America's looming physician shortage is not just approaching—it's accelerating. A recent decade-long study reveals a troubling rise in doctors leaving clinical practice, a trend that threatens to push the nation's projected shortage of up to 86,000 doctors by 2036 even higher.
Attrition Rates Spike Across the Board
The national analysis, published in Annals of Internal Medicine, tracked over 712,000 physicians caring for Medicare patients and found that the overall percentage of doctors exiting clinical practice jumped from 3.5% in 2013 to 4.9% in 2019. The researchers looked at physicians who did not bill for clinical services over three consecutive years to define attrition.
Crucially, this increase in attrition rates was observed across every specialty, geographic region, and demographic group. As senior author Dr. Cameron J. Gettel notes, 'Rates of attrition among physicians across specialties are increasing over the years studied... This includes male and female doctors, those practicing in rural and urban areas, across all specialties and age groups.'
The data highlights several high-risk groups disproportionately affected:
- Female physicians showed a 44% higher likelihood of leaving practice compared to their male colleagues.
- Rural physicians faced a 19% increased risk compared to those in urban settings.
- By specialty, Psychiatrists and Obstetrics/Gynecologists saw the steepest rises. Psychiatry attrition climbed from 7.4% to 10.1%, while OB/GYN attrition nearly doubled, soaring from 6.1% to 10.7%.
- The highest risk group, however, emerged when accounting for patient complexity: hospital-based physicians treating the most complex patients (those enrolled in both Medicare and Medicaid) showed a 57% increased likelihood of leaving practice.
The Systemic Root: Moral Injury
Why are doctors departing at this rate? Behind these statistics are physicians stretched thin and struggling to provide quality care in a restrictive system. Dr. Gettel points to 'moral injury' as a key driver. This occurs when doctors know the right thing to do for their patients, especially those with complex needs, but the system's constraints—such as appointment times that often last mere minutes—make it nearly impossible.
This moral conflict is fed by several underlying systemic pressures: the burdensome requirements of electronic health records (EHRs), insufficient staffing, time-consuming prior authorization requirements, and general workflow constraints. These factors collectively erode physician satisfaction and drive doctors from practice.
Targeted Solutions to Stem the Tide
With current projections estimating a critical shortfall of up to 86,000 physicians by 2036, the accelerating attrition trend poses serious implications for access to care. Dr. Gettel warns that this projected shortage could 'balloon even higher' without intervention.
The study authors urge for systematic solutions focused on addressing these pain points to keep doctors in the workforce. They suggest targeted interventions aimed at supporting physicians and granting them more control:
- Implementing enhanced caregiving supports.
- Increasing access to virtual resources, particularly for rural practitioners.
- Granting physicians greater control over work environments, including shift schedules and patient loads.
Ultimately, these efforts come back to the patient. 'These types of workforce studies are so needed because they're a big component of access to care, which is integrally linked to the workforce and availability,' Dr. Gettel concludes.
Source: Yale School of Medicine | October 7, 2025