Physicians Quit Over Moral Distress as Oregon Acts

Physicians in the U.S. are experiencing growing moral distress, data from a recent national survey and an Oregon case study presented by Rebecca Schoon, Ph.D., an associate professor of public health at Pacific University, now confirm.

National survey reveals alarming resignation rates

A survey of over 1,200 practicing physicians found that 27% had already left a job due to moral distress, while another 25% were actively considering quitting their current positions. Investigators linked these trends to visit quotas, restrictive noncompete clauses, prior-authorization requirements, and overwhelming administrative burdens that erode clinical independence.

Corporate consolidation intensifies workforce restrictions

Optum’s 2023 acquisition of Oregon Medical Group in Eugene included two-year noncompete clauses that kept departing physicians from practicing in the area. Such clauses, now common in corporate-owned practices, reflect a shift where management services organizations (MSOs) dictate hiring, firing, and scheduling-even when physicians retain legal ownership of their practices.

Under these arrangements, doctors often discover they lack control over fundamental workplace decisions, despite holding practice titles. Schoon described how MSOs increasingly standardize employment terms across acquired clinics, leaving physicians with limited recourse against restrictive policies.

Oregon’s 2025 law targets corporate control

Beginning next year, Oregon will enforce what officials call the nation’s strictest regulations on MSOs and noncompete agreements, capping their duration and restricting their use to protect physician mobility. The law reinforces a 1947 state Supreme Court decision that prohibited corporate practice of medicine—a rule previously bypassed through contractual loopholes.

Independent clinics face distinct administrative burdens

In independent practices, Schoon says moral injury comes more from prior authorization, denials, step therapy and paperwork. Focus groups with patients in Oregon revealed how these issues manifest: appointments limited to single concerns, extended waits for specialists after provider departures, and repeated claim denials that exacerbate psychological strain.

Universal health plan explores financing models

Oregon’s Universal Health Plan Governance Board, established following a 2022 ballot initiative that enshrined health care as a constitutional right, is designing a plan. Schoon argued most Oregonians would save compared with what they pay in premiums, deductibles, and copays.

The board has since moved its September deadline to December 1. All meeting materials and draft proposals remain publicly accessible through the board’s online portal. Schoon urged transparency in the process, noting that the plan’s success depends on clear communication about how funding mechanisms will operate in practice.