Studies have shown that patients receiving continuous care from their primary care provider results in better outcomes like more accurate diagnoses, fewer emergency department visits, fewer hospital admissions and ultimately lower costs.

The flipside is also true. Primary care physician turnover was a costly issue even before the COVID-19 pandemic began in the U.S. two years ago, according to the study.

While past research has focused on how physician burnout impacts productivity or recruitment and replacement costs, this is the first study looking at the excess spend associated with disruptions in care continuity between primary care physicians and their patients, according to the its authors.

Researchers used data from a survey of more than 5,000 U.S. physicians conducted between October 2017 and March 2018 focusing on questions around burnout and intentions to leave one’s current practice within two years.

They estimate that 11,339 primary care physicians are expected to leave their current practices each year, with 3,006 departing due to burnout.

Public and private payers in turn spend almost $1 billion a year on expenses related to patients losing their primary care providers, the study found.

Burnout is a key driver of turnover. While it has long been an issue in the healthcare field, the pandemic has greatly exacerbated burnout, according to numerous surveys among nurses, physicians and other healthcare workers.

A December report from Doximity found more than 73% of physicians reported feeling overworked and 50% are consequently considering a career change.

Doximity also identified a spike in retirements during the first few months of the pandemic that never fully recovered, resulting in roughly 1% of the entire physician workforce retiring earlier than expected based on pre-pandemic trends.

Burnout can have a number of adverse effects beyond increased physician turnover, including more frequent errors leading to higher medical malpractice claims, reduction in clinical hours and other organizational costs, according to the AMA study.