Alisa Limsuwan, MD¹ , Pongtorn Kietdumrongwong, MD² , Pimpana Wongchirat, RN³ , Thitima Wiriya, BNS, MSc² , Warut Chaiwong, BSc, MPH² , Somkiat Tonphu, MBA, BPH, BA, BSc, LLB² , Kawalee Sadangrit, MD, PhD²

Background: Physician attrition from the public health sector has emerged as a pressing issue in Thailand, with significant implications for healthcare delivery and workforce sustainability.

Objective: To explore the key factors contributing to physicians’ resignation from the Thai public health system and to examine physicians’ perceptions of factors that may support retention.

Materials and Methods: A cross-sectional survey was conducted in 2025 among 50 physicians who previously worked in the public health sector and are currently employed in private hospitals or other organizations. Data were collected using a structured questionnaire assessing demographics, workload, stress, career stability, and opinions on systemic problems. Descriptive statistics and the Stuart-Maxwell test was used for analysis.

Results: Most respondents were male (54%), aged 25-44 years (48%) and had >10 years of experience (66%). During public service, 40% reported working >60 hours/week, compared to 12% after resignation (p<0.001). The leading causes of resignation were inadequate income (62%), unsupportive management (46%), occupational stress (40%), and excessive working hours (38%). In contrast, job security (86%), welfare benefits (70%), and career advancement (64%) were key factors retaining physicians in the system. Physicians emphasized that improved welfare, adequate remuneration, supportive workplace environments, and transparent governance would prolong their service in the public sector.

Conclusion: Heavy workload, insufficient income, and organizational stressors were the most significant drivers of physician resignation. Policy reforms ensuring fair compensation, workload regulation, and adequate staffing are urgently required to mitigate brain drain and sustain Thailand’s public healthcare workforce.

Received 3 April 2026 | Revised 22 May 2026 | Accepted 15 June 2026

J Med Assoc Thai 2026;109(8):697-705

DOI: 10.35755/jmedassocthai.2026.8.04301