Radiologists, other docs quitting clinical practice earlier and for different reasons than before

Radiologists and other medical doctors are leaving clinical practice earlier and for different reasons than in generations past, according to new research.

Among 971 clinically inactive docs across all specialties included in the survey, about 63.8% were women at an average age of 46. “Hassle factor” and the profession being “too stressful” were among the top two reasons for leaving practice, cited by 44.7% and 44.5% of survey respondents, respectively. 

Data from similar 2008 surveys had shown that early departure was more likely due to personal health issues, insurance premiums and lack of professional satisfaction. Experts note that these newest findings indicate physicians are leaving practice nowadays more so for reasons related to burnout, chronic workplace stress and administrative burden. 

The research was conducted by the American Medical Association and published May 7 in The Permanente Journal, with support from the Permanente Foundation. 

"We hope that by better understanding what drove these physicians away from the clinical practice of medicine, we might uncover meaningful insights that will help us improve physician professional satisfaction and retention," Sea Chen, MD, PhD, the AMA’s physician director of practice sustainability, former Chicago-area radiation oncologist and the paper's corresponding author, said in a statement.

The study has led to discussions among radiologists and other doctors on social media. C. Michael Gibson, MD, an interventional cardiologist and researcher with Harvard, shared the study results on X.com (formerly Twitter) Tuesday. He noted that the average age of physicians who leave clinical practice in the U.S. is now 48.1 years, about 9 years younger than the age (57.1) observed in a similar cohort in 2008. About 11% of women decided not to even enter practice, he added, citing the new study.

“Unless our medical schools do a better job of screening admission candidates, we won’t have any doctors. If you don’t want to practice FULL time for at least 20–25 years, pick another profession,” Greg Murphy, MD, a practicing urological surgeon and Republican U.S. Congressmen, tweeted in response to Dr. Gibson. 

“Wow. No disrespect, but that comment is so out of touch,” Robert Graziano, MD, a radiologist and past president of the Radiological Society of New Jersey, responded to the representative on Twitter Tuesday. “The loss of independent practices and that autonomy is a far greater concern, with rising burnout leading to earlier retirements. Similarly, that is a multifactorial problem that needs to be addressed,” he added, citing factors including Medicare failing to keep pace with inflation. 

More on the original research 

For the study, Dr. Sea Chen and colleagues at the AMA targeted a sample of clinically inactive docs drawn from the association’s Physician Professional Data repository, who completed residency between 2000 and 2022. They conducted a survey between May and June 2024, with questions assessing education, clinical training and reasons for leaving medical practice. 

Women physicians were more likely than men to have exited medicine due to needing to care for a family member (7.9%) or children (21.3%). More than 1 out of 7 respondents graduated from a medical school outside of the U.S. (14.5%) and almost a third (27.9%) completed their residency in an internal medicine or related specialty. Over half (51.5%) also completed a fellowship. 

Among radiologists included in the survey, 4 were found to have never practiced, alongside 3 radiation oncologists. That’s compared to 107 or 11% across the entire survey. This amounts to about 3.7% of the 17 radiologists included and 2.8% of the 10 radiation oncologists surveyed who never entered medicine. Another 8 rads (1.5%) and 2 radiation oncologists (0.4%) said they currently aren’t practicing after previously doing so (vs. 53.6% and 521 across the entire survey population). 

Chen and colleagues contend that decreasing lengths of clinical careers will negatively impact the physician workforce. This small but “substantial” number of physicians who complete residency but don’t practice will lead to an “outsized effect on the magnitude of the workforce shortage.” Further study is needed to help slow this “leakage” from the workforce, they added.

"As the healthcare system works to further expand the physician pipeline by opening new medical schools and adding more residency slots, it's worth asking whether we should also focus on supporting physicians who are already trained," Chen said in the announcement from The Permanente Journal.