General practice is in 'crisis' and health bosses have failed to recognise the decline due to a lack of data, according to a report.
GPs are now working under such pressure that the profession is facing a major problem with both recruitment and retention.
Research by the King's Fund found the overall number of consultations - including face-to-face and telephone appointments - has increased by 15% over the last five years, three times the rate of increase in the number of GPs.
That means doctors are juggling ever-greater workloads.
Almost half of GPs who left the profession between 2009 and 2014 were younger than 50.
The report's lead author Beccy Baird told Sky News: "One of the biggest reasons we found that GPs were at least not considering working full time in general practice was the intensity of the working day.
"Lots and lots of short appointments, dealing with very complex problems, sometimes on the telephone, sometimes face-to-face and no extra time to do all the associated follow-up work that is needed - the paperwork, checking blood results. There is just too much work for them to do in a day.
"This crisis has slightly crept up on us because NHS England and the Department of Health have had no data to tell them what has been going on in general practice for a really long time.
"We think it is absolutely critical that they put measures in place to know and understand what is happening in general practice, in the same way they know what is happening in hospitals."
The report makes a number of recommendations to "avoid the service falling apart", including the use of technology to cope with growing demand, enhancing the workforce with new roles such as "health coaches" and reducing bureaucracy.
Dr Maureen Baker, chair of the Royal College of GPs, said, "This report provides cold hard facts that confirm what the College has been saying for years: that general practice is suffering under the unsustainable pressures of rising demand and a diminishing workforce.
"We should never have reached this point - the lack of national-level data on the state of general practice in recent years enabled many to turn a blind eye to the ever-worsening crisis until our profession was on the brink."
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