Becker's Hospital Review

22 CMO / CARE DELIVERY Physicians with the highest attrition rates: Study By Paige Twenter T he rate of physicians exiting clinical practice is increasing, and some specialties have higher attrition rates than others, according to research published Oct. 7 in Annals of Internal Medicine. In a study examining the attrition rate of approximately 72,000 physicians caring for Medicare beneficiaries between 2013 and 2019, researchers found the unadjusted rates of attrition increased from 3.5% in 2013 to 4.9% in 2019. Compared to a hospital-based specialty, physicians at greater risk for attrition were those practicing in psychiatry, primary care, and obstetrics and gynecology, according to an American College of Physicians news release about the study. Female physicians, those practicing in a rural area and those practicing outside of the Northeast region were also associated with a high attrition rate. Attrition rates — as defined by a physician exiting clinical practice without reentry for at least three years — grew among male and female physicians, those in urban and rural areas, those ages 35 and older, and across all geographic locations and six broad specialty categories. e specialty groups included in the analysis were primary care, medical specialty, surgical specialty, obstetrics and gynecology, hospital-based specialty and psychiatry. A similar study published Oct. 1 in the American Journal of Roentgenology examined the attrition rate among radiologists, finding an increase in attrition rates from 1.1% in 2014 to 2.5% in 2022. n 8 predictors of nurse burnout — and how leaders can help By Erica Cerutti R outinely leaving late is the strongest predictor of nurse burnout and is linked to a 2% to 6% higher turnover rate compared to teams on which nurses leave on time, according to a new report from the American Organization for Nursing Leadership and Laudio. The report, "An Early Warning System for Nurse Burnout: Metrics and Strategies," was published Oct. 7 and is based on an analysis of data from more than 95,000 nurses and their managers across more than 150 U.S. hospitals. Three notes: 1. The report identified eight early warning signs of nurse burnout: consistently arriving early; consistently skipping breaks; consistently leaving late; the threshold of nurses who have not taken PTO in six months; consistently calling out; consistently precepting; consistently serving as a charge nurse; and consistently floating. Each of these is associated with a statistically significant higher likelihood of turnover over time, researchers said. 2. While nurse staffing levels have improved, individual workloads have intensified, which has led to several of the burnout indicators increasing the past several years, according to the report. "These early signs often go undetected by traditional staffing metrics and reactive data, which can overlook the nuanced and unsustainable workload and wellness patterns influencing nurse retention," the AONL said in an Oct. 7 news release on the findings. 3. The report recommends more than 30 interventions for nurse executives and managers to better support their workforce. The recommendations are organized around two key leadership priorities that researchers identified through interviews with nurse leaders. Nurse executives' two core areas of focus should be to build visibility into early signs of burnout and design more sustainable roles and workflows. At the same time, nurse managers should focus on developing a better understanding of their teams and leveraging support roles. n quietly. "It's a whole different ball of wax, and we have a lot more documentation on the inpatient side," Dr. Rocchio said. "It's not even the same product … which is why it's taken Microso a little bit longer to roll this out than they did DAX." Dr. Rocchio foresees ambient listening for documentation eventually becoming the norm for nurses, especially as the EHR moves onto mobile devices. She believes this type of VR training could one day be done in nursing school. "It really is the base technology for opening up even more ways and pathways for nurses to spend more time at the bedside and get more documentation done, or actually be able to look for information in the EHR by speaking and looking for things, rather than having to search on a computer," she said. "It's going to be one of the more significant change management things that we do in nursing." n

• Cover