Oncology Physician Turnover in the United States Based on Medicare Claims Data

Physician turnover rates are rising in the United States. The cancer workforce, which relies heavily on clinical teamwork and care coordination, may be more greatly impacted by turnover. In this study, we aimed to characterize oncologists who move to identify targets for recruitment and retention efforts.

We identified medical, radiation, and surgical oncologists who treated Medicare beneficiaries diagnosed with breast, colorectal, or lung cancer in 2016-2019. We used multivariable logistic regression to identify physician-level and multivariable multinomial regression to identify region-level characteristics associated with turnover. Measures included demographic, practice, and patient-sharing network characteristics.

Our cohort included 25,012 medical, radiation, and surgical oncologists, of which, 1448 (5.8%) moved. Women [vs men; odds ratio (OR): 1.46; 95% CI: 1.30-1.64] and surgeons (vs medical oncologists; OR: 1.17; 95% CI; 1.04-1.33) had higher odds of moving. Compared with oncologists with moderate patient-sharing ties, those with many ties had lower odds of moving (OR: 0.55; 95% CI: 0.43-0.70). Patient-sharing networks with low efficiency (vs moderate) were more likely to have a net loss in their oncology workforce (OR: 3.06; 95% CI: 1.12-8.35), whereas those with low specialist vulnerability (vs moderate) were less likely to have a net loss (OR: 0.32; 95% CI: 0.1-0.99).

This study identified novel patient-sharing network characteristics associated with turnover, providing new insights into how the structural features of patient-sharing networks may be related to the recruitment and retention of oncologists.