ArticlesPhysician and Staff Turnover in Community Primary Care PracticeRuhe, Mary BS, RN; Gotler, Robin S. MA; Goodwin, Meredith A. PhD; Stange, Kurt C. MD, PhD Author Information From the Departments of Family Medicine, Case Western Reserve University, Cleveland, Ohio (Ruhe, Gotler, Goodwin, Stange) The Departments of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio (Goodwin, Stange) The Departments of Sociology, Case Western Reserve University, Cleveland, Ohio (Stange) The Case Comprehensive Cancer Center, Cleveland, Ohio. (Stange) This study was supported by grants from the National Cancer Institute (2R01 CA80862 and 3R01 CA80862) and a grant from the American Academy of Family Physicians for the Center for Research in Family Practice and Primary Care. Corresponding author: Mary Ruhe, BS, RN, Department of Family Medicine, Case Western Reserve University, 11001 Cedar Ave, Suite 306, Cleveland, OH 44106 (e-mail: [email protected]). Journal of Ambulatory Care Management: July 2004 - Volume 27 - Issue 3 - p 242-248 Buy Abstract The effect of a rapidly changing healthcare system on personnel turnover in community family practices has not been analyzed. We describe physician and staff turnover and examine its association with practice characteristics and patient outcomes. A cross-sectional evaluation of length of employment of 150 physicians and 762 staff in 77 community family practices in northeast Ohio was conducted. Research nurses collected data using practice genograms, key informant interviews, staff lists, practice environment checklists, medical record reviews, and patient questionnaires. The association of physician and staff turnover with practice characteristics, patient satisfaction, and preventive service data was tested. During a 2-year period, practices averaged a 53% turnover rate of staff. The mean length of duration of work at the current practice location was 9.1 years for physicians and 4.1 years for staff. Longevity varied by position, with a mean of 3.4 years for business employees, 4.0 years for clinical employees, and 7.8 years for office managers. Network-affiliated practices experienced higher turnover than did independent practices. Physician longevity was associated with a practice focus on managing chronic illness, keeping on schedule, and responding to insurers' requests. No association was found between turnover and patient satisfaction or preventive service delivery rates. Personnel turnover is pervasive in community primary care practices and is associated with employee role, practice network affiliation, and practice focus. The potentially disruptive effect of personnel turnover on practice functioning, finances, and longitudinal relationships with patients deserves further study despite the reassuring lack of association with patient satisfaction and preventive service delivery rates. © 2004 Lippincott Williams & Wilkins, Inc.