Primary Care Physician Turnover Results in Nearly $1B of Excess Healthcare Expenditures, Study Finds

About $260 million of annual excess healthcare expenditures from primary care physician turnover is linked to physician burnout.

Turnover of primary care physicians (PCPs) causes about $979 million in excess healthcare expenditures for public and private payers each year, a recently published research article found.

Care continuity between PCPs and their patients has been linked to better outcomes, including diagnostic accuracy, fewer emergency room visits, and lower hospital admissions, the co-authors of the research article wrote. Continuity of care has also been associated with lower costs, they wrote.

The research article, which was published by Mayo Clinic Proceedings, found that about $260 million of annual excess healthcare expenditures from PCP turnover is caused by PCP burnout. The cost of PCP turnover linked to burnout should be a powerful motivator to improve PCP well-being, the lead author of the study said in a prepared statement.

"Turnover of primary care physicians is costly to public and private payers, yet there is an opportunity to decrease unnecessary healthcare expenditures by reducing burnout-related turnover. Physician burnout is preventable and payers, healthcare organizations, and others have a vested interest in making meaningful changes to reduce physician burnout," said Christine Sinsky, MD, lead author of the study and vice president of professional satisfaction at the American Medical Association.

The methodology of the study has several essential points and conservative estimates.

• The average patient panel for PCPs was set at 1,000 individuals
   
• The average number of Medicare beneficiaries in a PCP patient panel was set at 196 and the average number of non-Medicare beneficiaries was set at 804
   
• Data from a survey of more than 5,000 physicians was used to estimate the prevalence of burnout and intention to leave a practice within two years
   
• Based on earlier research, it was estimated that Medicare patients generate $189 in excess healthcare expenditures in the first year after turnover of a PCP
   
• It was estimated that non-Medicare patients generate $61 in excess healthcare expenditures in the first year after turnover of a PCP
   
• Based on the most conservative estimate in the literature, it was estimated that 25% of physicians intending to leave their practice in the next two years would actually leave

The study generated five primary data points.

• In the first year after leaving practice, the excess healthcare expenditure per PCP was estimated at $86,336
   
• 11,339 PCPs were estimated to leave practice annually
   
• Given the excess healthcare expenditure per PCP and the estimated number of PCPs leaving practice annually, annual excess healthcare expenditure associated with PCP turnover was estimated at about $979 million
   
• Annual PCP turnover attributable to burnout was estimated at 3,006 physicians
   
• Given the excess healthcare expenditure per PCP and the estimated number of PCPs leaving practice annually due to burnout, annual excess healthcare expenditure associated with burnout-related PCP turnover was estimated at about $260 million

"In this analysis, we estimate that each instance of a PCP's leaving current practice results in $86,336 in excess healthcare expenditures during the following year. We estimate that PCP turnover results in $979 million in annual excess healthcare costs across Medicare and non-Medicare patients, of which $260 million (27%) is attributable to burnout. Physician burnout is therefore costly to public and private payers, who bear most of these excess healthcare costs," the study's co-authors wrote.