Healthcare leaders say retirements, burnout, and changing workforce expectations are complicating efforts to retain experienced clinicians, according to a study published in the Joint Commission Journal on Quality and Patient Safety. The findings were discussed by leaders from four major health systems in the Dallas-Fort Worth metropolitan area.
Dr. William Sage, founding director of the Texas A&M University Institute for Healthcare Access in Fort Worth and co-author of the study, said, "We've talked about clinical workforce shortages as a numbers problem involving training and retention. What these leaders described was something more complicated, as healthcare organizations are struggling to meet growing patient needs while accommodating five distinct generations of clinicians with different needs and perspectives about work, well-being and career longevity."
Seventeen participants from four major healthcare systems described clinician departures as one of their biggest concerns. They noted that replacing an experienced physician often requires hiring multiple younger clinicians due to how productivity is measured within the system. Keegan Warren, co-author and executive director at the institute, said, "When a veteran clinician leaves, healthcare organizations lose more than just a position. They can lose years of institutional knowledge, mentoring relationships and practical experience that are difficult to replace. For physicians in particular, departure carries a high institutional price tag. Treating clinicians as people whose lives and contributions matter is not just the right thing to do; it's a critical strategy for protecting both continuity of care and the financial health of the system."
Participants also highlighted issues such as burnout and shifting workplace expectations among younger physicians and nurses who increasingly discuss mental health concerns, work-life balance demands, and scheduling flexibility requirements—and expect employers to address these areas.
Sage said these findings should not be seen as generational conflict but rather as evolving expectations shaped by events like changes in trainee work hour regulations or shifts toward hospital employment models over physician-owned practices—as well as impacts from the COVID-19 pandemic. "This isn't a story about one generation being right and another being wrong," Sage said. "It's about how the profession is changing and how healthcare organizations can adapt while continuing to provide excellent patient care."
The researchers concluded that strengthening retention strategies across all generations is necessary for building resilient teams capable of supporting patient access to care throughout ongoing changes in medicine's workforce landscape.
