Clinician turnover abates, but impacts of pressure are affecting care
A study suggests that unresolved problems are being exhibited in persistent capacity constraints, talent shortages and exhaustion.
Clinician turnover and burnout have been two of the core issues threatening healthcare, with staffing trends already having been exacerbated by the COVID-19 pandemic.
However, there are growing indications that some of the churn caused by revolving-door policies to staffing are abating. But a recent report suggests that some of the negative effects of staffing upheaval remain, including restrictions on access, rising cost pressures and inconsistent outcomes.
Still, the suggestion that staff churn is abating suggests that healthcare organizations are improving efforts to find appropriate clinicians and staff, and then keeping them happier and willing to stay where they are.
Survey results
Lotis Blue and SullivanCotter collaborated efforts to gather and analyze responses from more than 1,000 patient-facing clinicians from more than 300 organizations nationwide on factors related to retention, turnover and job dissatisfaction. The study and ensuing report, “The Science of Staying: The Next Chapter in Clinician Retention,” sought responses from physicians, advanced practice providers, nurses and other clinical roles.
The study sought to identify the core drivers of retention, the root causes of turnover and dissatisfaction, and take a deep-dive into retention dynamics that specifically apply to these groups.
The findings suggest that 70 percent of medical groups report that turnover “has stabilized but not improved.” Healthcare employment, the researchers say, is now characterized less by “continued mass exits and more by persistent capacity constraints, talent shortages and exhaustion.”
SullivanCotter data show modest declines in voluntary physician turnover since 2023, while advanced practice provider turnover has stayed flat. Researchers call this “stabilization without meaningful improvement … the workforce is no longer deteriorating at crisis levels, but it has not meaningfully recovered.”
Data show 80 percent of clinicians surveyed intend to stay, while 11 percent are considering leaving and 9 percent had quit a healthcare job in the past year, which is “down sharply from a 19 percent quit rate” in a previous study by the researchers. Of clinicians leaving a job, nearly six in 10 were driven by job-related factors, a rate that’s been increasing, researchers contend.
Clinicians in their first year of service are significantly more likely to leave, which analysts say underscore the outsized impact of onboarding, early workload design and early support.
So good news for organizations, but not necessarily for the clinicians themselves, they conclude. “Many clinicians experience this ‘stability’ not as relief, but as sustained strain.”Healthcare systems still are facing staffing headwinds because the field is experiencing attrition and early retirement.
“According to the U.S. Bureau of Labor Statistics, nearly 190,000 registered nurse openings are expected annually through 2033 … meanwhile, the Association of American Medical Colleges projects a deficit of nearly 90,000 physicians by 2036,” the report notes.
Predictive factors
In analyzing employee value propositions that influence retention, researchers found that factors involving the foundations of an organization are most influential in clinicians’ decisions whether to stay or leave.
They found a 24 percent response rate mentioning organizational factors, a 22 percent rate on the care environment and an 11 percent response rate for those saying job demands are influencing quit or stay decisions.
Factors such as compensation, scheduling and benefits have far less impact on quit-or-stay decisions, survey data show.
By contrast, factors that increase the likelihood of staying include high job stability (mentioned by 76 percent), positive relationships with co-workers, meaningful work and feeling trusted to use clinical discretion, all mentioned by 68 percent.
And the freedom to express clinical discretion is rated as one of the most influential factors in affecting physicians’ decisions about staying or leaving. However, physicians are more heavily influenced by total compensation and benefits than in quit-or-stay decisions, compared with nurses and advanced practice providers.
Nurses place priority on schedule (mentioned by 16 percent) as a meaningful differentiator, while advanced practice providers place the most importance on whether day-to-day work is sustainable and whether they can expect visible growth and progression.
What should change in 2026
Healthcare organizations must recognize that, even though turnover may have abated in recent months, ;the workforce is still feeling stress and may react to perceptions that their well-being is not being taken into account.
“Health systems are contending with a workforce that is exhausted, discerning and increasingly willing to act when the psychological contract with their employer breaks,” researchers conclude.
Researchers identify eight imperatives that want to rebuild capacity, trust and long-term workforce resilience.
Fred Bazzoli is the Editor in Chief of Health Data Management.