A review of physician turnover: rates, causes, and consequences.

To assess current knowledge about physician turnover, this article reviews the available literature regarding the rates, causes, and consequences of physicians' leaving a practice. Reported rates of turnover vary widely, both because of differences in reporting methods and by type of healthcare organization and provider. A common contributor to turnover is a mismatch between physicians' expectations and organizational culture or rules, although greater understanding of ways to assess and to predict such mismatch is needed. The costs and consequences of physician turnover are substantial and may include: (a) financial consequences, (b) effects on patient satisfaction, and (c) effects on the organization or practice as a whole, related to the experience of other healthcare providers, and effects on institutional public relations. Our review suggests that greater attention to physician turnover is needed to clarify its frequency and predictors, and strategies to lessen its occurrence.