Physician Staffing Executive: 'The Numbers Are Increasingly Alarming'

Physician burnout and turnover at physician practices has increased, according to a new survey.

Jackson Physician Search presented the findings of a survey of physicians and practice administrators on burnout and related issues at this week's Medical Group Management Association (MGMA) conference in Boston.

Physician burnout was already a pressing issue before the coronavirus pandemic. A recently published research article found that physicians reporting at least one symptom of burnout rose from 38.2% in 2020 to 62.8% in 2021.

The new survey was commissioned by Jackson Physician Search and MGMA. The survey was conducted in August, and 354 physician practice administrators and 66 physicians participated.

The survey features several key data points:

• The percentage of physicians reporting they are experiencing burnout rose from 61% in 2021 to 65% in 2022
   
• Administrators' estimate of burnout among their physicians also increased from 68% in 2021 to 73% in 2022
   
• When asked to gauge how much their burnout levels changed from 2021 to 2022, 35% of physicians reported there was a significant increase and 40% reported burnout had increased somewhat
   
• Physicians were more likely than administrators to say the administration's handling of their practices was the source of burnout rather than the nature of the physicians' work
   
• Physicians and administrators shared perceptions on physician engagement, with both reporting physician engagement at 7.7 on a scale of 1 to 10
   
• Physician satisfaction with their employers was an average of 6.4 on a scale of 1 to 10
   
• 51% of physicians reported considering leaving their practice for a different job in healthcare
   
• 41% of physicians reported considering leaving the practice of medicine entirely
   
• 36% of physicians reported that they had considered early retirement
   
• When asked what they wanted most in their practices to increase work satisfaction, physicians reported that they wanted two-way communication with management for the second year in a row

The survey report's co-authors wrote that administrators need to make intentional efforts to retain physicians.

"Awareness alone will not prevent physicians from exiting the profession in the coming years; it will require empathy and organizational efforts to restore professional relationships that make high-quality care delivery a sustainable reality, producing healthier outcomes and margins in the process. Like most issues in medical practices across the country, physician stress and burnout can be tackled when positive, two-way communication between physicians and administrative leaders is in place to reach understandings around the significant challenges everyone faces within the organization," they wrote.

Interpreting the data

Jackson Physician Search President Tony Stajduhar presented the new survey during the MGMA conference. He said the survey reveals important trends now that the crisis phase of the pandemic has passed. "When we talk about the post-pandemic period, a few things emerge from the new survey. Administrators are acknowledging worsening levels of burnout in physicians. Physicians often perceive not enough is being done to mitigate burnout. So, the two-way communication is the thing that physicians believe is missing the most and the thing they desire the most."

Physician burnout has reached alarming levels, he said. "Physician burnout and the long-term cumulative stress and depersonalization that doctors experience continues to threaten the entire industry. Burnout is prompting more physicians to leave their jobs and, in some cases, the profession."

The shift from physicians working in independent practices to physicians working as employees has had some negative consequences, Stajduhar said.

"There is a sense of moral injury as well as detachment from the management. One factor that is important is more physicians are working as employees than ever. It has become rare to see independent contractor situations as we did 15 years ago. Our business flipped on a dime after Obamacare. So, now we see physicians who are engaged in employment and often they do not feel like physicians anymore. They do not feel they have the power to practice medicine in the way they want to. They feel they are being inhibited to do the things that need to be done. And it is killing them. Physicians are feeling more like an employee than a healer."

Physician turnover is a concern at physician practices, he said. "Right now, half of U.S. physicians are saying they are going to make a move to another practice. The turnover is getting greater and greater. The number of physicians making a move previously was 6%, or more than 50,000 physicians changing jobs annually. Now, it has gone up to 7%. It could potentially go up another percentage point. An increase of 1% does not sound like a lot, but when the turnover number has been at 6% for many years, the numbers are increasingly alarming."

A growing physician shortage is also an issue for physician practices, Stajduhar said.

"It is a reality that we have an aging population and the need for healthcare is going to keep growing. We do not have any additional residency programs that are being built—certainly not enough to meet the demand for new physicians. We could be 150,000 physicians short in the next 10 years. So, this is a major problem that practices are running into. … It gets harder every day to recruit physicians, whether it is temporary staffing or permanent positions. It is great for physician staffing companies—my company will be stable for a long time because there are physicians constantly moving. But it is not the best thing for the country. It is not the best thing for your patients. It is not the best thing for your practices."

Physician practices should have formal physician retention programs to help address staffing concerns, he said. "We must come up with some solutions on how to retain physicians. There is no single way to do it. There are a lot of things you can do. You can get creative. If you have a chief medical officer within your group, you can get them involved with a line to the administration and a dotted line to the physicians. You must have open lines of communication and find out what your physicians need. It is going to take a good plan and gathering data on what is important to your physicians."