Physicians and long-term care workers lead exodus from health care jobs

A study of more than 125,000 health care workers found that physicians and long-term care workers saw an upward trend in turnover rates. Health care workers employed as aides and assistants had persistently high turnover rates and were experiencing a slow recovery. The study was published on JAMA Network.

Researchers found a four-fold difference in turnover rates between physicians and health aides or assistants. Rates were also higher for health workers with children under five for both sexes and highest among women. By race and ethnicity, persistently higher turnover rates were found among American Indian/Alaska Native/Pacific Islander workers; White workers had persistently lower rates; and Black and Latino workers experienced the slowest job recovery rates.

Throughout the study period, health care workers in hospitals were less likely to turn over than workers in other settings.

Turnover rates varied widely across health care occupations with a nearly four-fold difference between jobs associated with lower wages (eg, aides/assistants) compared with higher wages (eg, physicians). Health aides and assistants had the highest turnover rates throughout the study period. Despite low overall turnover rates, physicians were the only occupational group to see continuous turnover increases over time.

Employment turnover among nearly all segments of the health care workforce has not yet fully recovered from the COVID-19 pandemic, with turnover rates among LTC workers and physicians worsening over time.

Turnover rates were mostly driven by exits from the labor force rather than unemployment. The underlying reasons for why an individual becomes unemployed versus leaving the labor force warrants attention. Being unemployed suggests that individuals are still seeking work, while those who exit the labor force are not, likely because of the availability of other resources (eg, working spouse) to sustain household income. For those exiting the labor force, further work is needed to understand whether workers are involuntarily leaving their jobs and may be marginally attached workers who would like a job only if the circumstances are right.

Researchers say the study suggests that although much of the health care workforce is on track to recover to prepandemic turnover rates, these rates have been persistently high and slow to recover among long-term care workers, health aides and assistants, workers of minoritized racial and ethnic groups, and women with young children. Given the high demand for long-term care workers, targeted attention is needed to recruit job-seeking health care workers and to retain those currently in these jobs to lessen turnover.