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DEVELOP A PHYSICIAN RETENTION PROGRAM—Avoid hearing reasons that sound like “irreconcilable differences” as the cause of physician turnover.


By Michael P. Broxterman, Chief Operating Officer, Pinnacle Health Group

A breakup can be tough, especially when you don’t see it coming. Fortunately, a resignation letter from a physician can oftentimes be avoided by paying close attention to any potential bone of contention that could damper commitment.

Some of the most common reasons for a physician resignation include unmet expectations, broken promises, reduced engagement, lack of equality, frequent conflicts and unhealthy communication patterns. With physician turnover increasing and the shortage worsening, earning physician commitment is critical to a hospital’s ability to provide care for its community and for administrators to preserve the bottom line.

The high cost of physician turnover

While no physician retention program can produce a 100 percent retention rate, reducing turnover by even one doctor creates a significant financial advantage.

Let’s look at a simple example.

Research shows that a primary care physician generates an average of $1.4 million in revenue per year. Upon that doctor’s resignation, the organization is facing a potential loss of $116,666 per month. And, because it can take six months or more to recruit a replacement, the cumulative loss in revenue can quite easily exceed $700,000. Simply put, it pays to keep your physicians happy—and employed.

Recognize when physician discontent may be looming

Creating a healthcare culture that values open communication equips leadership with the ability to see the red flags that could signal an impending physician resignation.

The telltale signs include:

  • Reduced productivity
  • Missed time from work
  • Sudden drop in patient satisfaction scores
  • Reduced communication with coworkers and leadership
  • Placing personal residence for sale
  • Accepting recruiter calls and participating in interviews

While old-school cultural norms deemed employees with one foot out the door better off gone, the impending shortage of 61,700 to 94,700 physicians by 2025 as reported in 2016 by the Association of American Medical Colleges means a dedication to keeping your physicians employed is no longer optional. It’s a buyer’s market, and physicians are often holding the cards.

Physician recruitment and retention work hand in glove

Have you ever accepted a new position only to find out that what you were told during the interviews and contract negotiation doesn’t quite match reality? As physician recruiters, we believe in setting the search up for success from the beginning, and that starts by being transparent about the opportunity, call demands, patient load, work-life balance, community strengths and weaknesses and potential organizational or leadership changes that could affect the healthcare facility’s long-term strategic direction.

Once the contract is signed and the physician is onsite, a strong onboarding program counts since it’s common for physicians to decide within the first several months if they’re going to stay long term. Most hospitals and practices are adept at assimilating the new physician into the organization, but sometimes stumble with physician retention. As is often the case, failing to plan is planning to fail, so incorporating a measurable physician retention program into your staffing initiatives is essential.

Elements of a physician retention program could include:

  • Formal mentoring program between culturally aligned, long-term physicians and new recruits. Peer mentorship programs increase physician engagement and allow new recruits to address concerns confidentially. Mentors are trusted advisors who often are the first to know about any mounting frustrations. They’re instrumental in opening the lines of communication between physicians and leadership.
  • Written policy to promote work-life balance. A demonstrated commitment to flexible scheduling, reduced call hours and using Locum Tenens to encourage time away serve to support the well-being of physicians.
  • Healthy organizational culture. Leading a strong culture that values transparency, kindness and engagement and that has a zero-tolerance policy for staff bullying and blame shifting should be prioritized. Missing the mark leads to reduced trust and a perceived lack of accountability, which leaves physicians and other staff feeling unnecessarily vulnerable.
  • Critical conversation training. In a dynamic industry such as healthcare, not all promises can be kept, which may lead to disappointment. As long as hospital and practice administrators preserve integrity by using direct and frequent communication, physicians feel heard and valued.
  • Quarterly physician satisfaction surveys. You can’t fix what you don’t know about. Implementing a formal physician satisfaction survey provides the opportunity to preemptively correct any issues that could lead to physician turnover. Also, don’t forget to include the family. Just as the physician is assimilating into a new organizational culture, the family is adjusting to a new community, people, schools, etc. Anything you can do to foster support for the entire family will improve physician retention.

Some turnover is inevitable—but is there a lesson to be learned?

Despite your best efforts to recruit physicians who are aligned with the culture, there are some situations outside a hospital’s control. Regardless, an exit interview by human resources, or another neutral party, is a must-do activity to avoid repeated mistakes and to minimize vulnerabilities in your organization that lead to turnover.

Pinnacle Health Group offers permanent physician search, Locum Tenens and advanced practice providers. Our sister company, PhysicianCareer.com is an industry-leading physician job board. Together, we’re committed to meeting your staffing needs. Call 800-492-7771 to learn more.

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