'The best use of a physician's time is practicing medicine' — on benefits, burnout and alignment

When physicians leave a practice, money is rarely the main reason. More often, they are worn down by overloaded schedules, unclear expectations and work that pulls them away from patients, according to Stu Schaff, FACMPE, FHFMA.

Schaff is executive director of El Dorado Multispecialty Medical Group and founder and lead advisor of The Best Practice, which advises medical group leaders on physician alignment, practice operations, recruitment and retention. Over nearly two decades, he has worked with more than 100 hospital- and physician-owned groups. He presented "Real Physician Alignment: Higher Productivity, Lower Burnout" on Sept. 29 at the Medical Group Management Association (MGMA) 2026 Annual Conference.

In a video interview with Medical Economics, Schaff said physicians may care about pay, but it's typically not why they leave.

"I've seen it working with hundreds of medical groups across the United States, and it reflects what the data tells us too, that physicians generally are not leaving their positions because of money," he said.

Schaff explained why compensation is the first lever many groups reach for and why productivity-based pay can backfire when benchmarks are unrealistic or when physicians don't control the factors that drive their own volume. He described the questions he asks physicians to learn what pulls them away from patient care, and why physicians deserve clear expectations about their priorities, workload and what success looks like.

Compensation "is a useful tool, but it doesn't replace the job of leadership," Schaff said. He argued that practices owe physicians the same clarity they give the rest of the team, and that the alternative is costly: One of his conference slides cited an American Medical Association estimate that the direct cost of physician burnout ranges from $500,000 to $1 million per physician.

He also made the case that protecting physicians' time is the most sustainable way to raise productivity, not a trade-off against it. As Schaff put it, practices need to defend their doctors from distractions to doctoring.

"I tell all my doctors I want them to retire with our practice," he said.