PCP Turnover, Burnout Generated $979M in Excess Healthcare Spending

Primary care physician turnover, triggered in part by clinician burnout, led to around $979 million in excess healthcare spending, according to a study published in Mayo Clinic Proceedings.

Care continuity between patients and their primary care physicians can be critical to maintaining positive health outcomes and high satisfaction levels. Continuous primary care can also help keep healthcare costs low, as it limits patient use of specialty, urgent, and emergency care services.

Primary care physician turnover can disrupt continuous care for patients and lead to higher spending from patients and payers alike. Physician burnout is a driving factor behind turnover in the healthcare industry.

To understand the excess healthcare spending that results from both general and burnout-related primary care physician turnover, researchers gathered data on physicians, Medicare patients, and non-Medicare patients between October 12, 2017, and March 15, 2018.

Researchers used previously estimated figures on patient spending and previous physician data that estimated the prevalence of burnout and intention to leave their current practice.

According to the study, Medicare patients generated an excess of $189 of healthcare spending in the first year after losing a primary care physician to turnover. Non-Medicare patients generated an average excess of $61.

After combining the excess expenditures from Medicare and non-Medicare patients, the researchers estimated that primary care physician turnover generated $86,336 per physician in extra spending in the first year following the turnover.

Using previous physician data, researchers estimated that 25 percent of physicians who expressed an intent to leave their practice would follow through. Subsequently, they determined that 11,339 primary care physicians would leave their current practice each year.

Using the excess spending generated from physician turnover and the number of physicians expected to leave their practice, researchers found that primary care physician turnover resulted in $979 million in excess healthcare spending each year.

A good portion of this turnover is a result of physician burnout, according to the study.

Out of the total 316,471 primary care physicians included in the study, researchers found that 152,205 are likely to experience burnout. They determined that physicians who experience burnout are 2.16 times more likely to intend to leave their practice.

The departure rate for primary care physicians without burnout was 5.27 percent, while the departure rate for physicians with burnout was 9.22 percent. Thus, the researchers deduced a 3.95 percent turnover risk attributable to physician burnout.

This means that 3,006 primary care turnovers each year were because of burnout. These burnout-related turnovers generated $260 million in excess healthcare spending—27 percent of the total excess spending due to turnover.

The study results suggest that reducing physician burnout could help decrease physician turnover and cut down on unnecessary healthcare expenditures.

“Although widespread, the current high levels of physician burnout are not inevitable. Interventions to improve practice efficiency, such as through advanced models of team-based care with in-room support, can reduce burnout,” the study stated. “Likewise, interventions to improve organizational culture, including interpersonal connections with colleagues and improved local leadership, can improve professional fulfillment and reduce burnout.”

Certain practices in the healthcare industry have increased physician burnout and turnover. For example, a past report from athenahealth revealed that providers at facilities undergoing a merger or acquisition were less likely to stay at their practice and more likely to experience burnout.

Additionally, the COVID-19 pandemic exacerbated physician burnout, especially in the primary care setting.

The healthcare industry has faced high levels of staffing shortages since the start of the pandemic. Physicians and administrators agreed that burnout was a driving factor behind their desire to leave their organization, with a handful citing the pandemic as the cause of their burnout.