Physician turnover hits 7-year high

Medical groups reported an average turnover rate of 6.8 percent in 2012, according to the 8th annual Physician Retention Survey from Cejka Search and the American Medical Group Association (AMGA), who released their findings March 18.

The 2012 physician turnover rate rose from 6.5 percent in 2011. It was significantly higher than the lowest rate of 5.9 percent reported in 2009 at the depth of the recession, according to researchers, and exceeded 6.4 percent reported in 2005, the first year data was collected.

Survey respondents also reported turnover of 11.5 percent among advanced practice clinicians (APCs), which includes physician assistants and nurse practitioners. This was essentially unchanged from 2011, the first year APC data was collected.

The Cejka Search and AMGA 2012 Physician Retention Survey was distributed electronically via e-mail to 2,174 medical organizations, representing both AMGA medical group members and non-members. Researchers collected survey data from October 2012 through January 2013, and attained a 3.6 percent survey response rate. Eighty respondents, who collectively employed 19, 596 physicians, reported the 2012 physician turnover data; a subset of 72 groups, who collectively employed 4,213 advanced practice clinicians, reported the APC data.

This increased turnover tracks with improvements in the housing market and recovery in stock prices and marks a shift from physicians delaying relocation and retirement due to depressed home and investment portfolio values, researchers reported.

Medical groups do not expect relief in turnover in the coming year, the researchers commented. The report indicates that competition to hire and retain top performing physicians will intensify as retirement accelerates among an aging physician workforce and health reform increases the demand for primary care.

“The survey findings provide evidence that recruitment and retention continue to be major challenges for health systems,” stated Donald W. Fisher, PhD, president and CEO of AMGA, in a prepared statement. “To rise to these challenges, medical groups are demonstrating remarkable leadership by investing in new staffing and delivery models, building and nurturing their teams in a strategic way, and making accountable care work for their patients and their communities.”

“The implementation of healthcare reform and changing demographics make efficient recruitment and effective retention paramount for medical groups,” stated Lori Schutte, president of Cejka Search, in a prepared statement. “Delivering data and insight points the way toward best practices and drives our industry toward innovative solutions.”

Other key findings from the report:

Highest turnover in late and early years of practice.

  • More than one-third (36 percent) of reporting groups expect the pace of retirements to increase in the coming year, compared with 27 percent with that expectation two years ago.
  • Nearly three-quarters (74 percent) of groups with fewer than 50 physicians said they expect turnover to “stay the same.” However this small group segment is already experiencing the highest rate of turnover among physicians over 64, at 19.4 percent, compared with an average 12.7 percent for physicians of this age in all groups.
  • On the other end of the spectrum, physicians who have recently joined a practice are equally vulnerable to turnover. The average turnover rate for physicians in their second to third year of practice is 12.4 percent and small groups suffer from 20.8 percent turnover among physicians in those early years.

Demand for care teams as intensified

  • More than three-quarters (76 percent) of respondents plan to hire more primary care physicians in the next 12 months.
  • Within that group, 22 percent said they will hire “significantly more” – more than twice the 9 percent reported in 2011.
  • Hiring plans for APCs will also accelerate: 67 percent plan to hire more nurse practitioners and 61 percent plan to hire more physician assistants.  This compares with 49 percent and 48 percent (respectively) in 2011.

Onboarding and mentoring may offer opportunities to improve retention.


  • A significant majority (85 percent) have an onboarding process for physicians, yet only one-third (33 percent) of these groups stated that their process is formalized through an onboarding committee or task force.
  • Groups who assign a mentor during onboarding reported a lower overall turnover rate of 6.0 percent compared with the 6.8 percent average turnover rate for all groups.
  • Extended onboarding correlates to higher retention of physicians in the early years with a practice. Groups that provide a year-long onboarding process reported a turnover rate of 10.5 percent compared with the average 12.5 percent for physicians between two and three years with the practice, when turnover peaks.

An electronic version of the 2012 survey is available to AMGA members for $100 and non-AMGA members for $200.