Physicians are leaving clinical practice earlier than ever — and administrative burden, stress and caregiving responsibilities are driving them out, according to research published May 7 in The Permanente Journal.
Researchers with the American Medical Association conducted the study, which analyzed survey responses from 971 clinically inactive physicians. Across this group, the mean age of physicians who left clinical practice was 48.1 years — nine years younger than a similar cohort from 2008.
The study defined clinically inactive physicians as those who completed residency but never entered clinical practice (11% of the study’s population), physicians who have stopped practicing (53.7%) and those working fewer than 20 hours per week (35.3%).
Among the 521 respondents who have altogether stopped practicing, 44.7% chose administrative burdens, or “hassle factor,” as a prime motivator for their departure, according to the study. A similar amount, 44.5%, selected “too stressful” as a reason.
Other common reasons for leaving clinical medicine were “increasingly unrealistic patient demands,” “lack of professional satisfaction,” “pursuing a non-medical career” and “need to care for young children.”
The findings come amid a projected physician shortage of between 13,500 and 86,000 in the United States by 2036, according to the Association of American Medical Colleges. The study’s authors note that a decrease in average retirement age by just two years would reduce the projected physician supply in 2036 by about 40,000 — underscoring how even modest shifts in career length can have an outsized impact on workforce supply.
Of particular concern to researchers was the 11% of respondents who completed residency training but never entered clinical practice — a population the authors say has not previously been studied and one they believe will have an outsized effect on the magnitude of the workforce shortage.
Women accounted for nearly two-thirds of the survey respondents, and compared to men, they were more likely to select these reasons for leaving clinical practice: Care for other family members (7.9% of women respondents vs. 0.6% of men), care for young children (21.7% vs. 4.2%), health concerns (13.8% vs. 3.8%) and too stressful (31.7% vs. 12.9%).
The study also found women had a statistically significantly shorter median career length — 9 years vs. 12 years for men.
These gender differences could have a significant effect on the U.S. physician workforce, as women now account for a slight majority, or 50.2%, of physician residents and fellows. The authors note that women comprised 55.4% of U.S. medical school matriculants as of the 2023-2024 school year, meaning the proportion of clinically inactive physicians who are women is likely to grow.
The authors concluded that “addressing key differences in attrition drivers, including a disproportionate number of women exiting due to needing to care for children, other family members or personal health issues, may lead to an amplified beneficial effect on the clinical workforce.”
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