Cassandra Kelleher, MD, and Ya-Wen Chen, MD, MPH, physician-scientists in the Department of Surgery at Massachusetts General Hospital, and an Associate Professor (CK) and an Instructor (YWC) of Surgery at Harvard Medical School, are the senior author and first author of a new study published in JAMA Network Open, Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019
What Question Were You Investigating?
We investigated the difference in rates of leaving academia between male and female physicians.
Physicians practicing in academic hospitals (such as Mass General) are expected to treat patients, conduct research to improve treatments for future patients and train future physicians. A difference in attrition rates from academic practice, therefore, may endanger the quality of medicine in the future.
What methods or approach did you use?
We used Care Compare data from the Centers for Medicare and Medicaid services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019. This was a novel way to track workforce attrition and allowed us to track nearly 300,000 physicians who work in academic hospitals across the US for five years to see if they left academic practice.
What Were Your Findings?
Over a five-year study period, the overall attrition rate was 38.3% for female physicians compared to 32.4% for male physicians. And female physicians had higher rates of attrition across every career stage: 40.5% female vs 34.8% male among junior career physicians (less than 15 years of experience), 36.4%. vs 30.3% among mid-career physicians (15-29 years of experience), and 38.5% vs. 33.3% among advanced-career physicians (30+ years of experience)
What Are the Clinical Implications?
Diverse individuals introduce novel ideas to a field. Women, for example, are more likely to practice patient-centered care, and through their teaching and research work at academic medical centers, they help to disseminate and normalize novel approaches to practicing medicine. Therefore, our study has important implications for the future quality of care in medicine.
What are the Next Steps?
Despite equal numbers of women and men graduating from medical school, the higher attrition rate from academia for women ultimately means the leaky pipeline leads to decreasing representation of women in the academic workforce. Our study adds to the literature by addressing hypotheses that have been proposed to explain why women have higher rates of attrition from academia.
For example, it is often suggested that family obligations are the main factor associated with female physicians leaving academic hospitals. However, we found that higher attrition rates for women persisted throughout all career stages, suggesting that family obligations are unlikely to explain this gender disparity.
With the physician shortage projected to reach 124,000 physicians by 2034 and the cumulated resources that are needed to train and recruit physician in academia, interventions to retain physicians—especially female physicians—are crucially needed.
Our current research focus includes identifying new ways to retain female physicians in the academic healthcare workforce and conducting further investigations into the drivers of attrition for female physicians.
Chen, Y. W., Orlas, C., Kim, T., Chang, D. C., & Kelleher, C. M. (2023). Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019. JAMA network open, 6(7), e2323872. https://doi.org/10.1001/jamanetworkopen.2023.23872
About the Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.