Are Physicians Leaving America?

The physician shortage is not new. Even before the COVID-19 pandemic, we witnessed a steady decline in the number of active doctors in the field.

A significant portion of this medical exodus has more to do with an aging population than anything else. The average age of retirement in the U.S. is 62, and 30% of the physician workforce has already celebrated their 60th birthday, which means they are also near retirement.

But another side of this shortage is physicians leaving America as a whole. The number of doctors wanting to relocate outside of America has been rising for years now, but it has become more apparent in the past couple of years. Factors such as burnout and dissatisfaction with the healthcare system are commonplace, but some, like gender, also come into play.

The answer is yes, American physicians are looking to relocate to more favorable practicing conditions, based on state laws, the physician shortage and burnout in America, excessive administrative burdens, and increasing governmental intervention.

Today, let’s discuss why physicians are leaving America and what this means for the healthcare system in the U.S and:

• Factors Affecting Physician Productivity
• Rising Trends In Physicians Leaving The Workforce
• The Future Of Medical Care In The U.S.

America: Land Of The Overburdened Physician?

40% of the workforce is looking to exit U.S. healthcare, either permanently to shift careers while staying in America or relocating for greener pastures abroad.

Physicians are overworked, overtaxed, and underpaid, which leads to increasing levels of burnout among the medical fraternity. While those problems have always existed in American healthcare, they increased exponentially after 2020, when the pandemic blew the lid off the long broken jar of healthcare.

Evidence shows that 81% of doctors stated they were burdened with too much work in 2024, citing the physician shortage as a main contributor to them being spread thinner. Part of that is aging. The above-65 population in the U.S. is expected to grow by 45% in the upcoming decade. This also means that two out of five active physicians will be retired in the next five years.

As physician numbers dwindle, the patient load is only increasing. More areas in the U.S. have turned into healthcare deserts due to the lack of primary care institutes, pharmacies, and more. So, the few active primary care physicians are left to deal with the growing pressure of providing care while they are being paid less for the amount of work they put in.

The primary care physician shortage is also a concern, with the AAMA projecting a shortage of 20,200 to 40,400 primary care physicians by 2036. The reason for this is financial, as primary care physicians don’t reap the same benefits as their specialist counterparts despite dealing with additional responsibilities and longer work hours.

So, it comes as no surprise that one out of five doctors plan to quit medicine altogether by 2025 or at least substantially reduce their clinical hours.

Practicing Medicine Locally Or Abroad: The Great Conundrum?

The main problem isn’t that doctors don’t want to continue practicing medicine in the U.S. but rather that the environment is no longer conducive.

Doctors have been sounding the alarm on burnout for years now, but before the pandemic their pleas for help fell on deaf ears. By then, it was too late. Physician demands increased, and we saw burnout levels drop by half for the first time since Covid, but the shortfalls were still there.

Healthcare funding is confusing; In the U.S. we allocated a huge budget to healthcare during the pandemic, around 17.8% of the total Gross Domestic Product (GDP), which according to the Commonwealth is around twice more than your usual OECD country.

In 2023, healthcare spending rose to $4.9 trillion, 17.6% of the total economy, with an 11.5% increase in private health care expenditure, estimated to stand at $11.5 trillion, Medicare at $1.0 trillion, and Medicaid at $872 billion.

Yet, there are some avenues where healthcare is severely underfunded, such as Graduate Medical Education. Graduate Medical Education has a direct link to physician shortages, where expanding it ensures more opportunities for physicians. But the lack of funding means worsening shortages.

Physician autonomy — or rather, the lack of it — has also been the center of conversation lately. Certain policies hinder doctors when dispensing medical aid, causing the system to become less value-based and more for-profit. This demotivates physicians, as they are limited in how they can help patients and have to abide by regulations that don’t always benefit different patient cases.

Healthcare is seeing a shift in the U.S., with a bigger focus on technology and documentation. While updating our medical knowledge is a good thing, the administrative backlog has become a hassle for many. Excessive paperwork and the transition to electronic medical records were stated to be the biggest contributors to burnout, according to Medscape.

And then some policies are controversial for important matters such as reproductive rights and health equity. Ever since Roe V. Wade was overturned, reproductive healthcare has been complicated across the U.S., with many doctors having to refuse basic procedures for patients because of state law variations.

It’s why we are seeing female physicians trying to leave their careers in the U.S. for countries more amenable to women. Thisshift has also bled into health inaccessibility for vulnerable communities, leading to a crumbling healthcare infrastructure.

It isn’t surprising that doctors don’t want to work in the U.S. anymore, considering the many polarizing decisions America has made in these past couple of months. From withdrawing from the World Health Organization to annexing public healthcare services, many doctors don’t feel comfortable about their careers with the government’s current direction in healthcare.

U.S. Healthcare: Where Are The Doctors Going?

Many U.S.-trained doctors believe they can’t continue practicing medicine in the U.S. and are looking for alternatives.

One of the most common answers is up north, in Canada. News sites in Canada confirm that many American board-certified physicians have been applying to work in the country, with states such as British Columbia working on policies to allow them to do so.

But even if they don’t leave the country, physicians aren’t happy to stay in states that are restrictive about healthcare. Many gynecologists are opting to move their practices across the country where they won’t face laws that hinder their work ethics. Meanwhile, others are moving to places that aren’t as overburdened by the lack of public health outreach as others.

The consensus is that American doctors aren’t able to work in healthcare that benefits both them and their patients. With the fragmented nature of public health in the U.S., alongside a corporate-heavy healthcare system, doctors are burnout and exhausted, with little to no career satisfaction.

After all, the U.S. ranks the lowest in both physician compensation and healthcare standards when compared to other countries in the Organization For Economic Co-operation And Development.

All in all, the future of American healthcare is precarious. With so many doctors entering retirement age and even more looking to retire early, we are on the precipice of a serious physician shortage. And this is only worsened by the current economic climate, which is causing uncertainty for our healthcare infrastructure.

This is why physicians are choosing to work outside of the U.S. where their work won’t be as undervalued.

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