If it feels harder to keep the same doctor, you are not imagining it. Across many healthcare systems, retirements, burnout and changing workforce expectations are making it increasingly difficult to retain experienced clinicians. A new study published in the Joint Commission Journal on Quality and Patient Safety suggests that the challenge extends beyond workforce shortages. Interviews with leaders from four major healthcare systems in the Dallas–Fort Worth region reveal that generational shifts are changing who enters healthcare, who stays and why clinicians leave. According to study co-author Dr. William Sage, healthcare organisations are no longer facing simply a staffing problem, but the challenge of supporting five generations of clinicians with different expectations about work, well-being and career longevity.
The study involved 17 senior leaders who consistently identified clinician turnover as one of their greatest concerns. They described the growing number of younger physicians leaving earlier in their careers, while many experienced clinicians have few options between full-time practice and complete retirement. Several participants noted that replacing a seasoned physician may require hiring multiple younger clinicians because of changes in productivity expectations and the way healthcare systems measure performance.
The consequences of clinician turnover extend well beyond filling vacant positions. Co-author Keegan Warren explained that when experienced clinicians leave, organisations lose valuable institutional knowledge, mentoring relationships and practical expertise that can take years to rebuild. Physician departures also carry high financial costs while disrupting continuity of care. The researchers argue that recognising clinicians as individuals with meaningful careers and lives is essential to building a stable workforce and protecting high-quality patient care.
Burnout and evolving workplace expectations were also identified as major drivers of turnover. Younger physicians and nurses increasingly prioritise mental health, work-life balance, flexible scheduling and supportive workplace cultures, expecting employers to address these needs actively. However, the researchers emphasise that these findings should not be viewed as a conflict between generations. Instead, workplace expectations have evolved through broader changes, including work-hour regulations for medical trainees, the shift from physician-owned practices to large healthcare organisations, and the lasting effects of the COVID-19 pandemic.
Rather than focusing solely on recruiting more clinicians, the researchers recommend strategies to strengthen retention throughout the career span. These include expanding mentorship programmes that transfer knowledge from experienced clinicians, improving early-career support through professional development and flexible work arrangements, involving multiple generations in leadership and decision-making, strengthening workforce planning through human resources, creating flexible late-career roles, and improving communication across generations to reduce workplace tensions.
The researchers conclude that a stable clinical workforce is fundamental to ensuring patients have consistent access to high-quality care. Retention can no longer be treated as an afterthought. By designing workplaces that recognise clinicians as people first—with families, responsibilities and limits—healthcare organisations can foster stronger commitment, preserve valuable experience and create a more resilient healthcare system that benefits both clinicians and the patients they serve.
More information: Andrew A. White et al, Generational Change in the Healthcare Workforce: Perspectives from Health System Leaders, The Joint Commission Journal on Quality and Patient Safety. DOI: 10.1016/j.jcjq.2026.06.009
Journal information: The Joint Commission Journal on Quality and Patient Safety Provided by Texas A&M University
