Although leaving or changing practice has been associated with burnout within individual health systems,1<\/a><\/sup> the extent to which burnout affects turnover nationally is not well understood. We linked repeated, cross-sectional national surveys of board-certified family physicians to Medicare claims data to examine the association between burnout and turnover.<\/a><\/p>\n\n\n\n Methods<\/p>\n\n\n\n We used the 2016 to 2020 American Board of Family Medicine (ABFM) surveys to measure burnout. ABFM surveys are completed by physicians applying to continue their board certification or in the last year of a certification stage. Similar to prior work,4<\/a><\/sup> we constructed a physician turnover measure and extracted physician and practice characteristics using the 2015 to 2022 Medicare Data on Provider Practice and Specialty (MD-PPAS) files and a 20% sample of the Medicare Carrier file. We excluded physicians who treated fewer than 4 Medicare enrollees in each year and who billed more than 2.5% of service line items to a third Tax Identification Number not in MD-PPAS. The Weill Cornell Medical College Institutional Review Board deemed this cross-sectional study exempt from review and informed consent because deidentified data were used. We followed the STROBE<\/a> reporting guideline.<\/a><\/p>\n\n\n\n Physician burnout was defined as reporting either of the following at least weekly: (1) \u201cI feel burned out from my work,\u201d or (2) \u201cI have become more callous toward people.\u201d5<\/a> <\/sup>Physicians were considered to have moved practices if they billed at least 4 months in 1 practice followed by at least 4 months in a different practice within 12 months of survey completion. Physicians were considered to have left practice if they did not bill any practice for 12 months, beginning in the 12 months after survey completion (eMethods 1-5 in Supplement 1<\/a>).<\/a><\/p>\n\n\n\n We constructed unadjusted and adjusted shares of physicians who changed practices, left practice, and either changed or left practice by burnout status. Shares were adjusted using logit regressions, controlling for physician demographic characteristics and primary practice size, geography, share of patients with low income (proxied by Medicare and Medicaid dual eligibility), and health system affiliation (using the Compendium of US Health Systems6<\/a><\/sup>).<\/a><\/p>\n\n\n\n Regressions used robust SEs clustered at the physician level. Two-sided P<\/em> < .05 indicated statistical significance. Analysis was conducted from July to December 2025 using Stata 16 (StataCorp).<\/a><\/p>\n\n\n\n Results<\/p>\n\n\n\n We included 19\u202f929 physicians (10\u202f440 males [52.4%]; mean [SD] age, 46.9 [11.1] years) who completed the burnout portion of the ABFM surveys. Of these physicians, 43.5% (8676) reported burnout (Table<\/a>).<\/a><\/p>\n\n\n\n Table. \u00a0Physician and Practice Characteristics by Burnout Status<\/p>\n\n\n\n![\"\"\/](\"https:\/\/cdn.jamanetwork.com\/ama\/content_public\/journal\/intemed\/939828\/ild260002t1_1781295465.64094.png?Expires=1785427553&Signature=WqgYQdEyGTeH5l0vyghLLdaxIvCSDH1RseDXGVltgUdnPWOVel2oHzplnXqQQFve04WWRMlA4A77u1kOYSLGQ~kSKUAxFEmTSuVaBaPkSueimUvZBAt8fCkiN9KRGBvS9I-7qVkiIgtMSL5fItyCJPxQ36L0F0rBc0epTyfb5rZVzgXKOmCg5SMcic42Mfj4yRmbyMf75M3tRT3UCBcUM0NCHpvMfsDoN2Alw0UorAX024Un5gAqzK~rEXWUeWyk543tzhR5jQo6uqyzYft1RCxfnQCAOfBOoIx~XWTg7O1R4EW3d4anQFflS6FBPPD42waHUc5JXlnwBi8qbClkoA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\")
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![\"\"\/](\"https:\/\/cdn.jamanetwork.com\/ama\/content_public\/journal\/intemed\/939828\/ild260002f1_1781295465.67088.png?Expires=1785427553&Signature=4ab9dZlCASNp9ektfXZAeDinvhryH9QbwL3U9pS6n6RoY8sd6ayl~wPd8INVEa3ghcnOxodCBAnQW8s6Kltn8svL15V-gWrc6B~8IBp92xy83nvnff63fLfo8Urqd8a8KAAToOfWe0Wztz~TurnBEKE0xYfOZ3e3OzsqJ2MEd32Ab5EzzsgpxC1yqMH1pRbhCT861nce9wIhMhqrKBV6jdqLXVNSQGcxg29xFQCw1e7JpfzasJeyXn1QmobdyY4bKYFre06M9plfpma5zx-L9gUbiJ0U-GRdG2qDRLIOLoidrkCe7iiLZ45zxW30~Z0R1iC2BrxsRGkHxdTL6CYoWg__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\")
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