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A new research letter outlines the toll that short-staffed teams take on physicians, and why many are considering cutting their hours, or walking away.
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In a new national study published May 14, 2025, in JAMA Internal Medicine, nearly half of surveyed physicians said they work with an incomplete clinical team more than 25% of the time — and those staffing gaps are significantly associated with higher burnout, reduced work hours and growing intent to leave their organizations.
“Physicians frequently experienced incomplete team staffing,” the study’s authors wrote. “Working with an incompletely staffed team was associated with significantly greater odds of burnout, [intent to reduce hours] and [intent to leave].”
The research, led by Lisa S. Rotenstein, MD, MBA, MSc, an internist at the University of California, San Francisco, is based on 2023 data from 970 physicians across 15 large health systems. The report adds new urgency to existing concerns about physician well-being and workforce stability — particularly in primary care.
Physicians were asked how often they work without their “standard number of support staff,” including medical assistants, nurses and administrative team members. Among respondents, 47.9% said they worked with less than a fully staffed team more than a quarter of the time.
That figure climbed as high as 62.4% in specialties like radiology, anesthesiology and pathology. In primary care, the rate was 44.8%.
Doctors in these understaffed environments reported significantly higher emotional and professional distress:
The report’s findings are consistent with prior research showing that work overload and lack of team control are major drivers of physician burnout — a problem that worsened during the pandemic, which has yet to fully abate.
According to a multivariable analysis, working with an incomplete team more than 25% of the time more than doubled the odds of burnout.
“When interpreted alongside evidence that work overload is associated with physician burnout and [intent to leave] … our results underscore the central role of health care teams in shaping physician experience,” the authors wrote.
Physician burnout isn’t just a matter of morale. Previous studies have estimated the cost of turnover driven by burnout to reach six figures per physician — not including the lost continuity of care for patients and disruption to remaining staff.
The authors of the study call for prompt action, particularly in designing interventions that prioritize sustainable staffing, writing that, “Future studies should test policies and interventions that facilitate sustainable and robust staffing of health care teams.”