A recent survey reveals that one in four US clinicians is considering switching careers.

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  Why are physicians leaving practices or contemplating quitting?

  Increasing numbers of unhappy doctors are leaving their practices or considering leaving soon, surveys show. About 8% of doctors—representing about 16,000 practices—shut down in 2020 due to COVID-19’s impact on business.
  
  The pandemic caused stress, financial loss, and other problems for doctors, but physician dissatisfaction with the profession has been a problem for years. A 2018 survey conducted prior to the pandemic found 54% were considering retiring in the next five years (including 30% of those under 50). Why? What are the primary factors causing so many doctors to want to quit?
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  1. Burnout

  More than half (53%) of doctors say they are burned out, up from 47% the previous year, according to the latest burnout survey from Medscape. Female doctors report significantly higher rates of burnout (56%) than their male colleagues (41%).
  
  Emergency medicine and internal medicine are now among the most burned-out specialties. The top cited factors for burnout include too many bureaucratic tasks, lack of respect from employers and colleagues, and too many hours at work. About 4% of doctors said they’ve quit their practices due to burnout, 1% have attempted suicide, and 13% have felt suicidal. However, many respondents say they were burned out even before COVID.
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  2. Increased verbal abuse and bullying by patients

  Some doctors report being cyberbullied, harassed or threatened when they interact with patients. Harry Severance, MD, adjunct assistant professor at Duke University School of Medicine, often speaks to doctors about career options. He says a physician recently confided that the verbal abuse he'd been receiving from patients had him contemplating quitting medicine.
  
  "When patients seem to turn on their doctors and accuse them of not operating in their best interest, that's a strong motivating force for leaving clinical practice altogether," Dr. Severance says. "For unhappy physicians already on the fence, this is a final straw."
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  3. Insufficient income

  Even before the pandemic, some doctors—especially in less lucrative specialties or in low-paying residencies—struggled to pay such expenses as student loan debt (average: $241,600, with 25% exceeding $300,000) and malpractice premiums (as much $100,000 to $200,000 annually). Insufficient pay was cited by 34% of doctors as a burnout cause in Medscape's survey.
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  4. Long hours and lack of family time

  The average doctor works 53.4 hours per week and may have 24/7 or weekend on-call periods. A University of Michigan survey found that nearly 40% of female doctors chose to go part-time or quit entirely six years after completing medical training, citing family conflicts as the reason. (Less than 5% of male doctors do the same.)
  
  In Medscape's 2023 physician burnout report, "too many work hours" was cited by 37% of physicians overall. More female doctors also expressed concern over parenthood/work conflicts (48%) than did males (29%).
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  5. Dealing with EHRs

  Electronic health records (EHRs) have been the bane of many doctors' existence in recent years, especially older physicians, with survey after survey citing them as difficult to use and interfering with doctor-patient interaction. This is especially true if a physician doesn't have a scribe and must input data into a computer during office visits, rather than maintaining eye contact.
  
  One study finds doctors spend two hours on EHR record-keeping for every single hour in clinical contact with patients. EHR dissatisfaction has been linked to higher burnout scores, and burnout can lead doctors to leave clinical practice or quit medicine altogether.
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  6. Too much bureaucracy

  It's not just EHRs that doctors perceive as taking them away from patients. "Too many bureaucratic tasks" was by far the highest-rated reason for physician burnout in Medscape's 2022 survey, with 60% of doctors citing it.
  
  Physicians spend nearly 25% of their time on nonclinical paperwork, a 2016 report found. They must deal with insurance companies, document compliance with various governmental regulations, and track quality data, among many other administrative chores. Doctors who go into medicine to work directly with patients can find such duties joyless and frustrating.
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  7. Lack of independence

  The majority of doctors today no longer work for themselves. As of January 2022, 74% of physicians were employed by a hospital or corporate entity, according to a study by the Physicians Advocacy Institute. Increasingly, doctors work for larger group practices, many of which today are owned by profit-driven private-equity firms.
  
  Doctors may be assigned larger caseloads than they feel is optimal and told how to treat patients by administrators focused on the bottom line, critics charge. Some physicians may choose to quit medicine rather than reduce quality of care.