Perspectives on Attrition Among Emergency Physicians

Why do emergency physicians stop practicing and what strategies support retention?In this qualitative study of 46 emergency physicians, participants reported that attrition was driven by a misalignment between professional duty and systemic constraints, rigid career structures, limited mental health support, disrespect from patients and colleagues, gender inequities in advancement, and stagnant professional development. Many participants felt that emergency departments were expected to fix problems created upstream, leading to moral injury exacerbated by superficial wellness initiatives.These findings suggest improving retention requires structural reforms, including increased physician and nurse staffing; emphasizing safety over throughput and satisfaction; and supporting advancement along flexible, nonlinear career pathways.

Corresponding Author: Michelle P. Lin, MD, MPH, MS, Department of Emergency Medicine, Stanford University School of Medicine, 900 Welch Rd, Ste 350, Palo Alto, CA 94304 (Mplin@stanford.edu).

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