March 2006
Medical Care
, Vol. 44, No. 3
Bruce Landon, James D. Reschovsky, Hoangmai H. Pham, David Blumenthal
Over the past decade, a confluence of forces has changed the practice of medicine in unprecedented ways. Anecdotal reports suggest that, in response, some physicians are leaving the practice of medicine or retiring earlier than they otherwise would have. This paper examines how physician demographic characteristics, practice characteristics, and career satisfaction are related to physician decisions to leave the practice of medicine or substantially cut back their practice hours. By using disposition codes in the CTS physician survey for physician selected for reinterview, this paper identies physicians who become ineligible for the survey because they provide less than 20 hours of direct patient care or because they retired. This allows us to examine precursors to these decisions. The findings demonstrate that dissatisfied physicians were two-three times more likely to leave medicine than satisfied physicians. Other factors, such as income and specialty are also related to decisions to "leave medicine." Indicators of clinical autonomy or ability to provide quality care were not found to be related.
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