Can we talk? In the dos and don’ts of physician retention, it is all about listening

Recent surveys indicate that only 15% to 30% of physicians are extremely happy in their current practice and are not considering other opportunities.1,2 This leaves 70% to 85% of physicians with some level of dissatisfaction and even considering other options. This statistic should make you quite uncomfortable.

The competition for physicians and physician executives is at an all-time high. The financial implications are enormous considering the average net revenues produced by each physician hover around $2.4 million, per a recent CFO survey conducted by Merritt Hawkins.3

The influences on physician turnover have become increasingly complex. Physician retention plans no longer consist of simply hosting an annual banquet for physicians and spouses to say “thank you.” Although a dinner remains a nice touch, today’s physician/physician-executive retention plan needs to be focused on the unique aspects of why physicians leave your organization.

I have been fortunate to have developed numerous physician retention plans. In doing so, I have experienced the ups and downs and have learned the dos and don’ts. The following is a guide to help develop, produce and implement a tailored retention program, unique to your organization.

Commitment

The first order of business before starting to plan is to gain commitment from your organization’s senior leadership to address each category of issues.

It’s important not to gloss over any issue; doing so will be the fastest way to lose your credibility. This does not mean you have to agree with all the recommendations of a retention committee. It means you need to address each, even by simply acknowledging disagreement or explaining why an issue cannot be addressed at this time.

Create a physician retention committee

It’s important to form a committee: to analyze the data captured, look for common themes and group data into categories, and brainstorm and make recommendations for remedies and improvements. In my experience, this piece of the process will improve physician turnover instantly by 5% to 10%. By demonstrating that the issue of physician turnover is being addressed in a structured, formal way, physicians and staff will understand that it is important to the organization, which brings hope for improvements.

In a larger group of 100 doctors or more, the committee should be six to 10 physicians and your head of physician recruitment/retention. For a group of only a few dozen physicians, the committee should be four to six doctors and the head of recruitment. Avoid including nonphysician administrators or vice presidents, which can make the committee less credible among the doctors; however, include a couple of your most vocal and influential physician naysayers or critics. If you can engage this group, it will help turn them into advocates who will help promote the positive results.

Gather your unique data

Data collected will be grouped in five to 10 categories to address. Individual data points include the following:

Turnover rate and assessing departures

How many physicians are leaving your organization of their own free will or involuntarily? When calculating this rate, I recommend excluding any temporary, interim and locum tenens physicians (any physician you hire or contract with a defined end date) to make your baseline more meaningful.

• Voluntary departures: You need to understand the issues behind physicians leaving voluntarily. There are two main ways to get this information.
  • The autopsy approach: The exit interview is the best way to hear firsthand about the reasons your physicians leave. Each should be well documented, blinded (removing the name) to lower the risk of bias and provided to the committee for analysis.
  • Send a simple survey to those who left in the past year: This can be done electronically via email for better response rates, or it can be mailed.
• Involuntary departures: It’s important to review everyone’s involuntary termination to look for issues that may have been overlooked during the hiring process. Information obtained is sensitive and should be handled appropriately. Results should be blinded before shared with the committee.

Current staff

Create a simple electronic survey to be sent to all your physicians regarding their current feelings about practicing with your organization. You can include multiple reminders to help get more staff engaged.

The survey should ask physicians:

• What one or two issues create the highest level of dissatisfaction in practicing with us?
• What one or two things are responsible for your highest level of satisfaction?
• What one or two issues would cause you to leave for another opportunity?

 
Results should be tabulated and grouped by category through your retention committee.

Retention committee recommendations

Once the data is collected, the committee should review and categorize. Each category should be addressed individually with recommendations for improvements.

A findings report should be developed for presentation to senior leadership for consideration. That presentation should be attended by your CEO, COO, CMO, CFO and CHRO, head of physician recruitment/retention and the designated retention committee representative or spokesperson.

All the issues should be discussed and recommendations evaluated. Determine what can be agreed to in this initial meeting. Leave the final report with recommendations for attendees to review on their own, and schedule a second meeting for the following week with expectations that each category will be discussed and addressed.

The results and agreed-to recommendations should be compiled into a report and presented to the medical staff. This is a subject that hits home with them, so be prepared for a large turnout. The designated committee representative along with senior leadership should be involved in making the presentation to ensure credibility.

Expect this process to take about three to four months to complete. It needs to be a point of emphasis, so senior leadership should be driving it forward at every possible opportunity.

Following this process, you should expect:

• A 30% to 40% reduction in physician and physician executive turnover
• Happier and more engaged physicians
• An increase in successful recruitment
• Significant revenue saved with fewer departures
• Additional revenue through a more productive staff.

 
The level of importance and total commitment by senior leadership to address each issue cannot be overstated.

The bottom line: Having a non-documented retention plan will only reduce your physician turnover by 5% to 10%. By documenting it, your results will improve significantly — even if the plan needs some work. Put some resources and thoughtfulness behind it and you will be amazed at the results.

Notes:

1. “Understanding the physician passive jobseeker.” NEJM Career Center. White paper. November 2013. Available from: bit.ly/2F7aIj5.
2. “Modern Recruiting Is Social Recruiting.” Doximity. Available from: bit.ly/2QB8MVn.
3. Merritt Hawkins. 2016 Physician Inpatient/Outpatient Revenue Survey. 2016. Available from: bit.ly/2MJwAFo.