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Dissatisfaction with organizational leadership has emerged as the leading driver of clinician turnover, ahead of all factors, except personal reasons, such as retirement or career advancement, according to data from KLAS Research.
The findings indicate that dissatisfaction with leadership frequently arises in the context of poor EHR experiences. Among at-risk clinicians, those who cite misalignment with leadership as their primary reason for leaving are also the least satisfied with their EHRs.
Clinicians, particularly nurses, report feeling insufficiently supported as they take on additional responsibilities created by staffing shortages, including tasks beyond direct patient care.
The financial implications are significant: the organizational cost of losing a nurse is estimated at $52,350 per departure (2024 study), while replacing a physician can cost up to $1 million (2017 study).
This pattern is pronounced among physicians, whose average Net EHR Experience Score (NEES) is just 7.7 on a scale from -100 to 100. When EHR systems are perceived as slow, unreliable or inadequately supported, clinicians are more likely to view leadership as unresponsive and to consider exiting their organization or the profession.
Jenna Anderson, vice president, Arch Collaborative Insights, KLAS, told Healthcare Finance News that physicians who indicate plans to leave their organizations can still be reached by their organization and are open to an improved experience.
"Even among physicians who ultimately decided to leave their health system, two-thirds expressed a strong willingness to engage with their organization by receiving more EHR education," Anderson said.
She added that this trend remains robust even when accounting for various other factors – regardless of their personal efforts to learn the EHR, overall satisfaction with EHR, previously reported plans to leave, or burnout levels, most physicians express the desire to receive more EHR training.
"This highlights the broad importance of enabling physicians to acquire necessary skills and knowledge to effectively navigate EHR systems," Anderson said.
The study noted some health systems are treating EHR optimization as a retention strategy, leveraging measurement, benchmarking and targeted improvement efforts.
Reported returns include greater workforce stability, operational efficiency, improved organizational reputation, and higher staff morale and trust, alongside less easily quantified benefits such as better mission alignment and clinician well-being.
Many cite improved EHR technology and workflows, including quick text, ambient speech tools, streamlined logins and enhanced clinical communication.
The study noted that organizations pairing these changes with ongoing education and support are seeing smoother adoption, reduced burnout and improvements in satisfaction that appear to correlate with reduced turnover risk.
"Technology experience is becoming a competitive differentiator," Anderson said. "More organizations recognize they need to offer sophisticated tech, like ambient speech, to recruit and retain clinicians."
She said that even before AI tools, organizations have reported challenges with recruitment if they don't have the newest and greatest EHRs.
"Particularly the latest generation of med and nursing school grads, they expect a certain level of tech sophistication," she said.
Investments in clinician efficiency, such as workflow optimization and workflow education, empower clinicians to get back to what they love doing: spending time caring for patients.
"Interviewed organizations consistently tie patient safety and clinical outcomes to clinician satisfaction," she said.