The toll of COVID-19 burnout: 2 of 5 nurses, 1 of 5 doctors plan to leave practice

Healthcare leaders have said burnout in their staff ranks as one of their most serious concerns, and a new study provides ample reason for their worries.

At least one in five doctors (23.8%) said they plan to leave practice within two years due to the stress and exhaustion they’ve endured in the COVID-19 pandemic, according to the study published in Mayo Clinic Proceedings. Two out of five nurses (40%) also said they plan to leave in two years.

“If these clinicians follow through on these intentions, this has significant implications for the future health care workforce,” the authors wrote. “Burnout, workload, and COVID-19–associated stresses were associated with intent to reduce hours or leave, whereas feeling valued was strongly associated with lower odds of reducing hours or leaving.”

If some of those doctors follow through with their desire to walk away, it would only add to the nation's physician shortage.

The study, which was led by the American Medical Association, evaluated responses from 20,665 participants at 124 institutions. Workers were surveyed between July 31 and December 31, 2020. They were asked about workloads, burnout and anxiety or depression tied to COVID-19.

Overall, about 1 in 3 clinical healthcare workers, including doctors and nurses, said they planned to reduce their hours within the next year. The survey found 34% of nurses said they planned to work fewer hours in the next 12 months, while 31% of doctors planned to work less in the coming year.

Hospital leaders across the country have pointed to staffing challenges as they struggle to deal with the latest wave of COVID-19 cases and hospitalizations.

Most have cited the shortage of nurses as the prime problem in staffing. Some have left for other careers or for family reasons, while some have opted to pursue opportunities as traveling nurses, which has become an increasingly lucrative choice. Healthcare leaders say some nurses, doctors and other hospital staff have opted for early retirement.

Previous studies have indicated when doctors experience burnout, they are more likely to trim their hours or stop practicing altogether.

The new AMA-led study showed those who felt highly valued by their organizations were less likely to reduce their hours or leave. Roughly three out of four healthcare professionals (74%) who felt highly valued said they did not intend to leave their practice within the next two years.

The study found administrators were the least likely to express plans to walk away within two years, with only 12.6% saying they planned to do so.

For healthcare providers, replacing doctors and nurses tends to be an expensive proposition, the study notes. Replacing a doctor can cost anywhere from $250,000 to $1 million per physician, the study noted. To replace a nurse, it can cost 1.2 times to 1.3 times a nurse’s salary.

Nationwide, the cost of physicians cutting their hours due to burnout is estimated at $4.6 billion annually, the study noted.

Healthcare providers must ensure doctors, nurses and clinical staff have access to confidential mental health services, the authors said.

Healthcare organizations also should aim to reduce the workload as much as possible through better teamwork, the study said. Providers should strive to create more efficiency and improve their workplace culture to help ease stress and burnout in their staff.

The COVID-19 pandemic has dealt disporportionate setbacks to the careers of women physicians, according to a separate study published last month.