Are you seeing more health care workers planning to leave medicine?

"We’ve had no trouble recruiting because we focus on creating a positive culture with our team," says 1 urologist.

“I’m a bit more insulated because I started a new solo practice in August 2020 at the start of the pandemic when a lot of doctors went to hospitals and big groups for security. I’m doubling down on ‘smaller’ and customer service. I see colleague burnout, I hear about it, but I’m not experiencing it, nor is my team.

I’ve never been happier. Part of my frustration [with] being part of bigger private practices, hospital employed, and multispecialty groups was I didn’t have autonomy, so it’s been fantastic opening my own practice.

We’ve had no trouble recruiting because we focus on creating a positive culture with our team.

That being said, I’m in Nashville, where everybody and their mother are moving to. Our practice has a unique, family feel that people find different than other organizations. People like to be appreciated.

Much of my office staff works from home. Being flexible with people’s work-life balance helps me find and retain good people.

I hear doctors are unhappy and that’s trickling down to the staff. More administrative burdens, increasing overhead, and decreasing reimbursements. I have colleagues who have decided they made enough money and are going to retire.

An excellent urologist in the Southwest had to [close] his office completely because he had no more employees. A lot of young urologists are unemployed by choice. Some are doing locums work and doubt they’re going back to traditional practice because of these issues.”

Joseph Pazona, MD

Nashville, Tennessee

“More people are retiring or leaving for something else than in the past, although it’s hard to quantify that.

One reason physicians are unhappier is the loss of autonomy. Physicians join hospitals or large groups, but in doing that, they’re losing autonomy.

I’m one of 12 urologists in a multispecialty group of 150 providers. I was part of a 4-person, private-practice urology group. Joining the large multispecialty was the only way to have any say against Intermountain Healthcare. They try to control everything, and unless you have enough doctors together, you have no say at all. It’s not like we’re going to push them around even now, but at least they have to deal with us. Otherwise, they’d just pick everybody apart and do whatever they wanted. If we could do what we preferred, we would probably be just a urology group.

We are definitely losing staff people. Some go to other jobs because they can make more money because other practices can’t find people either. No doubt, that’s been a challenge for us.

To try to keep or recruit staff, we’ve had to increase our pay and then try to be nice to them—I mean, we always try to be nice, but we try not to give them any reason to leave.

More than the pandemic, it’s a general trend—you have big systems telling everybody what they can do. Doctors feel like they’re working harder and making less, yet making more money for the health systems. That’s not a recipe for satisfaction.

A lot of people joined hospital staffs during the pandemic for the stability. But then they were told, ‘You aren’t working as much, so we can’t pay you as much,’ even though the hospitals were collecting a lot of federal money.”

Blake Johnson, MD

Salt Lake City, Utah

“We’re actually the third largest medical group in the country, with close to 9000 physicians across 7 states. We’re not seeing the turnover reported nationally, but we’re seeing an uptick. Historically, we’ve had 6% to 7 % physician turnover, but in 2021 that was closer to 11%, higher among advanced providers.

Even before [COVID-19], we had increasing levels of burnout year to year, but [COVID-19] intensified many variables, putting pressure on clinicians. We’re trying to reduce those pressures.

There’s no magic solution. We’re working to decrease administrative burdens on physicians. We’re testing AMBE [advanced multiband excitation] dictation [so that] doctors can actually look the patient in the eye; the entire appointment is recorded. Artificial intelligence generates a note the doctor reads and signs off on. It decreases busywork for doctors and gives them the opportunity to connect with patients in a way [that has been] lost because of the burden of the EMR [electronic medical record].

With the pilot program, we’ve seen a 40% to 60% decrease in documentation time. Doctors are saving 1 to 2 hours a day—which can mean getting home for dinner with your family. There are material benefits to it.

We’re also working to retain nursing and other staff with a program called, ‘Our Caring Way,’ which is a platform to reinforce with our caregivers why they come to work every day [and] why they went into health care. We are focusing on retention. We want to be known as the best place to both get care and give care.”

David Kim, MD

Irvine, California