Female physicians were more likely to leave clinical practice than male physicians, with a 1.43 likelihood of attrition across ages, specialties, and practice settings in a nationwide longitudinal study.
Among physicians who left clinical practice, female physicians exited at younger ages. The median age at attrition was 49 years for female physicians vs 64 years for male physicians, with consistent patterns across specialties and locations.
The higher likelihood of attrition among female physicians was observed in both rural and urban settings, at 1.42 and 1.43, respectively. Across specialties, the likelihood of attrition for female vs male physicians ranged from 1.26 in hospital-based specialties to 1.72 in psychiatry. Estimates were 1.55 in primary care, 1.41 in ObGyn, 1.38 in medical specialties, and 1.32 in surgical specialties.
Unadjusted rates were also higher overall among female physicians, at 4.57 exits per 100 person-years vs 4.33 among male physicians. Rates varied by specialty, with the highest overall observed in ObGyn followed by psychiatry, and were higher in rural compared with urban settings.
Using Medicare administrative data from 2013 to 2023, researchers evaluated time to clinical practice attrition among physicians who provided care to Medicare patients. Attrition was defined as at least 3 consecutive years without meeting a threshold of 50 or more evaluation and management services. The cohort included 707,934 physicians, of whom 31% were female, reported Lisa S. Rotenstein, MD, of the University of California at San Francisco, and colleagues.
The analysis was based on Medicare fee-for-service claims and may not capture all clinical activity, including physicians who do not treat Medicare patients or those who transition to nonclinical roles. The threshold used to define active practice may also misclassify physicians with low clinical volume.
“US female physicians are significantly more likely to leave clinical practice than male counterparts at every age, across specialties and practice locations,” the researchers wrote.
Disclosures: Dr. Rotenstein reported funding from the Physicians Foundation. Several researchers reported support from the Centers for Medicare and Medicaid Services. Additional grants, advisory roles, and equity interests were reported.