Turnover and Reduction of Work Effort

Clinician burnout can lead to increased turnover and reduction of work effort, further straining a health care system struggling to meet access needs.

While the personal toll of clinician burnout is significant, burnout also has notable effects on the sustainability of health care organizations and the health care system as a whole. Burnout can lead to high turnover rates as well as illness, death and lateral abuse from those suffering, further straining a health system already struggling to meet access needs. Burnout may also lead to reductions in work effort due to job dissatisfaction and work-related stress, presenting financial implications from productivity losses in the workplace.

Work-Related Stress and Job Dissatisfaction

Work-related stressors, such as high job demands, poor supervision, high workloads, inadequate staffing, documentation requirements, and unresolved conflicts with colleagues, administration and patients, all impact if and when clinicians will experience the stages of burnout. These stressors can lead to high levels of job dissatisfaction and recent studies have found burnout in physicians to be independently associated with job dissatisfaction and increased odds of intent to leave for reasons other than retirement.  Similarly, burnout and job dissatisfaction have been associated with plans to leave the nursing field.

Clinician Turnover

Burnout is a major driver of clinician turnover, leading some to completely leave the field of medicine. Studies in both physicians and nurses indicate that burnout is one of the largest predictors of whether someone will leave their current position in the next two years. Increased turnover not only has substantial financial impact on organizations, it can also have a disruptive effect on patients and an organization’s culture and reputation. Unexpected turnover from productive and valuable people may have harmful consequences on the care team and may also increase the likelihood that colleagues will experience burnout, even when someone new is hired.


Clinician burnout can have grave consequences on staff attrition, turnover rates, and productivity. The time to act is now-the sustainability of our health system depends on it.

Work Effort and Productivity

Job dissatisfaction and emotional exhaustion in physicians has resulted in an actual reduction in professional work effort. A recent study showed that for each 1-point increase in emotional exhaustion between 2011 and 2013, a 28 percent greater likelihood of reduction in professional work effort (i.e., reduction in work hours according to payroll records) was seen.  For each 1-point decrease in job satisfaction between 2011 and 2013, a 67 percent greater likelihood of reduction in professional effort over the following year was seen. The resulting loss of productivity at the national level is estimated, by one account, to eliminating the contributions of graduating classes of seven medical schools. Changes in productivity can place a financial burden on organizations and can significantly disrupt he consistency and quality of care a patient receives.


Bottom Line

Clinician burnout can have significant consequences for work productivity and staff attrition. These have notable implications for overall health care costs, team performance, and the sustainability of the health care system. Organizations must prioritize efforts to promote clinician well-being in order to retain qualified and contributing caregivers and to keep health care teams functioning at their highest capacity.