Estimates of costs of primary care physician turnover.

作者：Sharon B. Buchbinder, Modena E. H. Wilson, Clifford F. Melick, Neil R. Powe · 发表于：PubMed · 年份：1999 · 被引用次数：175 · 研究领域：Diversity and Career in Medicine、Global Health Workforce Issues、Primary Care and Health Outcomes

OBJECTIVE: To provide estimates of the institutional costs associated with primary care physician (PCP) turnover (job exit). SUBJECTS AND METHODS: A cohort of 533 postresident, nonfederal, employed PCPs younger than 45 years of age, in practice between 2 and 9 years, participated in national surveys in 1987 and 1991. Data from a national study of physician compensation and productivity and data from physician recruiters were combined with PCP cohort data to estimate recruitment and replacement costs associated with turnover. RESULTS: By the time of the 1991 survey, slightly more than half (n = 279 or 55%) of all PCPs in this cohort had left the practice in which they had been employed in 1987; 20% (n = 100) had left 2 employers in that same 5-year period. Among those who left, self-designated specialties and proportions were general/family practice (n = 104 or 37%); general internal medicine (n = 91 or 33%); and pediatrics (n = 84 or 30%). Estimates of recruitment and replacement costs for individual PCPs for the 3 specialties were $236,383 for general/family practice, $245,128 for general internal medicine, and $264,645 for pediatrics. Turnover costs for all PCPs in the cohort by specialty were $24.5 million for general/family practice, $22.3 million for general internal medicine, and $22.2 million for pediatrics. CONCLUSIONS: Turnover was an important phenomenon among the PCPs in this cohort. This turnover has major fiscal implications for PCP employers because loss of PCPs...