A new study in the Annals of Internal Medicine found that nearly 5% of U.S. physicians left clinical practice in 2019, representing a 40% increase in just six years.
It confirms what every practicing doctor already knows: America’s physicians are burning out, checking out, and getting out, with female physicians and those in rural areas being the most likely to exit.
The study, conducted by Rotenstein and colleagues from Yale, UCLA, and UCSF, examined over 700,000 physicians who treated Medicare patients and found that doctors caring for older, sicker, and poorer patients were more likely to leave the profession. Although the paper is descriptive rather than prescriptive, the message is clear — the medical profession is hemorrhaging.
Medicine has become the only profession where the customer isn’t the patient, the boss isn’t the doctor, and the computer always wins.
The reasons for this mass departure aren’t mysterious; they’re baked into the system.
For many doctors, it’s death by a thousand clicks. The modern doctor’s day is no longer defined by caring for patients but about feeding the bureaucratic beast. Electronic health records were promoted as time-savers, but they quickly became time thieves.
For every hour of patient care, physicians spend nearly two hours on documentation and desk work. None of it enhances health care, but all of it keeps lawyers and administrators satisfied. Sacrificed are evenings with family, replaced by late-night charting marathons to satisfy billing requirements.
Then there’s malpractice anxiety, the ever-present sword of Damocles. Roughly one in three physicians has faced a lawsuit at some point in their career. Even in states with tort reform, a single bad outcome or an opportunistic attorney can bring years of stress and financial burden.
The result is “defensive medicine,” where tests and referrals are ordered not because patients need them but because lawyers might. There is also the psychological stress. Any physician who has been sued, whether the case had merit or not, carries that scar forward. Every future patient becomes a potential plaintiff.
Add to that decreasing reimbursements and increasing costs. Medicare physician payments have fallen 33% since 2001 after adjusting for inflation, while practice expenses have risen 59% during the same period.
Insurers set payment rates that barely cover overhead, while inflation, staffing shortages, and mandatory technology upgrades push expenses higher. Independent physicians, those who still see medicine as a calling rather than a corporate job, are selling out to hospitals.
According to the AMA, “The share of physicians working in private practices in 2024 was 42.2 percent, a decline of 18 percentage points from 60.1 percent in 2012.” In other words, less than half of doctors remain in private practice.
Private equity’s involvement in medicine has surged. Their approach is straightforward: Acquire practices, increase productivity, cut expenses, and sell for profit. For doctors, this translates to more metrics, less independence, and ongoing pressure to see more patients in less time. The outcome isn’t about efficiency — it’s corporatized medicine, where healing becomes a profit center and burnout a rounding error.
Blue Cross Blue Shield now uses AI algorithms to cut payments to doctors they believe are overcharging for their most complex patients. Yet politicians face no such “adjustments” for their own ongoing fiscal malpractice.
Surveys reveal that approximately 45% of U.S. physicians currently report symptoms of burnout, and 1 in 5 doctors plan to leave clinical medicine within the next two years.
