Young doctors’ attrition and retention in the GP scheme: a national cohort study from Norway

Abstract

Aims:

Several countries struggle with general practitioner (GP) burnout, recruitment and retention. The reasons are not well understood. The aim of this study was to predict the tenure of young GPs in the GP scheme and detect important predictors for remaining or leaving.

Methods:

Using data from Norwegian registries, LASSO Cox regression models were applied to identify variables, including the personal attributes, appointment details, patient profiles and workload indicators of GPs that predicted GP tenure among GPs under 40 years who joined the Norwegian GP scheme between 1 January 2010 and 31 December 2018. GPs were followed until leaving the scheme or until 31 December 2020.

Results:

We followed a total of 2038 GPs aged under 40 years old at recruitment. Of these, 499 (24.5%) resigned by 31 December 2020. The most important predictors for remaining in the GP scheme throughout the follow-up period were (a) having a high activity-based income and (b) being a specialist in general medicine. The most important predictors for leaving the GP scheme were (a) working more than 50 days per year in the emergency room and (b) working in less central areas.

Conclusions:

High income, specialisation and a large patient base predicted staying in the GP scheme, whereas working in emergency rooms and less central areas predicted leaving. This study suggests that workload within the GP practice is not the main driver of early retirement.