As retirement age nears, many physicians naturally begin to think about stepping down or reducing their workload. However, recent data from an AMA survey reveals a concerning trend: more than one-third of all physicians, including a significant number of younger or midcareer doctors, are considering leaving the profession or cutting back on their work hours. This trend raises alarms about the future stability of healthcare as experienced physicians contemplate early retirement or reduced workloads.
The American Medical Association (AMA) gathered over 12,400 responses from physicians across 31 states through the AMA Organizational Biopsy®, involving more than 80 health systems. The findings, exclusive to the AMA and not published elsewhere, reflect 2023 trends in six key areas: job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization, and total hours spent on work-related activities each week (referred to as “time spent”). These aggregated data aim to provide a national overview of organizational well-being and serve as a benchmark for other healthcare organizations, though the results are somewhat limited by the number of participating health systems.
From 2022 to 2023, 35.7% of doctors expressed a moderate interest in leaving their current jobs within the next two years or indicated they would like to or definitely would leave during that period, according to the national physician comparison report. Although this figure represents a slight decrease from 39.3% in 2022, the intent to leave remains highest among physicians who are 20 or more years out of training, at 40.8%. Part-time physicians also reported a high intention to leave, with 39.1% considering departure, compared to 34.9% of full-time physicians. Male physicians showed a slightly higher tendency to leave (35.9%) compared to female physicians (33.2%).
Specific specialties are more affected by this trend than others. Internal medicine physicians had the highest intent to leave at 39.1%, followed by family medicine at 37.3%, obstetrics and gynecology at 34%, hospitalist medicine at 32.9%, emergency medicine at 32.3%, and pediatrics at 30.2%. These figures highlight the growing dissatisfaction across a range of specialties, which could have significant implications for patient care and the healthcare system as a whole.
Furthermore, 35.9% of physicians surveyed stated they plan to reduce their work hours within the next 12 months, a slight decrease from 38.1% in 2022. The AMA, as a leader in promoting physician well-being, is actively working to reduce physician burnout by minimizing administrative burdens and offering practical solutions to help doctors rediscover the joy in their profession.
At Sanford Health in Sioux Falls, South Dakota, a member of the AMA Health System Program, the situation mirrors the national statistics, with 35.5% of physicians reporting an intention to leave within two years. Sanford Health is implementing several strategies to improve job satisfaction and reduce the number of physicians considering departure or reducing their work hours.
One of the key strategies Sanford Health has adopted is providing annual check-ins with physicians. Research shows a clear link between work overload and burnout or the intention to leave a job. Dr. Heather Spies, an obstetrician-gynecologist and physician director of clinician experience and well-being at Sanford Health, emphasized the importance of intentional and proactive conversations and investments in relationships between physicians and their leaders. “Why someone is considering leaving an organization can be complex—it may be different for everybody,” Dr. Spies explained.
To address this complexity, Sanford Health has instituted annual check-ins for physicians and other health professionals to meet with their department chair and directors individually, and offers additional opportunities to connect as needed. “Listening, understanding and building trusting relationships are essential to determining how best to help clinicians avoid burnout or alleviate it once it’s happened,” Dr. Spies noted. These conversations are crucial for early intervention if physicians are considering reducing their hours, leaving entirely, or retiring early.
Maintaining open communication is another critical component of Sanford Health’s approach. Solutions to physician dissatisfaction vary, and open communication helps leaders apply individualized solutions. This involves having deeper conversations to uncover the specific reasons why a physician may be considering leaving or reducing their work hours. “Is it because they are not able to keep up on their charts or their in-baskets? If it’s something operationally adjustable, then we could find ways to enhance teamwork within their clinic or their department,” Dr. Spies suggested. She added that tools like Epic signal data can help identify how much time physicians are spending on work-related tasks outside of regular hours, such as charting or managing their in-baskets. “If they’re high and their time spent outside of work on charting or the in-basket is an outlier, then we can talk to them about supporting them further with resources,” she said.
This data-driven approach allows Sanford Health to tailor solutions to individual physicians while also identifying broader trends that may impact multiple clinicians. “It’s really just looking at all the different things that they might need,” Dr. Spies explained. “Then the clinician and their leader can also work better together to have discussions on solutions—some of which may apply to and help other clinicians as well, and some of which may be more unique to a certain physician.”
At Sanford Health, the intent to leave is highest among physicians who are 20 years or more post-training, at 48.9%, and among obstetrician-gynecologists, at 46.1%. The upcoming Organizational Biopsy at Sanford Health aims to identify what physicians need to thrive in a high-stress, high-stakes environment. Previous data from Sanford Health’s Organizational Biopsy showed that “the highest turnover rate is in those first couple of years after joining a practice,” Dr. Spies mentioned.
In response, Sanford Health has heavily invested in new physician orientation and extended onboarding programs to ensure physicians feel integrated into the organization’s culture. These initiatives also help physicians adapt to the community where they live and connect them with mentors or coaches if needed. “Our goal with our clinician experience strategy is to continually look at ways to be intentional about assessing the needs of our clinicians so that if there is a need, we can try to be proactive and provide for that need rather than getting to the point where we’re retroactively trying to find out why people are leaving,” Dr. Spies said. She emphasized that data is a crucial part of understanding and addressing the well-being of clinicians at an organizational level, allowing Sanford Health to stay vigilant for red flags that might indicate potential issues.
“We want Sanford to be a place where clinicians come and a place where they retire,” Dr. Spies stated. “So, it’s really important to us that we’re looking at that whole career spectrum and what we can do in each phase of that spectrum to keep making it better.”
As leaders, Dr. Spies and her colleagues are committed to continuously finding ways to reduce administrative burdens and maintain a strong focus on patient care. They also strive to recognize clinicians for their hard work and to help them find joy in their profession. “We have to be ready as leaders in this work to pivot and keep finding ways to reduce administrative burdens and keep the focus on the care of the patient, keep finding ways to recognize clinicians for the great work they do and keep finding ways to help our colleagues have joy in their work,” she added.