Leo Sher, M.D.

A research report titled “Trends in and predictors of physician attrition from clinical practice across specialties: A nationwide, longitudinal analysis” was recently published online ahead of print in the Annals of Internal Medicine (1).

In this study, researchers from Connecticut, California, and Massachusetts examined national trends in physician attrition from clinical practice and identified factors associated with an increased likelihood of leaving practice. The analysis included physicians who provided care to Medicare beneficiaries between 2013 and 2022. Attrition was determined based on the reimbursement of clinical services; physicians who did not bill for any services over three consecutive years were considered to have left clinical practice.

The unadjusted rate of clinical practice attrition rose significantly from 3.5% in 2013 to 4.9% in 2019. Increases were observed across nearly all subgroups—among both male and female physicians, in rural and urban settings, across specialties and geographic regions, and among physicians aged 35 years and older.

In adjusted models, female physicians and those practicing in rural areas were more likely to leave clinical practice. Attrition was also associated with caring for Medicare beneficiaries who had higher average risk scores, older age, and a greater proportion of dual-eligible (Medicare and Medicaid) patients.

By specialty, psychiatrists and obstetrician-gynecologists exhibited particularly high attrition rates. In psychiatry, attrition rose from 7.4% in 2013 to 10.1% in 2019, while in obstetrics and gynecology, it increased from 6.1% to 10.7% over the same period.

Reference

1. Rotenstein LS, He Z, Dziura J, Tsugawa Y, Venkatesh AK, Melnick ER, Gettel CJ. Trends in and predictors of physician attrition from clinical practice across specialties: A nationwide, longitudinal analysis. Ann Intern Med. 2025 Oct 7. doi: 10.7326/ANNALS-25-00564. Epub ahead of print.