Rates of Physician Attrition From Clinical Practice Have Risen Since 2013

Physician -A nationwide, longitudinal study published in Annals of Internal Medicine (2025) examined the rates at which physicians are leaving clinical practice in the U.S., and found that attrition has been steadily increasing since 2013.

What the studies found

A nationwide, longitudinal study published in Annals of Internal Medicine (2025) examined the rates at which physicians are leaving clinical practice in the U.S., and found that attrition has been steadily increasing since 2013.

The study followed 712,395 physicians who provided care to Medicare fee-for-service patients between 2013 and 2022.
In 2013, the unadjusted attrition rate was about 3.5%. By 2019, it had risen to approximately 4.9%.
The rise in attrition occurred across the board: among male and female physicians, urban and rural settings, across all specialties, in all regions, and for all physician age groups above 35.

Which physicians are most affected

The study identified factors and groups more likely to leave clinical practice:

Female physicians are at a greater risk of attrition compared with male peers.
Physicians in rural areas have a higher likelihood of leaving than those in urban settings.
Specialties with relatively higher attrition include psychiatry, obstetrics and gynecology (OB/GYN), and primary care.
Other physician- and patient-panel related factors were also relevant: serving patients with higher risk scores, older average age, higher share of dual-eligible beneficiaries (i.e. patients who qualify for both Medicare and Medicaid).

Additional findings: Emergency medicine and service volume

Another part of the research looked more closely at emergency physicians:

Among emergency physicians, annual attrition rates ranged between 3.1% and 6.6% over the period from 2013 to 2021.
Physicians who ended up leaving emergency medicine showed a decline in their ED (emergency department) service volumes in the year before leaving. On average, they delivered about 12.3% fewer ED services in that year compared to those who remained active.
A substantial fraction (approx. 27.9%) of those who later left practice had reduced their ED service load by more than 50% in the year before exit.
After leaving ED practice, many did not leave medicine entirely but shifted to other settings: urgent care or office-based clinical settings.

Why this matters & implications

Rising physician attrition threatens access to medical care. If more doctors leave clinical practice permanently (or reduce capacity substantially before leaving), patient access—especially in rural or under-served areas—may worsen.
The attrition trend intensifies existing physician shortages. Projections before this increase already estimated large shortfalls of physicians by 2030-2036; increasing attrition will make it harder to meet patient demand.
Physician well-being and system pressures seem to play a big role. The studies point toward burdens like complex patient panels, administrative load, staffing issues, possibly “moral injury” (where physicians feel that systemic constraints prevent them from delivering care as they believe they should) as contributors.

What can be done

Based on the findings, the authors and commentators suggest some actions:

Workforce planning — accounting for attrition trends in projections, especially considering that certain demographics (e.g. rural, female, certain specialties) are more affected.
Interventions to reduce attrition — these might include reducing administrative burden, improving staffing, improving support for patient-panels with complex needs, and ensuring physicians have manageable workloads.
Monitoring service volume — noticing reductions in service as potential early warning signs of impending attrition, especially in emergency medicine.