PCP turnover raises annual medical spending by $1 billion: study

Turnover among primary care physicians (PCPs) adds an estimated $1 billion to the health care spending annually, of which more than $200 million is due to burnout-related turnover, according to results of a new study.

Using physician surveys and publicly available data, the authors estimate that about 11,300 PCPs leave practice each year, and that 3,000 of these departures are due to burnout. They also estimate the average PCP patient panel size, the number of Medicare and non-Medicare patients in each panel, and the excess per-patient expenditure for both types of patients ($189 for Medicare patients and $61 for non-Medicare) in the first year after their PCP leaves practice.

Based on this data, they conclude that excess spending per departing PCP totals about $86,300 in the year after the PCP leaves practice, leading to $979 million in annual excess health care costs, of which 27%, or $260 million, is due to burnout.

According to the study’s authors, the loss of care continuity resulting from PCP turnover can raise spending in several ways. Among these are patients turning to emergency departments for care rather than getting it in an outpatient setting, or replacing primary care with lower-value, non-primary care.

These costs, the authors note, don’t include other consequences of physician burnout, such as reduced patient satisfaction, lower quality care, and the resulting increase in medical errors and medical malpractice claims.

They add that hospitals and practices can take steps to improve satisfaction levels and reduce burnout among the doctors they employ. Among these are greater use of team-based care with in-room support, more opportunities for interpersonal connections among providers, and promoting participatory leadership and teamwork.

The study, “Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis” was published online February 26 in Mayo Clinic Proceedings.