Physicians are quitting sooner, younger and for different priorities than in years past

Physicians who walk away from medicine before reaching their 25th year of practice tend to quit mainly due to the stress and hassles of the job. Both those factors have been linked to complaints associated with burnout. 

That will probably come as no surprise to many. Still, as recently as 2008, primary reasons also included personal health issues, rising malpractice premiums and a lack of professional satisfaction—issues less in evidence now. 

Interestingly, the hassle factor ranked high in both periods, but “unrealistic patient demands” seems a more nettlesome negative today than 15 years ago.

The findings are from a survey conducted by American Medical Association researchers. The Permanente Journal published the study report May 7.

Corresponding author Sea Chen, MD, PhD, and colleagues received 971 completed surveys from early-leaving physicians whose profiles met the study criteria as of spring 2024. 

One of the more troubling findings was the falling mean age of departing physicians at the time of resignation or retirement—from 57.1 years old in 2008 to 48.1 in 2024. 

Chen and co-researchers also observed a “small but nontrivial” subgroup of nonpracticing physicians who never practiced clinical medicine after completing residency. 

The authors state they don’t know of any reports addressing the size or characteristics of this population of physicians. 

Regardless, “identifying drivers of attrition for this completely trained but never practicing physician group, including but not limited to burnout, will be important to shape interventions aimed at keeping residents engaged and helping them transition successfully into clinical practice.”

Focus on the physician workforce 

In their discussion section, Chen and co-authors note the importance of understanding reasons physicians call it quits in the midst of an ongoing physician shortage.

“A key parameter in physician workforce supply projections is the average retirement age,” they write. “Any changes in this parameter can greatly change workforce estimates.”

For example, Chen and colleagues add, in the latest Association of American Medical Colleges physician workforce projections, a decrease in the average retirement age by two years would result in a decrease of the projected physician supply in 2036 by approximately 40,000.

National rates of attrition from the clinical workforce are difficult to measure but are estimated to have risen from 1.7% in 2010 to 3.1% in 2018, the researchers write.

The lack of precision notwithstanding, “it is difficult to imagine that this proportion is getting smaller,” Chen and co-authors maintain. 

Meanwhile, given the evidence of increasingly shorter clinical careers—including for those who never practice—the trend will likely “contribute to a greater shortfall in the physician workforce.”

Hurts to lose trained and experienced doctors 

Chen et al. believe the present study represents the only research in well more than a decade to analyze national survey data from physicians who are not currently practicing medicine as their primary vocation. 

“Understanding the attributes of early attrition from the clinical workforce can help stakeholders and policymakers tailor interventions to support a more sustainable physician workforce,” they write.

Looking at sex-based differences, the team found women physicians comprised the majority of the studied cohort, 64%. 

In addition, women physicians were more likely than men to have exited due to needing to care for family members (7.9% vs 0.6%) or children (21.3% vs 4.2%). 

“Addressing key differences in attrition drivers—including a disproportionate number of women exiting due to needing to care for children, other family members, or personal health issues—may lead to an amplified beneficial effect on the clinical workforce,” Chen and colleagues write. 

Chen builds out that theme in comments made to the Permanente organization.  

“The women in our study left clinical practice earlier than men, and they left due to pressures like caring for young children or other family members more often than men,” he says. “Addressing these issues—through better childcare access, flexible work policies, and equitable treatment—could help retain more women in the physician workforce.”

More broadly, he notes: “As the healthcare system works to further expand the physician pipeline by opening new medical schools and adding more residency slots, it’s worth asking whether we should also focus on supporting physicians who are already trained.” 

The study is available in full for free.