Doctor departures: The financial and emotional impact to a practice

Female nurse looking stressed
It's time to get back to "tribal values" that create a sense of community among doctors, according to Dr. David Loxterkamp. (Getty/gpointstudio)

It wasn’t easy for David Loxterkamp, M.D., when two younger doctors who he had recruited left the family practice where he works in rural Maine earlier this year.

Their leaving was especially painful as they were regarded as among the brightest and most respected in the group, writes Loxterkamp in the Annals of Family Medicine.

"For a rural family practice such as ours, such losses are not easily absorbed. The financial costs are enormous—by some estimates between $250,000 and a million dollars when recruitment fees, lost revenue and retraining are taken into account. And there is little chance of quickly replacing young family physicians,” he writes.

But it wasn’t the financial impact as much as reflection on why those doctors chose to leave the practice while he decided to stay, that caused Loxterkamp to think about the state of medicine. In his case, the recent expansion of the practice after it was sold to a federally qualified health center, led to a loss of intimacy as staff no longer know each other by their first names, he says.

At a time when the majority of primary care physicians are employed and decisions are made farther and farther away from the point of care, Loxterkamp says doctors must focus on patient care and teamwork and get back to “tribal values” that create a sense of community.

“At very least, we could begin to meet, talk, set goals, solve problems, and celebrate together. That would be a start,” he says.