Physicians are leaving clinical practice nine years earlier than they did in 2008, AMA study finds

The reasons U.S. physicians are leaving clinical practice early have shifted since the last time researchers took a national look. And they are leaving sooner.

A study published May 7, 2026, in The Permanente Journal surveyed 971 clinically inactive physicians across all specialties who completed residency between 2000 and 2022. Funded entirely by the American Medical Association (AMA), the analysis identified "hassle factor" (44.7%) and "too stressful" (44.5%) as the leading reasons cited by physicians who had stopped practicing, followed by increasingly unrealistic patient demands (41.1%) and lack of professional satisfaction (38.4%).

"We hope that by better understanding what drove these physicians away from the clinical practice of medicine, we might uncover meaningful insights that will help us improve physician professional satisfaction and retention," said Sea Chen, M.D., Ph.D., the paper's corresponding author and a researcher at the AMA in Chicago, in a statement accompanying the release.

The paper is the only national survey of its kind published in the U.S. in well over a decade. The previous comparable study, conducted in 2008, identified personal health issues (37.8%), hassle factor (32.5%), rising malpractice premiums (24.4%) and lack of professional satisfaction (23.6%) as the top drivers of early exit.

A younger cohort of physicians leaving practice

Physicians in the new sample left clinical practice at a mean age of 48.1 — nine years younger than the 57.1 mean age observed in the 2008 cohort. Roughly 11% of respondents reported never practicing clinical medicine after completing residency at all, a finding that surprised researchers.

The Association of American Medical Colleges (AAMC) projects a shortage of up to 86,000 physicians by 2036. According to the paper, a two-year drop in the average physician retirement age alone would reduce projected supply in 2036 by roughly 40,000 doctors.

"As the health care system works to further expand the physician pipeline by opening new medical schools and adding more residency slots, it's worth asking whether we should also focus on supporting physicians who are already trained," Chen said.

Sex differences and caregiving pressure

Women made up nearly two-thirds of eligible respondents, despite representing approximately half of the broader physician population sampled. Female physicians were significantly more likely than male physicians to report leaving practice to care for young children (21.3% vs. 4.2%), care for other family members (7.9% vs. 0.6%), address health concerns (13.8% vs. 3.8%) and because the work was too stressful (31.7% vs. 12.9%).

Those findings align with separate research published in April in the Journal of General Internal Medicine, which used Medicare claims data on more than 700,000 physicians from 2013 to 2023 to show that female physicians leave clinical practice at a hazard ratio of 1.43 compared with male counterparts, with the gap holding across specialties and across rural and urban settings. Women in that analysis left at a median age of 49, compared with 64 for men.

Lisa Rotenstein, M.D., MBA, M.Sc., the corresponding author of the JGIM study and an internal medicine physician at UCSF Health, told Medical Economics that ambient artificial intelligence (AI) documentation tools may help retain women and primary care physicians, who tend to carry heavier baseline documentation loads.

"Folks were saying, I can pay attention to my patients again, I can look them in the eye, I can call my patients back before 7 or 8 p.m.," Rotenstein said of clinicians using AI scribes in a Physicians Foundation-funded study she led that was published in fall 2025. "I do think we have to move beyond just documentation into the rest of the work of medicine that doesn't feel like the work of medicine."

Related content: Take note: The AI scribe era is here

Burnout’s roots in throughput

The drivers cited in the AMA paper align with the components of burnout, defined in the study as “the prolonged response to chronic workplace stressors and consist of emotional exhaustion, depersonalization and lack of personal accomplishment.” The authors stop short of asserting direct causation.

Others in the industry have framed the issue similarly.

"The cause of burnout is basically the industrialization of medicine. It's about throughput, and as long as we prioritize throughput over quality of care and the doctor-patient relationship, burnout is not going to get better," Richard Anderson, M.D., FACP, CEO of The Doctors Company and TDC Group, told Medical Economics. He criticized the typical organizational response, calling it "kumbaya things — well, let's have pizza on Friday, or let's meet to talk about our issues once a month for half an hour."

Bill Heller, chief operating officer at CHG Healthcare, pointed Medical Economics earlier this year to data from the firm's 2025 physician sentiment survey showing 75% of physicians are satisfied with their jobs, but only 18% are highly engaged. Forty-five percent of respondents to that survey reported spending more than 15 hours a week on paperwork.

"If you can engage your physician force, you've solved a lot of your problems," he said. "Compensation is a part of engagement, but it's certainly not all of it. Physicians want flexibility … and physicians want time with patients."

So, what’s the fix?

AMA researchers point to several specific levers: scheduling models that allow flexibility without penalty, team-based support to triage patient messages, dedicated time for inbox management and cultural changes that normalize taking time away from work.

Chen also flagged female-focused solutions like improved access to child care, flexible work policies and equitable treatment as potential ways to retain more women in the physician workforce.

Notably, despite extensive prior literature linking electronic health record (EHR) work to burnout, EHRs did not crack the top reasons for exit in the new study. The authors suggested that although EHR-focused interventions may still help reduce burnout, concentrating on other drivers may be more impactful.

"The current motivational drivers of early exit from clinical careers may be different than those of the past," the authors concluded. "Allocation of resources for intervention will need to adapt to these changing needs."

For physicians who have spent the last several years watching colleagues cut hours, move to part time or leave clinical practice altogether, that probably reads less like a finding than a confirmation.