Physician Turnover in the United States

Change in Patient Enrollment After Site Principal Investigator Turnover in Surgical Clinical Trials

This cohort study examines the association of principal investigator (PI) turnover with patient enrollment in surgical clinical trials.

Health care provider movement increased through COVID-19

COVID-19 placed unprecedented strain on the health workforce, raising concerns of increasing worker turnover and attrition. This study explores the use of 2 publicly available Medicare datasets-Provider Enrollment, Chain, and Ownership System (PECOS) and Doctors and Clinicians-to track provider movement across states and organizations from 2017 to 2023. We found an increase in state-to-state movement of providers post-COVID-19, with an initial spike in physician movement in the first year (April 2020 to March 2021). Movement varied across specialties and professions. Between organizations, we saw an initial increase in movement for family physicians but not internal medicine physicians. Overall, provider movement was generally to larger organizations. Our study finds increasing movement of providers in the post-COVID-19 period through the novel use of 2 publicly available Medicare datasets. Tracking health care workforce movement closer to real time is important to understand a changing workforce-with differences across communities-and to guide policies to ensure sufficient workforce and prevent worsening disparities over time.

Drivers of hospital nurse practitioner turnover: A national sample survey analysis

BACKGROUND

Hospital nurse practitioner (NP) turnover is costly and complex.

PURPOSE

Provide a pre-COVID-19 pandemic baseline of hospital NP turnover.

METHODS

A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017. We describe rates of turnover, intention to leave, and reasons for leaving or staying. Using multivariate logistic regression, we examine the association between individual and organizational characteristics and turnover. Survey weights and jackknife standard errors were applied to analyses.

DISCUSSION

Approximately 10% of NPs left their job the following year, and 53% of NPs that remained considered leaving at some point. The top reasons cited for leaving or staying were largely organizational factors. Regression analysis revealed not practicing to one's fullest scope, lower income, lack team-based care, and non-white race were associated with an increased likelihood to leave.

CONCLUSION

We find several modifiable factors associated with hospital NP turnover that can be used to tailor recruitment and retention strategies.

Development of a Universal Advanced Practice Provider Fellowship: A Roadmap to Increase Program Accessibility and Financial Sustainability

Advanced practice providers (APPs) are a growing and essential component of today's health care delivery models. APP fellowship programs have been developed by health care systems to address APP recruitment, retention, and preparedness. However, APP fellowship programs are not widely accessible to most new graduate APPs or experienced APPs who wish to change their specialty. The development of these programs can be costly for health care systems to initiate and maintain. This article discusses the development of a "universal" APP fellowship program that allows for increased program accessibility and financial sustainability for health care systems. [J Contin Educ Nurs. 2024;55(1):4-6.].

Addressing Eldercare to Promote Gender Equity in Academic Medicine

This Viewpoint argues for an expansion of paid family leave policies to include eldercare as a way to support the well-being of faculty members, retain physicians, and promote gender equity in academic medicine.