About one out of four clinicians in the U.S. are considering leaving healthcare, primarily due to unrelenting burnout.
Even among doctors and nurses who want to stay in healthcare, about a third are considering switching employers, according to a Bain and Company survey. Research shows that around half of clinicians surveyed report their mental health has declined since the start of the pandemic.
Of those considering leaving the field entirely, 89% cite burnout as the main cause, the consultancy firm's survey of nearly 600 clinicians found. Additionally, around 40% of all clinicians surveyed say they don’t have the resources they need to operate at full potential. They report a lack of effective processes and workflows, supplies and equipment. And 59% don’t believe their teams are adequately staffed.
Clinicians' dissatisfaction is also illustrated by drastically dropping Net Promoter Scores (NPS), a measure of their likelihood to recommend their employer. U.S. physicians’ NPS dropped 17 points from 36 points in 2020 to 19 points and this year, nurses weighed in with a dissatisfied NPS of 11 points, according to the company.
These challenges, including turnover and potential departure from the industry, come as the healthcare industry is already facing a tight labor market that is on track to be short 38,000 to 124,000 physicians by 2034, according to data from the Association of American Medical Colleges.
Aligned with the low NPS scores, hospital-based staff has the highest turnover rate, which increased 6.4 percentage points in the past year alone, according to NSI’s National Health Care Retention & RN Staffing Report. The staff RN turnover rate has reached 27%, exceeding the turnover rate for hospital staff overall (26%) for the first time.
New research from the Medical Group Management Association (MGMA) and physician recruitment firm Jackson Physician Search highlights the same trend as physician burnout and turnover rates remain dangerously high due to the rising toll of stress during the COVID-19 pandemic and resulting staffing shortages.
According to an August 2022 survey of physicians and healthcare administrators, more than half of doctors (51%) have considered leaving for a different job in healthcare. More than 4 in 10 (41%) considered leaving the practice of medicine and more than one-third (36%) considered early retirement.
Nearly two-thirds of physicians (65%) report they are experiencing burnout in 2022, up four percentage points from the 2021 study, according to MGMA. Further, four in 10 medical practices (40%) had a physician resign or retire early in the past year due to burnout.
"While burnout is certainly not new, it's disheartening that one in three physicians is reporting a significant increase in their level of burnout in 2022," said Tony Stajduhar, president of Jackson Physician Search, in a statement "Administrators and physicians recognize that solving the burnout crisis is complicated as many of its drivers are rooted in the business of healthcare. However, burnout mitigation should include creative recruitment and staffing strategies that bring additional talent into the organization to help defuse the impact of stress and administrative overload, and that allow for the pursuit of physician work-life balance."
Healthcare administrators acknowledge worsening levels of burnout in physicians, but physicians often don't perceive enough is being done to mitigate that burnout or to engage them, the MGMA survey found.
Redoubling efforts to address physician burnout
Administrators vary their approaches to retention and engagement, often with informal efforts rather than structured, strategic programs, according to the MGMA and Jackson Physician Search report.
Both reports take a deep dive into short-term and long-term fixes for providers and healthcare administrators to effectively address physician burnout.
The Bain and Company survey results point to a clear message from clinicians: better compensation, support to deliver high-quality patient care, a more manageable workload, flexible work arrangements and more clinically focused job responsibilities.
In the near term, provider organizations and medical groups need to routinely assess and address clinician well-being. Leading employers are measuring clinician well-being and providing access to mental health support at the individual and group levels.
Ochsner Health, for example, has stood up an Office of Professional Well-Being. It also developed a four-pronged approach to mental health, including measuring and benchmarking overall staff wellness and creating a resource group for women to discuss the unique stressors they face. Other organizations, including Rutgers Biomedical and Health Sciences, Hartford HealthCare and the University of Michigan Medical School, have established a chief wellness officer role, the Bain and Company report highlights.
There are other near-term initiatives to improve the workplace such as engaging clinicians in decision-making and building a culture of recognition as many clinicians stay in healthcare because they believe it is a "calling."
Over the long term, Bain and Company researchers advise organizations to invest in technology and people to ease administrative burdens and redesign the clinical operating model. Some providers are implementing multidisciplinary care teams in both inpatient and outpatient settings, which allow clinicians to work at the top of their licenses.
Organizations should take steps to champion support and inclusion. Strong coaching and mentorship are also directly correlated to employee satisfaction and well-being, the report said.
More organizations are starting to formalize their efforts as opposed to simply “planning to have a plan.” In a May 11, 2021, MGMA Stat poll, nearly 9 in 10 (86%) healthcare leaders reported that they did not have a formal plan or strategy to reduce physician burnout. A year later, among medical group leaders, more than 1 in 3 (34%) said they have a formal plan or program to address physician burnout, compared to 66% who did not.
Some of the top efforts that practice leaders shared with MGMA were adding scribes to aid with documentation, ongoing recruitment of new physicians to address panel sizes and improved call coverage and efforts to address disruptive or violent patient behavior. Medical groups also were implementing regular check-ins with physicians and ensuring they get adequate leave time or formal sabbatical periods and developing new wellness initiatives, EAP availability, malpractice carrier-provided resources and app-based programs to help improve work-life balance.
Other efforts include increasing flexibility in employment packages and improvements to EHR workflows to minimize administrative burdens for doctors and nurses.