By Francesca Mathewes

A study published May 7 revealed that the reasons behind why physicians leave practice early are shifting.

The survey evaluated responses from a sample of clinically inactive physicians from the Physician Professional Data between May and June 2024. Questions assessed demographics, education, clinical training and reasons for leaving clinical practice. It included responses from 971 participants.

1. In the current survey of clinically inactive physicians, “hassle factor” (44.7%) and “too stressful” (44.5%) topped the list of reasons for leaving clinical medicine, followed by “increasingly unrealistic patient demands” (41.1%) and “lack of professional satisfaction” (38.4%).

2. In 2008, the top reason was personal health issues at 37.8% — which has since dropped significantly and no longer leads the list.

3. Rising malpractice premiums ranked third among reasons for leaving in 2008, cited by 24.4% of physicians. In the current survey, that figure has dropped to approximately 8%.

4. Lack of professional satisfaction has surged by roughly 15 percentage points. In 2008, lack of professional satisfaction was cited by 23.6% of departing physicians. That figure has climbed to 38.4% today.

5. Despite extensive literature linking electronic health records to physician burnout, frustration with EHRs was cited by only about 21% of respondents as a reason for leaving.

6. Physicians are leaving nearly a decade earlier than they used to. The mean age of physicians who had left clinical practice in this study was 48.1 years — nine years younger than the mean age of 57.1 observed in the comparable 2008 cohort.

7. A new and previously undocumented group is now leaving before they ever start. 11% of respondents — 107 physicians — reported never having practiced clinical medicine at all after completing residency. The authors note this group has never previously been studied on a national scale. Given that these are fully trained physicians who exit before generating a single day of patient care, the authors describe their impact on the workforce shortage as “outsized.”

8. The qualitative data points to overwork and system dysfunction as root causes. Among 252 free-text responses coded thematically, the top themes were overwork, pursuing a nonclinical role, frustration with health system structures and organizational administration, and burnout, moral injury, and lack of autonomy.