Physician turnover contributes to medical practice consolidation as new physicians are more likely to join large practices that are integrated into health systems, and older physicians are more likely to leave small ones, according to a new study published in Annals of Internal Medicine.
For the study, University of Minnesota School of Public Health and Harvard researchers examined 630,979 physicians treating Medicare patients.
They found considerable physician turnover during the 2008 to 2017 study period. Nineteen percent of the physicians (median age 35) treated their first Medicare patient during that time, while 12.4 percent (median age 65) treated their last, researchers said.
The study also found that only one physician entered the smallest practices (one or two physicians) for every three who left, while in the largest practices (more than 50 physicians), more than 2.5 physicians entered for each who left.
"Physicians entering Medicare are much more likely than physicians exiting Medicare to work in large, hospital-owned practices," study lead Hannah Neprash, an assistant professor in the Minnesota School of Public Health, said in a news release. "These findings are consistent with surveys of medical residents, which show a growing preference for hospital employment among new doctors. This pattern suggests that natural turnover in the physician workforce likely contributes to consolidation in physician markets."
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