Physician Attrition From Clinical Practice Rose Through 2019, Hitting Primary Care, Psychiatry and OB/GYN Hardest

Overview

• Unadjusted exit rates increased from 3.5% in 2013 to 4.9% in 2019 among physicians caring for Medicare beneficiaries.
• Adjusted models found greater attrition risk in psychiatry (HR 1.53), obstetrics and gynecology (1.62), and primary care (1.09) compared with hospital-based specialties.
• Women physicians and those practicing in rural settings were more likely to leave clinical practice during the study period.
• Physicians caring for panels with older patients, higher average risk scores, or larger shares of dual-eligible beneficiaries faced higher exit risk.
• The study followed 712,395 clinicians and defined attrition as leaving practice without reentry for at least three years, with limitations tied to its Medicare-focused sample and lack of data on nonclinical career moves.