Workplace Accommodations and Attrition Among Physicians With Disabilities.

Importance: Physicians with disabilities face bias and barriers in the workplace, including stigma, lack of accommodations, and mistreatment, which may contribute to workforce attrition. Given the projected physician shortage and the importance of physicians with disabilities in providing informed and empathetic care, understanding attrition within this group is critical. Objective: To examine the associations among disability, workplace accommodations, and physician workforce attrition, including consideration of leaving medical practice and reductions in clinical hours. Design, Setting, and Participants: This survey study used a cross-sectional design to analyze data from the 2022 National Sample Survey of Physicians. Logistic regression models assessed associations between disability and attrition outcomes, adjusting for demographic and workplace factors. Participants included 5917 active physicians who self-reported personal (eg, disability status) and professional (eg, accommodations) data. Data were collected from May 10 to November 9, 2022, and analyzed from October 1, 2023, to May 1, 2025. Main Outcomes and Measures: The primary outcomes were (1) having considered leaving medical practice within the past 12 months, including reasons why, and (2) having ever reduced clinical hours for 6 months or longer. The core independent variable was accommodation status. Results: Among the 5917 physicians surveyed, 154 (2.6%) reported having a disability. A total of 3707 respondents (62.6%) were men or transgender men and 5620 (95.0%) identified as heterosexual; the mean (SD) age was 53.9 (10.8) years. Fifty-six physicians with disabilities (36.4%) considered leaving the practice of medicine, compared with 1316 of 5600 physicians (23.5%) without disabilities. Sixty-seven physicians with disabilities (43.5%) reported transitioning to part time or pausing their practice at some point, compared with 1327 (23.7%) without disabilities. Multivariate regression analysis found physicians with disabilities were more likely than their peers without disabilities to consider leaving medical practice (odds ratio [OR], 2.22; 95% CI, 1.24-3.96; P = .01) and to have reduced clinical hours or paused practice during their careers (OR, 1.94; 95% CI, 1.09-3.43; P = .02). Burnout was the most common reason among both groups, and physicians with disabilities more frequently cited underlying health conditions (self or family) (32 [52.7%] vs 122 [8.5%]). Among physicians with disabilities, those who received accommodations were significantly less likely than those without accommodations to report an intent to leave (42 of 123 [34.3%] and 13 of 24 [54.2%], respectively). Conclusions and Relevance: In this survey study, physicians with disabilities were significantly more likely to consider leaving the workforce and to reduce clinical hours than their peers without disabilities. Clear, stigma-free disclosure and accommodation processes, along with inclusive workplace cultures, are essential to retaining this vital segment of the physician workforce.