A Poor Prognosis: More Than One-Third of Burned-Out U.S. Primary Care Physicians Plan to Stop Seeing Patients

Primary care in the United States is in a crisis, with insufficient primary care physicians to meet patient demand and patients reporting difficulty finding and keeping primary care providers. Further, fewer physicians are entering the field and instead choosing other higher-paying specialties. By 2036, the U.S. is estimated to have a shortage of 68,020 primary care physicians.

In addition to these systemic challenges, individual providers are in crisis. In 2022, more U.S. physicians, particularly younger ones, experienced emotional distress and were burned out, compared to providers in other countries. Research also has shown that family physicians, compared to those practicing other specialties, are more likely to report burnout, characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment.

Other factors — workload, administrative burden, and moral distress — can contribute to heightened feelings of exhaustion and burnout. The U.S. Surgeon General warns that burnout can affect the mental and emotional well-being of providers, leading to depression, stress, and early retirement. It can also have systemwide impacts, like excessive health care costs resulting from turnover and diminished quality of care.

Using data from the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, we assessed the extent to which U.S. primary care physicians experience burnout and how this affects their views of their work and the health system at large.

In our survey, nearly half of physicians reported they were burned out, and over one-third of these burned-out physicians said they plan to stop seeing patients in the next one to three years. Research has found that burnout can directly lead to provider turnover, which could exacerbate shortages and worsen access for patients. Relatedly, dissatisfaction with practicing medicine was significantly associated with burnout. Some research suggests that job satisfaction can protect against burnout.

Research also suggests that cultural factors, such as politicization of science, demoralization among physicians, misinformation, and limited autonomy, may contribute to burnout and shape health workers’ views of the health system. Our results hint at this — significantly more physicians who were burned out rated the U.S. health system poorly compared to those who were not burned out.

When asked about various aspects of their job, the majority of primary care physicians, regardless of burnout, reported being dissatisfied with how they spend their time. Primary care physicians in other countries report similar trends, potentially pointing to broader health care challenges related to unsustainable administrative burdens and workload levels.

Despite overall high rates of dissatisfaction, burned-out physicians were significantly more likely than those who were not burned out to report they were dissatisfied with all aspects of their work. In addition, the amount of time spent at work may be related to burnout. Physicians who worked less than 45 hours per week were less likely to report they were burned out than those who worked more hours (data not shown).

Ultimately, primary care is associated with improved health outcomes, reduced use of costly and avoidable hospitalizations and other services, and reduced health disparities. The significant access and supply challenges facing primary care, which are likely to be exacerbated by physician burnout, are cause for concern. Leaders at every level of the health system have an opportunity to strengthen our primary care system by prioritizing the well-being of primary care physicians.

Federal and congressional policymakers can increase investment in primary care and change how physicians are paid to provide them with sufficient resources and greater flexibility to deliver high-quality care. This would be a shift from the current emphasis on delivering a high volume of services and relatively lower investment in primary care over other specialty services, both of which our survey showed were associated with burnout among physicians. Congress recently proposed such changes, and the Centers for Medicare and Medicaid Services and several states are already implementing payment reform.

Payers can reduce physician burnout by addressing the underlying causes, specifically administrative tasks that pose a substantial burden. The Surgeon General recommends streamlining reporting requirements across payers to reduce duplicative documentation, ensuring quality measurement is meaningful and not overly burdensome, and reducing the burden associated with prior authorization requests by leveraging teams and technology to optimize the process or by revising and reducing requirements.

Health care organization leaders can leverage evidence-based interventions within their practices that can alleviate and prevent the burnout physicians and other providers may face. For example, leaders can optimize technology to minimize administrative burden, like automating tasks or streamlining messages from electronic health records to reduce the amount of time physicians spend responding to messages. Leaders also can implement team-based care models to streamline workloads, by leveraging scribes or nonclinical staff to support documentation and prior authorization requests, for example.