Physician Turnover in the United States.

Physician turnover is an important source of expense, burnout, and poor quality of care. Using a novel method with Centers for Medicare & Medicaid Services data, this study examined turnover rates by physician, practice, and patient characteristics. The findings shed new light on turnover trends over time and differences across specialty and gender and, collectively, have important policy and clinical implications. Visual Abstract. Physician Turnover in the United States: Physician turnover is an important source of expense, burnout, and poor quality of care. In this study, Bond and colleagues used a novel method with Centers for Medicare & Medicaid Services data to examine turnover rates by physician, practice, and patient characteristics. Their findings shed new light on turnover trends over time and differences across specialty and gender and, collectively, have important policy and clinical implications. Background: Medical groups, health systems, and professional associations are concerned about potential increases in physician turnover, which may affect patient access and quality of care. Objective: To examine whether turnover has changed over time and whether it is higher for certain types of physicians or practice settings. Design: The authors developed a novel method using 100% of traditional Medicare billing to create national estimates of turnover. Standardized turnover rates were compared by physician, practice, and patient characteristics. Setting: Traditional Medicare, 2010 to 2020. Participants: Physicians billing traditional Medicare. Measurements: Indicators of physician turnover—physicians who stopped practicing and those who moved from one practice to another—and their sum. Results: The annual rate of turnover increased from 5.3% to 7.2% between 2010 and 2014, was stable through 2017, and increased modestly in 2018 to 7.6%. Most of the increase from 2010 to 2014 came from physicians who stopped practicing increasing from 1.6% to 3.1%; physicians moving increased modestly from 3.7% to 4.2%. Modest but statistically significant (P  < 0.001) differences existed across rurality, physician sex, specialty, and patient characteristics. In the second and third quarters of 2020, quarterly turnover was slightly lower than in the corresponding quarters of 2019. Limitation: Measurement was based on traditional Medicare claims. Conclusion: Over the past decade, physician turnover rates have had periods of increase and stability. These early data, covering the first 3 quarters of 2020, give no indication yet of the COVID-19 pandemic increasing turnover, although continued tracking of turnover is warranted. This novel method will enable future monitoring and further investigations into turnover. Primary Funding Source: The Physicians Foundation Center for the Study of Physician Practice and Leadership. [ABSTRACT FROM AUTHOR]