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Analysis: Exodus of health care workers continued in 2022

Written on Oct 27, 2023

More than 145,000 health care providers left the industry from 2021 through 2022, according to a report from Definitive Healthcare. 

Physicians had the highest number of exits, accounting for almost half of departures during that period. Nurse practitioners followed with an estimated 34,834 quits. 

In some cases, staffing shortages may lead to decreased quality of care and increased medical errors, the report concluded, but health care facilities can mitigate the impacts of the staffing shortage by consolidating operations or investing in telehealth. 

Provider quits varied by role, specialty and geography, according to the report’s analysis. 

The high quit rates of physicians and nurse practitioners could be due to their proximity to the COVID-19 pandemic, the report said. 

Often, physicians and nursing staff were on the front lines of the pandemic, working in direct contact with vulnerable populations. As a result, they were more exposed to the negative effects of the pandemic, including a fear of infection, untenable hours, depression and stress, the report said. 

Internal medicine and family practice physicians accounted for more than 16,000 of the 71,309 doctors who left the field by 2022, according to the report. 

Other specialists, such as those in optometry, obstetrics and gynecology, and anesthesiology may have exited their professions due to challenges converting to telehealth and lost revenue associated with the infeasibility of in-person appointments during the height of the pandemic. 

The staffing shortages were most critical in South Carolina, Maryland, Michigan, Delaware and Virginia.  

Physicians reported high levels of burnout last year, which may indicate that turnover will remain elevated, the report suggested. Burnout has long been identified as a risk factor for attrition. As of 2019, burnout cost the industry $4.6 billion in turnover and reduced productivity. 

Data showed burnout was partially explained by increased workloads related to staffing shortages. It was also associated with poor work-life balance and increased time spent on paperwork. 

Staffing shortages may lead to decreased quality of care and increased medical errors. In a 2022 study cited in the Definitive Healthcare report, 34% of doctors worldwide said medical errors increased when their units were short staffed. Patient care can also be disrupted or delayed, according to the report.  

The problem is often worse in rural hospitals. In one survey of rural providers cited in the report, 27% of respondents said that nurse staffing-related issues led to the suspension of services at their facility. 

Some hospitals are considering consolidating in order to reduce overhead supply and labor costs and offer operations at scale. However, a recent study from insurer Elevance Health found that mergers are typically associated with diminished quality of care. The study reported post-merger patients tend to pay higher commercial insurance prices and experience higher readmission rates. 

The Definitive Healthcare report recommends hospitals invest in technologies and services like telehealth that allow providers to see patients with less-severe conditions virtually. Research has linked telehealth to a reduction in facility operating costs and lower readmission rates, the report said. 

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