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Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019
Ya-Wen Chen1,2, Claudia Orlas1,3, Tommy Kim2,4
1Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
Insights
Female physicians leave academic medicine at higher rates than male physicians across all career stages. This highlights a need for diversity, equity, and inclusion initiatives to address physician attrition.
Area of Science:
- Medical Workforce Research
- Academic Medicine
- Physician Retention
Background:
- Retaining female physicians in academic healthcare is crucial for serving diverse patient populations.
- Understanding gender-based attrition is key to maintaining a robust academic health workforce.
Purpose of the Study:
- To investigate and compare the rates at which male and female physicians leave academic positions.
- To identify gender-specific differences in physician attrition from academic health care.
Main Methods:
- A cohort study analyzed Medicare billing data from teaching hospitals (March 2014-December 2019).
- Physicians who retired were excluded; leaving academia was defined as over one year of no Medicare billing from a teaching hospital.
- Multivariable logistic regression adjusted for physician characteristics and geographic region.
Main Results:
- The study included 294,963 physicians (69.5% male); overall 5-year attrition was 34.2%.
- Female physicians exhibited higher attrition rates (38.3%) compared to male physicians (32.4%).
- Female physicians were more likely to leave academia across all career stages (adjusted OR, 1.25; 95% CI, 1.23-1.28).
Conclusions:
- Female physicians demonstrate a significantly higher likelihood of leaving academic medicine than their male counterparts.
- Findings underscore the need for diversity, equity, and inclusion (DEI) strategies to tackle female physician attrition in academic settings.
- Addressing attrition is as vital as recruitment for achieving gender equity in academic medicine.
Importance:
Retaining female physicians in the academic health care workforce is necessary to serve the needs of sociodemographically diverse patient populations.
Objective:
To investigate differences in rates of leaving academia between male and female physicians.
Design, Setting, And Participants:
This cohort study used Care Compare data from the Centers for Medicare & Medicaid Services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019, excluding physicians who retired during the study period. Data were analyzed from November 11, 2021, to May 24, 2022.
Exposure:
Physician gender.
Main Outcome And Measures:
The primary outcome was leaving academia, which was defined as not billing Medicare from a teaching hospital for more than 1 year. Multivariable logistic regression was conducted adjusting for physician characteristics and region of the country.
Results:
There were 294 963 physicians analyzed (69.5% male). The overall attrition rate from academia was 34.2% after 5 years (38.3% for female physicians and 32.4% for male physicians). Female physicians had higher attrition rates than their male counterparts across every career stage (time since medical school graduation: <15 years, 40.5% vs 34.8%; 15-29 years, 36.4% vs 30.3%; ≥30 years, 38.5% vs 33.3%). On adjusted analysis, female physicians were more likely to leave academia than were their male counterparts (odds ratio, 1.25; 95% CI, 1.23-1.28).
Conclusions And Relevance:
In this cohort study, female physicians were more likely to leave academia than were male physicians at all career stages. The findings suggest that diversity, equity, and inclusion efforts should address attrition issues in addition to recruiting more female physicians into academic medicine.
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