country, make it harder to support a family and make medicine an overall harder career to enjoy. Simultaneously, physician autonomy and inclusion in hospital administrative decisions are seemingly going away."

Clinician turnover will likely have a significant impact on the health care workforce going forward. Among U.S. clinicians, 83% said there will be a shortage of nurses, and 74% said there will be a shortage of doctors in the future.

How to recruit and retain clinicians going forward

According to the report, "[a] robust, motivated workforce is essential for a sustainable functioning healthcare system" and "[e]ngaged, valued clinicians would be less likely to leave the profession and at lower risk of burnout, especially if they were part of a fully staffed team."

To recruit and retain clinicians going forward, the report offers three recommendations:

1. Focus on clinician wellbeing

It is important to reduce the pressures clinicians face, which will enable them to have better job satisfaction and overall work-life balance.

To do this, health organizations could implement digital solutions designed with and for clinicians to reduce their burden, particularly with administrative tasks. Wellbeing programs could also be implemented, such as those that offer access to online knowledge hubs to provide support.

2. Invest in the health care workforce

To ensure a complete workforce, investments and resources should be used to support clinicians and the burdens they face.

Some recommendations offered by clinicians to improve their roles include allocating more time for continuous learning and developing a more preventive health care system. In addition, clinicians should be involved in the development of their roles and be able to work closely with policy makers that are driving change in health care to ensure their roles are well-adapted for the future.

3. Optimize medical education and training

According to the report, medical education will be vital in "addressing clinician shortages, reducing burnout and ensuring clinicians are ready to keep up with new approaches." Globally, 83% of the clinicians surveyed said that current training needs to be changed to keep up with advances in the field.

In particular, clinicians said health care training and education should stay up to date with new scientific knowledge and technologies. They also noted that more training in how to use digital health technologies effectively would assist in the delivery of remote patient care.

In addition, medical education should be accessible to a broader and more diverse population. Online education could also increase the capacity for more students.

"Doctors and nurses play a vital role in the health and well-being of our society. Ensuring they are being heard will enable them to get the support they need to deliver better patient care in these difficult times," said Jan Herzhoff, president of Elsevier Health.

"We must start to shift the conversation away from discussing today's healthcare problems to delivering solutions that will help improve patient outcomes," Herzoff added. "In our research, they have been clear about the areas they need support; we must act now to protect, equip, and inspire the clinician of the future." (Elsevier Health press release, 3/15; Gooch, Becker's Hospital Review, 3/16; "Clinician of the Future" report, 3/15)

Advisory Board's take

How to fix the clinician workforce. (Hint: 'It won't be cheap.')

Alex PolyakBy Alex Polyak


Regardless of whether you’ve seen the movie Network, you’ve likely heard its most famous line: “I’m mad as hell and I’m not going to take this anymore.” Well, guess what? That’s what a lot of health care workers are saying today, and what’s more, they’re following through on their promise.

Let’s be honest with ourselves: it’s been getting harder and harder to work on the frontlines of health care. Dismissing younger workers as entitled or suggesting that staff leave because they lack resilience won’t cut it anymore. The Elsevier/Ipsos survey shows that 60% of American nurses and 63% of American physicians say that their job has changed considerably for the worse in the last 10 years. Why is that? Well, here are a few options:

  • Health care is an unsafe profession: Health care workers make up 50% of all victims of workplace violence incidents in the USA.
  • Clinicians are doing less and less clinical work: The number of U.S. physicians spending more than 10 hours a week on paperwork has more than doubled in recent years, from 33% in 2014 to over 70% in 2018.
  • Providing care is becoming more exhausting: From the Elsevier/Ipsos Survey, less than half of U.S. doctors (45%) and U.S. nurses (43%) feel that they spend enough time with patients to deliver good care.

And, as I said a few paragraphs ago, health care workers aren’t going to take it anymore. On top of that, today they know just how much they’re worth: if a travel nurse can make over $3,000 a week, then it amounts to financial sabotage for an RN to not at least consider the option. So, what’s a health care employer to do?

Let’s start with a caveat: it won’t be cheap. But then again, what good is that new MRI machine if you have no one to operate it?

At Advisory Board, we’ve been talking about ‘rebuilding the foundation for a resilient workforce’ by addressing foundational cracks in their work experience: those cracks now amount to a fissure. Security for our health care workers has to be massively boosted. Employers need to dramatically innovate new care team models, in order to address clinician shortages, boost top-of-license practice, alleviate concerns about compromises in care delivery, and enable more flexible work models. And above all, employers have to invest in (re)-training their workforce with the skills necessary to thrive in our new health care landscape: soft skills, technical/digital skills, analytics, and adaptable behaviors. Because let’s face it, the pace of change in our health care landscape isn’t slowing down, rather, it’s only speeding up. We’re facing an era where there are no easy, cheap solutions to our workforce issues. But either we make the tough investments, or we get run over. I know which one I prefer.







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