Why Physicians Change Jobs

Are you happy in your current position? What would drive you to leave? Physician burnout and career dissatisfaction are on the rise -- so much so that some physicians are ready to hang up their stethoscopes.

Physician recruitment firm Pinnacle Health Group has conducted a survey to find out why physicians leave their jobs in an effort to help improve physician retention and understand the underlying causes of discontent.

The survey was sent to 2,500 doctors in 10 specialties with a response rate of approximately 4 percent. Here's what it revealed:

Need for a Higher Salary

For two years running, the need for better compensation topped the list of reasons why physicians leave their jobs. Physicians also commented on the need for better benefits, incentives, bonuses, and more vacation time. Others asked for more compensation for extended hours and loan repayment.

According to one respondent, "In the Northeast, on an hourly wage, primary-care physicians make on par with many bachelor's-level occupations. Given the duration and intensity of physician training, as well as educational debt incurred and lost years of income, primary care seems not a responsible financial decision. Perhaps recognizing this reality and working to address it with compensation or loan repayment may help retention in areas where this is a concern."

High Malpractice Premiums

Malpractice is on the minds of more physicians this year; respondents cited it as the number two reason they would leave their job, up from a number 10 ranking last year. Many physicians are taking dramatic steps for relief, including relocation. One respondent called for "more physician advocates in the insurance industry." Another advised the industry to "listen to the physician's ideas, assist with malpractice rates until premiums decline, and help us make our practices meet financial goals."

(tie) Underutilized Medical Skills
Need for Upward Advancement/
Long Hours and Busy Call Schedule 

According to surveyed physicians, underutilized medical skills, the need for advancement, and long hours/busy call schedules tied for third. Last year, long hours and call schedules ranked ninth. One cardiologist commented that his job did not draw on all his available skills and expertise; he mentioned that he was actively looking for a "more challenging situation that is bigger and more complex."

Lack of Autonomy/Appreciation

Physicians asked for more control and respect in their practices. One family practitioner said, "In the business model for a hospital-based practice, physicians seem to be treated as cash factories with constant pushing to drive up productivity." Likewise, an anesthesiologist commented, "Physicians should not be treated as just a disposable commodity." According to one general surgeon, "Physicians are easy to retain. You just need to show you appreciate them and take their concerns seriously."

Restructuring/Declining Practice

There are times when doctors have no choice but to leave -- for example, when a practice is forced to close shop as a result of decreased revenue. When a practice is restructured, physicians may be forced to search for other opportunities.

Poor Relationships with Hospital Administration,
Poor Relationships with Medical Faculty/Colleagues

This year's rankings are consistent with last year's. These issues can lead to low morale and high stress levels. Many respondents emphasized the need for administrators to listen to physicians and involve them in the decision-making process.

One radiologist didn't like the "politics with partners." Another suggested that administration should "allow for meetings between parties [about] how to improve and expand a practice" and to "assist in advancing the office atmosphere to be more patient-friendly rather than pushing the patients through." Yet another physician said, "Listen to our concerns and quit talking 'adminispeak.'"

Proximity of Work to Family

Physicians tend to look for career opportunities that are close to family and friends. An OB-GYN respondent commented that, otherwise, it is "extremely difficult trying to balance work and family life."

Physician Desires Another Climate

What can be done when a doctor who lives in Alaska (or upstate New York) yearns for a warmer climate? Not much, except a move.

Family Uncomfortable in the Community

Family issues are an important factor in whether physicians stay put or move on. You can find a practice with the best compensation, state-of-the-art technologies, and advancements, but if your spouse and children are unhappy, chances are the job won't last long.  

Wendy Abdo is staff writer and Michael Broxterman is COO of Pinnacle Health Group. They can be reached at wabdo@phg.com or editor@physicianspractice.com

This article originally appeared in the July/August 2004 issue of Physicians Practice.