Burned Out, Buried in Paperwork: Why Doctors Are Walking Away From Medicine Sooner

Doctors Are Leaving Clinical Practice Earlier, With Women Leading The Trend

America is facing a doctor shortage, and a new national survey adds a worrying piece to the picture. Many doctors who have already stepped back from clinical practice did so earlier than expected. Physicians, particularly women, are leaving patient care sooner in their careers than a similar group of doctors did roughly 18 years ago, and the reasons paint a troubling portrait of a profession under serious strain.

A survey of nearly 1,000 physicians who had stepped back from clinical practice, published in The Permanente Journal, found that the average age at which doctors left was 48.1 years, about nine years younger than the mean of 57.1 years recorded in a comparable 2008 survey. Still, the results come with an important caveat: the response rate was low, and the findings describe doctors who responded to this survey, not all U.S. physicians. Researchers say even a modest shift in when doctors exit clinical practice can significantly shrink the number available to care for patients. According to the Association of American Medical Colleges, a two-year drop in the average retirement age alone could reduce the projected physician supply in 2036 by approximately 40,000.

What’s pushing doctors out the door? According to the survey, it largely comes down to administrative hassle and stress. Nearly half of the physicians who had stopped practicing cited “hassle factor,” the mountain of paperwork and bureaucratic tasks that eat into patient care time, as a top reason for leaving. An almost identical share said the job was simply “too stressful.” For women doctors, the picture was more complicated: they were more likely than men to report leaving because of caregiving responsibilities, personal health concerns, and workplace stress.

How Researchers Identified Doctors Who Left Clinical Practice

Researchers drew from a database maintained by the American Medical Association to identify physicians who graduated from their training programs between 2000 and 2022 and who appeared to no longer be in full-time clinical practice. An online survey went out to more than 61,000 contactable doctors in spring 2024, and 971 responses met the criteria for inclusion.

Among those respondents, nearly two-thirds identified as women, the average age was 45.8 years, and more than three-quarters were married. A plurality had trained in internal medicine or a related specialty. Three groups were captured: doctors who had practiced and stopped, those currently working fewer than 20 clinical hours per week, and those who completed full medical training but never entered independent clinical practice. That last group made up about 11% of respondents.

From the 521 physicians who had practiced and then stopped, the most commonly cited reasons for leaving were “hassle factor” at 44.7% and “too stressful” at 44.5%, followed by “increasingly unrealistic patient demands” and “lack of professional satisfaction.” When respondents wrote in their own explanations, the themes that came up most often were overwork, the appeal of nonclinical career paths, frustration with how health systems are run, and profession-related personal reasons such as burnout and a loss of autonomy.

Notably, frustration with electronic health record systems, digital tools widely blamed for fueling burnout in other research, did not rank among the top reasons for leaving in this study. Malpractice insurance costs, which ranked third in the 2008 survey, also fell off the list entirely, replaced by patient demands as a major driver.

Women Physicians Are Leaving Clinical Practice Earlier Than Men

One of the most telling findings was how differently male and female physicians experienced the decision to leave medicine. Women were far more likely than men to report stepping away from clinical practice to care for young children: 21.7% of women cited this reason, compared to 4.2% of men. Women were also more likely to leave to care for other family members, deal with their own health concerns, and because the job was too stressful.

Women in this sample also had shorter clinical careers overall. Among physicians who had left practice entirely, women had a median of nine years in clinical medicine before stepping away, compared to 12 years for men, a statistically meaningful difference.

This matters even more considering who is entering medicine today. Women now make up more than 55% of new medical students and are approaching nearly half of all doctors in residency training. If women are leaving clinical practice earlier, as this survey suggests, the effect on the overall physician workforce could be substantial.

Researchers point toward a need for targeted action: reducing administrative burdens, giving physicians more schedule control, supporting working parents, and addressing gender disparities in pay, leadership, and workplace treatment.

Doctors Who Trained but Never Practiced

Perhaps the least-examined finding is the group of physicians who finished all of their training, including years of medical school and residency, and then never entered independent clinical practice. Women were disproportionately represented in that group, and the authors say virtually no national research has examined this population before.

For a healthcare system already straining under a projected shortage that could reach tens of thousands of physicians by 2036, that is a largely invisible drain. America’s doctor shortage is not only about training enough new physicians. It is also about keeping the ones already in the pipeline, and this survey suggests that effort is falling short.

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Disclaimer: This article is based on an observational survey study and reflects the responses of a self-selected group of clinically inactive physicians. The findings cannot be generalized to all U.S. physicians. Survey results describe associations, not causes, and should not be interpreted as definitive proof of national trends in physician attrition.

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