of Primary Care Doctors

Assessments of the state of primary care in the United States generally point to both its importance and its poor condi-tion.1-3 Primary care physicians make up less than 40 % of the physician workforce,4 and the small number of new physicians who choose to go into primary care fields is a serious policy concern. Primary care physicians ’ continua-tion in practice has received less attention, with a primary research focus on psychological factors such as stress and job satisfaction.5 However, when asked in the Common-wealth Fund’s 2009 Survey of Primary Care Doctors in 11 countries if they plan to leave their medical practice in the next 5 years, some 42 % of American primary care physi-cians indicated that they might. In only one country (Swe-den) was the percentage higher. In this article, we examine practice characteristics associated with American primary care physicians ’ plans to retire or leave their practice for other reasons in the next 5 years. Methods We used data from a 2009 Commonwealth Fund mail survey of 1442 American physicians practicing internal medicine, family or general practice, or pediatrics. The response rate was 39%, and the sample was weighted to reflect the charac-teristics of the physician population.6 We focused on physi-cians who, when asked if they planned to leave their practice in the next 5 years, indicated that they planned to retire, planned to leave for “other reasons, ” or were uncertain about leaving or continuing. (The exact question was “Do you pla