One in seven Swiss physicians has left patient care - results from a national cohort study from 1980-2009

Abstract

AIMS OF THE STUDY: Physician shortage is problematic, but the percentage of physicians who left patient care in Switzerland is unclear. We set out to describe this percentage and determine whether gender or language region was associated with leaving patient care. METHODS:We analysed the National Registry (Medreg) of all physicians who graduated between 1980 and 2009 in Switzerland. Based on the last known working status noted in Medreg, physicians were classified as "probably involved in patient care" or "potentially left patient care". We drew an unrestricted random sample of 250 from each category. We searched professional directories / social media to classify each sample. Those with undetermined status received a questionnaire that asked their working status. We quantified the percentage of physicians who left patient care and used Poisson and Cox regression to determine rates and the association of leaving patient care with gender, language region, and year of graduation. RESULTS: We identified 23,112 living physicians in Medreg in 2015. Of these, 18,406 (79.6%) were probably involved in patient care and 4706 (20.4%) had potentially left patient care. In the random sample of 250 physicians probably involved in patient care, 237 were involved in patient care, 11 had left and the status of 2 was undetermined (0.8%). In the random sample of 250 physicians who had potentially left patient care, 109 were involved in patient care, 109 had left, and the status of 32 was undetermined (12.8%). We estimated that 13.6% of physicians had left patient care (95% confidence interval [CI] 11.1-16.1%). According to the most realistic scenario, the rate of physicians who had left patient care was 1.2 per 100 physicians/year (95% CI 0.9-1.6) for those who had graduated between 1980 and 1994, and 1.8 per 100 physicians/year (95% CI 1.4-2.3) for those who graduated between 1995 and 2009 (adjusted hazard ratio 1.74, 95% CI 1.12-2.71). There was no evidence that the risk of leav-ing patient care was associated with gender or language region.CONCLUSIONS: Approximately one in seven physicians in Switzerland who graduated between 1980 and 2009 left patient care. Leaving patient care was not associated with gender, but the probability of leaving patient care was increased considerably in physicians who graduated more recently. Interventions that aim at keeping physicians in the work force and encourage their return to practice are sorely needed.

Motivation and personality factors of Generation Z high school students aspiring to study human medicine

“…In our survey, more than a third of future Gen Z physicians see their professional future in a hospital. Most physicians make their career choices early on during residency [48], and during this period a considerable proportion of them leave the field of medicine [3]. To keep the medical profession attractive for the future, a first step might be to obtain more insight into the reasons for highly stressful working conditions, so as to gain a better understanding of challenges to clinician well-being.…”

“…The next generation of physicians is urgently needed [1]. Many residents of the current generation (Generation Y, or Millennials, born 1980 to 1995) are not satisfied with their work-life balance, and they seem to be a vulnerable population regarding mental well-being, burnout, and quitting patient care, as found by various Swiss [2][3][4] and international studies [5][6][7]. A new generation of students, Generation Z (Gen Z, born 1995 to 2010), is becoming the predominant population at university and will join the workforce in a few years' time [8].…”

Factors associated with health professionals’ stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations

“…There are multiple studies regarding stressors, stress reactions, and long-term consequences among health professionals working in different management levels [ 23 , 24 ], professional roles [ 2 , 3 , 21 , 25 ], or work areas [ 14 , 26 , 27 ]. However, most studies focus on one specific work area (e.g., acute care hospitals or nursing homes) [ 3 , 15 , 19 ] or on only one specific health profession (e.g., nurses) [ 14 , 28 ].…”

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China

“…On one hand, the experience of workplace violence can detrimentally impact on employees’ mental health and quality of sleep, while also exacerbating symptoms of depression and burnout [ 6 , 9–11 ]; on the other hand, workplace violence in healthcare settings is associated with decreased job satisfaction and increased turnover intention of employees [ 12 , 13 ]. Therefore, early detection and prevention are necessary, especially given the global concern about physician shortages [ 14 , 15 ].…”