More than 1 in 5 physicians reported plans to reduce their clinical hours in 2024, although intentions to both reduce hours and leave their organizations declined compared with levels reported during the COVID-19 pandemic, according to a large serial cross-sectional study published in JAMA Network Open.
The study analyzed responses from 37,112 physicians across 160 US health care organizations participating in the American Medical Association’s Organizational Biopsy survey between 2022 and 2024. Included organizations employed at least 100 physicians.
The prevalence of physicians intending to reduce clinical hours decreased from 26% in 2022 to 23% in 2024. Over the same period, the proportion intending to leave their current organization within 2 years declined from 20% to 15%.
Despite these improvements, the authors characterized the findings as “mixed progress.” While intent to leave was lower than levels reported in national studies from both 2014 and 2021, intent to reduce clinical hours remained higher than prepandemic benchmarks (20% in 2014), underscoring ongoing concerns about physician workforce capacity.
Several groups had higher adjusted odds of workforce reduction. Female physicians had higher odds of intending to reduce clinical hours but lower odds of intending to leave their organization compared with male physicians. Part-time physicians and those with more than 20 years in practice had higher odds of both intending to reduce hours and intending to leave. Hospital-based physicians were more likely than primary care physicians to report plans to reduce clinical hours, while psychiatric physicians had higher odds of intending to leave their organization.
Among physicians considering reducing clinical hours, the most commonly cited factors that could influence them to maintain their current workload included improved workflow efficiency, higher compensation, reduced electronic health record burden, less documentation and after-hours work, and more consistent staffing. Among those considering leaving their organization, higher compensation, consistent staffing, and improved workflow efficiency were the most frequently selected factors that could encourage them to stay.
The authors noted several limitations. The study was cross-sectional and did not track individual physicians over time. Outcomes were based on self-reported intentions rather than confirmed behavior, and the median organizational response rate of 42% raises the possibility of selection and nonresponse bias. Additionally, participating organizations determined whether to survey all physicians or selected groups.
The findings suggest that although physician retention indicators have improved since the pandemic, operational pressures – not only burnout – continue to shape physician workforce stability. The authors conclude that addressing factors such as workflow inefficiencies, staffing challenges, compensation, and administrative burden will be critical to sustaining physician workforce capacity.
Disclosures can be found in the study.
Source: JAMA Network Open