The unexpected reasons driving physician turnover

Many physicians describe their reality with words like burnout, administrative overload and workforce strain. But that’s not the full story. To move the needle, we have to look deeper.

The data should get our attention. Research shows the percentage of physicians leaving clinical practice will compound a projected shortage of up to 86,000 doctors by 2036. This isn’t isolated to one region or specialty. A study tracking more than 712,000 physicians caring for Medicare patients found attrition climbing across every specialty, every geographic region and every demographic group.

Every single one.

This isn’t a niche issue. It’s systemic. And systemic challenges require new ways of thinking from health systems and hospitals if we want different outcomes.

Widening the lens on turnover

Here’s what stands out: Physicians often leave roles for different reasons than what drew them there in the first place. If we’re only focused on recruitment, we risk falling behind.

When you dig into the research, a few themes consistently show up:

Leadership alignment matters more than we think.
Results of a recent study show that 34% of physicians don’t feel heard by organizational leadership. That’s not a small number. Transparency and communication aren’t soft skills. They’re retention strategies.

Autonomy is non-negotiable.
 A survey of more than 1,000 U.S. physicians found that loss of autonomy is one of the most serious threats to the workforce. Nearly two-thirds say limits on their autonomy negatively impact the quality and timeliness of patient care. When physicians feel they can’t practice medicine the way they were trained, it significantly increases the likelihood they will leave.

The “second shift” is burning people out.
Administrative burden isn’t new, but it’s getting worse. There’s even a term for it, “pajama time,” the unpaid work physicians do at home after a full day of patient care. It’s become the norm, and it’s not sustainable.

Culture is a differentiator.
When physicians don’t feel valued or supported, they look for environments where they are. Cultural alignment isn’t a nice-to-have. It’s foundational to retention.

How health leaders can take action

Physician vacancies don’t just affect access to care. They disrupt teams, strain the providers who remain and impact patients. In already stretched systems, even one departure can create a ripple effect that’s hard to recover from.

The good news is that there are models working right now.

Locum tenens is one of them. It’s increasingly being used as a strategic tool, not just a stopgap, helping health systems maintain continuity of care and expand access, especially in rural and underserved communities. For physicians, it offers something many are looking for: more control over how and where they practice.

Internal physician float pools are gaining traction as well. Some health systems are building groups of part-time physicians who already understand the organization’s culture and workflows. That familiarity reduces disruption and adds flexibility, both for physicians and for the system.

Models for change

The organizations seeing progress aren’t taking a one-size-fits-all approach. They’re investing in understanding what their physicians actually need and building around that.

Sutter Health is one example. They reduced physician turnover from 9% to approximately 3% over three years while also reducing burnout and reclaiming clinical time. Their approach focused on building an ecosystem around learning, leadership and long-term development.

HCA Healthcare is taking a different approach, with a strong focus on listening, leadership, and innovation. They’re using AI to reduce administrative burden and embedding physicians more directly into business decision-making.

Different approaches, same theme: intentional investment in physicians.

There’s no single solution here. The organizations making progress are the ones willing to understand their specific physician community and respond accordingly.

The most important thing: Start now

The most effective strategies combine short-term flexibility with long-term change. Not one or the other, but both, because physicians aren’t all looking for the same thing. What keeps one engaged may not work for another. That’s not a barrier. It’s a signal to ask better questions and listen more closely.

This isn’t about blame. But it is about responsibility.

The solutions exist. The models are out there. What matters now is the willingness to act.

Physicians want to feel valued, supported and able to do their best work. Making it easier for them to focus on that work is worth the effort and too important to get wrong.

Brooke Bowers is president of CompHealth, a division of CHG Healthcare. CHG is a leader in physician staffing and the nation’s largest provider of locum tenens services.