• Amelia M Bond, Lawrence P Casalino, Ming Tai-Seale, Mark Aaron Unruh, Manyao Zhang, Yuting Qian, and Richard Kronick.
• Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (A.M.B., L.P.C., M.A.U., M.Z.).
• Ann. Intern. Med. 2023 Jul 1; 176 (7): 896903896-903.

BackgroundMedical groups, health systems, and professional associations are concerned about potential increases in physician turnover, which may affect patient access and quality of care.ObjectiveTo examine whether turnover has changed over time and whether it is higher for certain types of physicians or practice settings.DesignThe authors developed a novel method using 100% of traditional Medicare billing to create national estimates of turnover. Standardized turnover rates were compared by physician, practice, and patient characteristics.SettingTraditional Medicare, 2010 to 2020.ParticipantsPhysicians billing traditional Medicare.MeasurementsIndicators of physician turnover-physicians who stopped practicing and those who moved from one practice to another-and their sum.ResultsThe annual rate of turnover increased from 5.3% to 7.2% between 2010 and 2014, was stable through 2017, and increased modestly in 2018 to 7.6%. Most of the increase from 2010 to 2014 came from physicians who stopped practicing increasing from 1.6% to 3.1%; physicians moving increased modestly from 3.7% to 4.2%. Modest but statistically significant (P < 0.001) differences existed across rurality, physician sex, specialty, and patient characteristics. In the second and third quarters of 2020, quarterly turnover was slightly lower than in the corresponding quarters of 2019.LimitationMeasurement was based on traditional Medicare claims.ConclusionOver the past decade, physician turnover rates have had periods of increase and stability. These early data, covering the first 3 quarters of 2020, give no indication yet of the COVID-19 pandemic increasing turnover, although continued tracking of turnover is warranted. This novel method will enable future monitoring and further investigations into turnover.Primary Funding SourceThe Physicians Foundation Center for the Study of Physician Practice and Leadership.

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