Estimating the Cost of Poor Work Control Among Physicians in the United States.

Abstract

Estimate the costs incurred by healthcare organizations due to physician turnover related to poor work control. This is a cross-sectional survey of a sample of U.S. physicians between November 2022 and December 2023, assessed with a 6-item measure of work control; the Mini-Z single-item burnout measure; and an established measure of intent to leave the current practice (ITL). Among 2339 physician respondents, adequate work control was found in 62.6% (1464/2339) and poor work control in 37.4% (875/2339). ITL among physicians with poor work control was twice as likely (OR= 2.03; 95% CI 1.43, 2.88) relative to physicians with adequate work control after controlling for personal and professional factors and burnout. Mediation analysis determined that 36% of the effect of work control on ITL was direct (i.e., independent of burnout) while 64% of the effect was mediated through burnout. Using an established algorithm, we determined that an organization of 500 physicians with average prevalence of poor control among their physicians can expect to lose 10 physicians due to poor work control each year with an estimated annual replacement cost of $5-13 million. Poor physician work control has substantial economic costs for healthcare organizations. Providing physicians improved control over their work environment could improve retention and have a positive financial return for an organization.