By Brian C. Joondeph
American Thinker
November 5, 2025
A new study in the Annals of Internal Medicine found that nearly 5% of U.S. physicians left clinical practice in 2019, representing a 40% increase in just six years.
It confirms what every practicing doctor already knows: America's physicians are burning out, checking out, and getting out, with female physicians and those in rural areas being the most likely to exit.
The study, conducted by Rotenstein and colleagues from Yale, UCLA, and UCSF, examined over 700,000 physicians who treated Medicare patients and found that doctors caring for older, sicker, and poorer patients were more likely to leave the profession. Although the paper is descriptive rather than prescriptive, the message is clear - the medical profession is hemorrhaging.
Medicine has become the only profession where the customer isn't the patient, the boss isn't the doctor, and the computer always wins.
The reasons for this mass departure aren't mysterious; they're baked into the system.
For many doctors, it's death by a thousand clicks. The modern doctor's day is no longer defined by caring for patients but about feeding the bureaucratic beast. Electronic health records were promoted as time-savers, but they quickly became time thieves.
For every hour of patient care, physicians spend nearly two hours on documentation and desk work. None of it enhances health care, but all of it keeps lawyers and administrators satisfied. Sacrificed are evenings with family, replaced by late-night charting marathons to satisfy billing requirements.
Then there's malpractice anxiety, the ever-present sword of Damocles. Roughly one in three physicians has faced a lawsuit at some point in their career. Even in states with tort reform, a single bad outcome or an opportunistic attorney can bring years of stress and financial burden.
The result is "defensive medicine," where tests and referrals are ordered not because patients need them but because lawyers might. There is also the psychological stress. Any physician who has been sued, whether the case had merit or not, carries that scar forward. Every future patient becomes a potential plaintiff.
Add to that decreasing reimbursements and increasing costs. Medicare physician payments have fallen 33% since 2001 after adjusting for inflation, while practice expenses have risen 59% during the same period.
Insurers set payment rates that barely cover overhead, while inflation, staffing shortages, and mandatory technology upgrades push expenses higher. Independent physicians, those who still see medicine as a calling rather than a corporate job, are selling out to hospitals.
According to the AMA, "The share of physicians working in private practices in 2024 was 42.2 percent, a decline of 18 percentage points from 60.1 percent in 2012." In other words, less than half of doctors remain in private practice.
Private equity's involvement in medicine has surged. Their approach is straightforward: Acquire practices, increase productivity, cut expenses, and sell for profit. For doctors, this translates to more metrics, less independence, and ongoing pressure to see more patients in less time. The outcome isn't about efficiency - it's corporatized medicine, where healing becomes a profit center and burnout a rounding error.
Blue Cross Blue Shield now uses AI algorithms to cut payments to doctors they believe are overcharging for their most complex patients. Yet politicians face no such "adjustments" for their own ongoing fiscal malpractice.
Surveys reveal that approximately 45% of U.S. physicians currently report symptoms of burnout, and 1 in 5 doctors plan to leave clinical medicine within the next two years.
Where are all these doctors heading?
Some retire early, feeling exhausted and disillusioned. Others find new careers in consulting, biotech, or administration -- anything that doesn't require insurance pre-authorizations or "productivity dashboards."
A growing number switch to concierge or direct-pay practices, charging cash and bypassing the insurance middleman entirely.
It's not that doctors no longer want to care for patients, but they simply can't within the current system. As one colleague said, "Medicine used to be about healing the sick. Now it's about satisfying the spreadsheet."
Who will be left to care for us? A 2024 AAMC report found "the nation will face a physician shortage of up to 86,000 physicians by 2036."
But that may be optimistic. As more doctors leave the profession, their replacements will likely come from three sources: foreign medical graduates (FMGs), nurse practitioners (NPs), and physician assistants (PAs).
FMGs have long been vital to America's healthcare system, especially in underserved rural regions. However, obtaining an H-1B visa is complex, costly, and unpredictable.
The Trump administration proposed significantly increasing H-1B visa fees, up to $100,000, which, if enacted, would effectively prevent most foreign doctors from practicing in the US.
While many FMGs are excellent healthcare providers, language and cultural differences can create communication challenges, especially in high-pressure situations.
NPs and PAs are valuable members of the care team, but they are not physicians, and pretenting otherwise weakens both quality and accountability. Their overall training typically makes up about one-sixth to one-eighth of a physician's clinical hours.
More patients now see an "advanced practice provider" instead of a doctor, often without being informed. While that might be acceptable for simple issues, it becomes risky for complex, undiagnosed, or high-risk cases.
The chickens have come home to roost. Patients are waiting longer for appointments and traveling farther to find doctors still accepting new patients. It now takes an average of 31 days to schedule an appointment in the 15 largest U.S. metropolitan areas.
Emergency departments are overcrowded, urgent-care centers are expanding rapidly, and telemedicine is being stretched beyond its practical limits.
In the long term, the physician exodus threatens not only access but also the core of medicine itself.
When doctors lack the time or autonomy to think deeply about their patients, care becomes purely transactional. The sacred bond between doctor and patient is replaced by cold efficiency, measured in "clicks per encounter." Physicians are now just another "service provider."
Fixing this won't be easy. It starts with reducing bureaucracy, reforming malpractice laws, and paying physicians fairly for their time and expertise. Regulators must stop treating doctors as interchangeable cogs in a health care system.
Technology, when used correctly, can be helpful. Artificial intelligence could one day take over the boring tasks of charting and billing, letting doctors focus more on patient care. But unless the culture changes -- if medicine stops prioritizing judgment over metrics -- the exodus will continue.
What we face isn't just a labor shortage; it's a moral crisis. A country that pushes away its healers with red tape, lawsuits, and bean counting shouldn't be surprised when fewer people want to heal.
If we continue treating doctors like data clerks, we'll get what we deserve: A healthcare system managed by accountants, defended by lawyers, and staffed by whoever's left. And the ones who suffer the most won't be the bureaucrats or executives; they'll be the patients, waiting for a doctor who no longer answers the call.