Annual Physician Turnover Rate Increased 43% Between 2010 and 2018, Study Finds

By Christopher Cheney

The annual physician turnover rate increased significantly between 2010 and 2018, according to a recently published journal article.

Physician turnover was defined as physicians moving to a new practice or leaving the practice of medicine. Physician turnover has several negative consequences, including the cost of replacing physicians who leave a practice, interruption of continuity of care, and reducing access to care such as for rural patients.

The recent journal article, which was published by Annals of Internal Medicine, is based on a new method of gauging physician turnover through Medicare billing records. The analysis compared turnover rates by physician, practice, and patient characteristics.

The journal article features several key data points:

• The annual physician turnover rate rose from 5.3% to 7.2% between 2010 and 2014, was stable through 2017, and rose to 7.6% in 2018
• From 2010 to 2014, most of the increased turnover rate was due to physicians who stopped practicing, with an increase from 1.6% to 3.1%
• Younger physicians were more likely to move to a new practice, with 5.6% of physicians between 35 years old and 44 years old moving in a given year, and 2.6% of physicians 65 years old or older moving in a given year
• Older physicians were significantly more likely to leave practice, with 9.8% of physicians 65 years old or older leaving practice compared to 1.4% of physicians 35 to 44 years old leaving practice
• Physicians in rural areas were more likely to move than physicians in urban areas (5.1% vs. 3.9%) and more likely to leave practice (3.3% vs. 2.7%)
• Female physicians were more likely to move and leave practice than male physicians
• Compared to physicians in larger practices, physicians in solo or 2-physician practices were less likely to move or leave practice
• Physicians seeing a higher proportion of dual-eligible (Medicare and Medicaid) patients were more likely to move (top vs. bottom quartile: 4.2% vs. 3.9%) and more likely to leave practice (top vs. bottom quartile: 3.5% vs. 2.9%)
• Among specialties, hospitalists had the highest annual moving rate (5.4%), followed by surgical specialists (4.5%) and primary care physicians (4.0%)
• Among specialties, obstetrician-gynecologists had the lowest annual moving rate (3.5%)
• Among specialties, hospitalists had the highest annual rate of leaving practice (3.6%), followed by primary care physicians, obstetrics-gynecology, and hospital-based physicians (ranging from 3.1% to 3.2%)
• Among specialties, medical specialists (2.0%) and surgical specialists (2.4%) had the lowest annual rates of leaving practice

The increase in turnover rates between 2010 and 2018 is significant, and it poses challenges for healthcare providers and patients, study co-author Lawrence Casalino, MD, PhD, emeritus professor of public health, Department of Population Health Studies, Weill Cornell Medical College, told HealthLeaders.

“You have to look at the percentage change and the absolute numbers. The change in the absolute numbers—5.3% to 7.6%—does not seem that large, but it is still one out of 13 physicians leaving medicine or moving to another practice. That is fairly high, and it is close to the other studies that have looked at physician turnover. It is expensive for a practice or a health system if a physician leaves. When they have to look for a new physician, there are several costs involved. It is also bad for patient care, particularly for patients who have had a physician for a long time,” he said.