Measuring the toll COVID-19 took on the physician workforce

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Have you had a doctor retire unexpectedly in the past year?”

• 28% said yes.
• 72% said no.

Among the healthcare leaders who reported an unexpected retirement:

• Nearly half (45%) said it was related to the pandemic:
  • 4% said a doctor retired after a COVID-19 diagnosis.
  • 41% said the retirement was pandemic-related, such as burnout, health risks, loss of reimbursement.
• 30% said the retirement was based on non-COVID-19 health reasons.
• 26% said “other,” which included at least one physician who left to pursue alpaca farming.

The poll was conducted March 2, 2021, with 921 applicable responses.

The gap between physician supply and demand

The Association of American Medical Colleges (AAMC) reported in 2020 that the projected physician shortage could be as high as 139,000 physicians by 2033, and the healthcare industry sees a turnover rate of about 6% to 7% annually — about 50,000 or more physicians each year.

Viewed through the lens of a healthcare administrator faced with a physician leaving a practice, millions of dollars can be lost through unexpected physician turnover, depending on how long it takes for a newly hired physician to build a patient base and become a profitable contributor to the group.

The disconnect between administrators and physicians

Tony Stajduhar, president, Jackson Physician Search, recently joined the MGMA Insights podcast to detail the organization’s new whitepaper, On the Verge of a Physician Turnover Epidemic. In a JPS survey of more than 485 active physicians and administrators, 83% of physicians reported that their organization had no physician retention program in place, whereas 70% of administrators said there was either a formal or informal retention program in place.

“The results suggest that healthcare administrators have been working diligently on effective physician retention programs so they can increase engagement, mitigate turnover and also contribute to a positive workplace culture,” Stajduhar said. “Unfortunately, physician responses show that it isn't working and seems largely ineffective at worst, and poorly communicated at best.”

Similarly, the survey found disagreement on engagement: “69% of physicians report that they are actively disengaged, while only 25% of administrators feel that their physicians are that way,” Stajduhar said. “There’s obviously a communication gap. What may be happening is healthcare administrators just may not yet have a pulse on how the physician workforce feels about the current working conditions.”

Stajduhar said that one area where physicians and administrators have more agreement is on the state of physician retention programs: Just 2% of physicians and 10% of administrators rated their programs highly, Stajduhar said.

“The typical annual turnover rate might be ready to explode”

Months of strain from the COVID-19 pandemic added to existing burnout issues for healthcare providers, and it has set the stage for physician turnover.

“When bad things happen, people really reevaluate their personal situation,” Stajduhar said. “Flash forward seven or eight months and there’s a resurgence of COVID-19, and it’s difficult to see the light at the end of the tunnel. … We need to be planning on how to help them get through this and feeling as positive and hopeful as possible.”

Stajduhar noted that a certain amount of turnover in the industry is natural, usually related to progressing to the next stage in a physician’s career, relocating or just the feeling of being overworked and underappreciated. “This is not unusual,” Stajduhar said.

But what the pandemic has done is amplify feelings of isolation, disengagement or being undervalued, which existed before COVID-19. In the JPS survey, more than half (54%) of respondents said COVID-19 changed their employment plans. Of that 54%:

• 21% are seriously considering early retirement.
• 50% are seriously considering leaving to work for a new healthcare employer.
• 15% are seriously considering leaving the practice of medicine entirely.

While many in the industry heard similar concerns from physicians after the Great Recession and the passage of the Affordable Care Act, most of those doctors “didn’t have nearly the personal hardship and pain that’s been brought” by the effects of the pandemic downturn and the risk of exposure, Stajduhar added. “If nothing else, this suggests that the typical annual turnover rate might be ready to explode,” he said.

Better engagement and retention strategies

To address these issues, Stajduhar recommends practice leaders “either immediately start on a retention plan or dust the cobwebs off your existing one and revamp it.” This should entail:

• Build a committee with at least 50% physician participation.
• Call a town hall meeting (virtual, if necessary) to get additional feedback from physicians and staff about your desire to improve their work lives.
• Find opportunities to compliment and recognize physicians and staff. “A little praise can go a long way,” Stajduhar said.
• Consider working to find mentors for physicians and other administrators in the organization.

The time and resources put toward a new retention strategy is likely to be “much less expensive” than turnover, and it has potential to pay off in improved productivity and overall well-being of your staff.

Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at connection@mgma.com.
 

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Additional resources

• Hear from Medical Practice Excellence: Pathways Conference keynote speaker Laurie Baedke, MHA, FACHE, FACMPE, on resilient leadership and the role of well-being in healthcare.
• Mark Davis, chief executive officer, Wasatch Pediatrics, joins the MGMA Insights podcast, detailing the mental health toll the pandemic has had on healthcare workers.
• Learn from Chris Widener, a Motivational Speakers Hall of Fame inductee and author of 22 books, about how to thrive in tough and challenging times.
• Watch for the April issue of MGMA Connection magazine for a feature on effective coaching and mentoring strategies in healthcare settings.