Clinical practice attrition rates up since 2013: study

Physician attrition from clinical practice across specialties has increased since 2013, according to a US study, noting specific patient and physician characteristics associated with a higher risk for attrition.

Physicians who provided care to Medicare patients between 2013 and 2022 in all clinical settings were identified in this nationwide, longitudinal study. A total of 712,395 physicians (70.8 percent male, 90.8 percent in urban settings) were included in the analysis.

A significant increase was observed in the unadjusted rates of clinical practice attrition from 3.5 percent in 2013 to 4.9 percent in 2019 (rate difference, 1.4 percentage points, 95 percent confidence interval, 1.3‒1.4). Attrition rates rose across the study period for both male and female physicians, in both rural and urban settings, across specialties, across geographic regions, and in those aged ≥35 years.

In the adjusted models, clinical practice attrition was more common among female physicians and those practicing in rural areas.

Notably, attrition was associated with caring for Medicare beneficiaries with a greater average risk score, a greater average age, and a higher percentage of dual-eligible beneficiaries.

“These findings have implications for workforce planning and the design of interventions to sustain the physician workforce,” the authors said.

The study was limited by its focus on services provided to Medicare fee-for-service beneficiaries.