When a physician executive resigns, the conversation in the C-suite almost always centers on the same two questions: How fast can we fill the role, and how much will the gap cost us? Those are fair questions. But in my experience working with health systems to place physician leaders, they are also the wrong place to start. The more valuable question is the one most organizations rush past: Why did this person actually leave, and how does that information shape how we hire for and support the next person in the job?
The departure of a physician leader is rarely the result of a single event. It is usually the culmination of a series of issues that began months earlier. The only way to reflect on those issues and how they might have been avoided or handled differently is through an exit interview. This is often the only structured opportunity an organization gets to understand what, if anything, went wrong.
Of course, leaders leave for a variety of reasons, many of which are unavoidable, but the exit interview allows the organization to reflect on what could have influenced the leader to stay and what might have made the leader more effective during their tenure.
Healthcare Leadership Turnover
Leadership turnover in healthcare, as in any industry, is a recurring operational reality. The American College of Healthcare Executives, which has tracked the metric since 1981, reported hospital CEO turnover holding at 16% for three consecutive years through 2022. More recent figures suggest the rate is increasing. Research from Challenger, Grey & Christmas, as reported by Beckers Hospital Review, shows hospital CEO turnover rose 32% in the first quarter of 2026, with 41 hospital CEOs departing, many due to retirement.
Whatever the reason for the departure, a leader’s exit can cause disruption in the form of stalled strategies, shifting protocols, and slowed recruitment. The downstream effect can be especially significant when physician executives leave, due to their unique position as a bridge between the clinical and administrative worlds.
What Drives Physician Leader Departures?
As noted, retirements account for many physician executive departures, but not all. Of course, some may leave for a better title or a bigger paycheck, but these rarely tell the whole story. The broader physician-retention research points to causes that may be applicable to physicians at every level.
Over the years, Jackson Physician Search research points to several themes driving the physician retention problem. Administrative burden, increasing burnout, lack of autonomy, leadership issues, and just feeling like they can’t make a difference, to name a few. In my work with physician leaders, I see these same themes driving both the desire to get into leadership and the reason for getting out.
- Misalignment on the mission. Physician executives take leadership roles to make a broad, lasting impact on care. When the role turns out to be administrative firefighting with little impact on the issues that matter, the gap between expectation and reality becomes untenable.
- Lack of true voice in decisions. Title without influence is one of the fastest paths to disengagement. Physician leaders want a genuine seat at the strategy table, not a ceremonial one.
- Burnout that a leadership position does not cure. Burnout is not exclusive to the front line. The same pressures that drive clinician attrition follow physicians into leadership, and the isolation of a leadership role can intensify them.
- Weak organizational support and unclear expectations. Many physicians step into leadership with limited formal preparation (a gap that our research into where the next generation of physician leaders will come from explores in depth). Without onboarding, mentorship, and a clear mandate, even talented leaders are set up to struggle.
None of these causes announce themselves in a resignation letter. They surface in a well-run exit interview…if the organization is willing to listen.
The Exit Interview as a Tactic, Not a Formality
The most useful research on this topic comes not from healthcare but from a broad study of exit-interview practices. In their analysis Making Exit Interviews Count, published in Harvard Business Review, Everett Spain and Boris Groysberg argue that exit interviews are widely conducted and rarely useful because they are undermined by poor data quality and a lack of consensus on how to run them. Their conclusion is blunt: a thoughtful exit interview can reveal what does and doesn’t work inside an organization, surface hidden problems, and even improve retention among the people who stay, but most programs squander that potential.
A few of their practical recommendations translate well to physician leadership departures:
- Have the interview conducted by an objective third party. People are far more candid with someone one or two steps removed from the relationship they are leaving.
- Combine structured and unstructured questions. Standardized questions let you spot trends across multiple departures; open-ended ones surface the insights you didn’t know to ask about.
- Treat the data as data. A single exit interview is an anecdote. A pattern across several is intelligence. The organizations that benefit are the ones that aggregate and review what they hear, then act on it.
For physician executives specifically, the exit conversation should probe the themes above directly: Did the role match what was promised? Did you have real authority? What would have made you stay? The answers are frequently uncomfortable, which is exactly why they are worth collecting.
From listening to improving
Hearing the feedback is only half the work. The organizations that turn exit interviews into lower turnover are the ones that close the loop and change something. That is also where most fall short: in the JPS/MGMA research, only 15% of medical groups reported having a formal physician retention plan, despite persistently high turnover.
The fix is not complicated, but it does require discipline:
- Build retention into onboarding. The themes you hear in exit interviews should inform how you support leaders from day one. Provide clear expectations, real authority, and structured mentorship.
- Give physician leaders a genuine voice. Models like triad leadership, which pairs physician, nursing, and administrative leaders in shared decision-making, can institutionalize the influence that physician executives say they want.
- Use your physician leaders to retain other physicians. Engaged physician executives are among your strongest retention assets, a dynamic I explore in three ways physician executives can improve physician retention. Retaining the leader and equipping the leader to retain others are two sides of the same strategy.
A physician executive’s departure is a loss, but it can also be a gift of information. Whether they are retiring or leaving for other reasons, they can provide a candid account of what your organization is like to lead within. A board that treats the exit interview as a checkbox will learn nothing, but those members who treat it as a structured listening exercise, then act on what they hear, can turn one leader’s exit into a reason for the next leader to stay.
If your organization is recruiting physician executives, the Physician Executive Search team at Jackson Physician Search can help you find leaders who fit, succeed, and stay. Reach out to learn more.
About Tom Rossi
Tom Rossi has over three decades of dedicated experience in recruitment and leadership within the healthcare sector. Before joining Jackson Physician Search as the Vice President of Executive Search in 2023, Rossi served as National Vice President of Physician Recruitment for HCA Healthcare for 20+ years. Before spearheading physician and provider recruitment, Rossi played a pivotal role in HCA’s executive recruitment division and spent six years prior to that leading a team of executive recruiters for a professional services firm.
Outside his professional endeavors, Rossi engages in meaningful volunteer work, contributing to organizations such as Football Parents at Ohio State (FPAOS) and Habitat for Humanity. Rossi cherishes family life and is a proud parent of three adult children.
