Hanging onto your best physicians isn’t something you want to leave to chance, yet many practice leaders skip over the structure for a successful retention strategy.
A May 9, 2023, MGMA Stat poll asked medical group leaders if they have a formal program or strategy for physician retention. The majority (77%) said “no,” while only 15% reported “yes,” and another 8% responded “unsure.” The poll had 451 applicable responses.
Preparing for a wave of physician departures
One of the most critical areas for medical group staffing are the most experienced physicians in the workforce. As noted in a recent whitepaper by MGMA Executive Partner Jackson Physician Search, a record number of physicians are nearing retirement age. Data from the Association of American Medical Colleges (AAMC) found that nearly half (46.7%) of practicing physicians were over the age of 55 in 2021. In other words, “more than two of every five active physicians will reach age 65 within the next 10 years.”
Additionally, multiple pandemic-era surveys have shown physicians expressing increased desire to retire early or leave the practice of medicine:
- In a 2021 Jackson Physician Search survey, more than half of physicians said COVID-19 had changed their employment plans. Of that group, one in five were seriously considering early retirement.
- An Aug. 23, 2022, MGMA Stat poll found 40% of medical practices had seen a physician retire early or leave the practice due to burnout.
Of course, while many physicians may want to retire as soon as possible, the volatile economy has pushed the timeline for 38% of all respondents. Concerning physicians over age 60, the percentage is slightly higher, with 46% saying they have delayed their plans.
The dos and don’ts of physician retention
As Kurt Scott, founder and CEO of The Physician Leadership Career Network, wrote for MGMA Connection magazine, building an effective physician retention strategy will require a lot of listening and commitment from the organization’s senior leadership to address issues that come up.
“It’s important not to gloss over any issue; doing so will be the fastest way to lose your credibility,” Scott wrote. “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.”
Creating a physician retention committee
Looking at current turnover rates and other bits of data, it’s evident that having a committee to review and analyze the numbers for common themes is an important step to “brainstorm and make recommendations for remedies and improvements,” Scott wrote.
“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,” he added.
Scott recommends that for larger medical groups of 100 doctors or more, the committee should be six to 10 physicians, including your organization’s head of physician recruitment/retention. For a group of only a few dozen physicians, the committee should be four to six doctors and whomever leads your group’s overall recruitment efforts.
Scott also urges caution about bringing in many nonclinical voices. “Avoid including nonphysician administrators or vice presidents, which can make the committee less credible among the doctors,” Scott wrote. “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.”
Gathering unique data
Scott suggests groups categorize data into 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? Scott recommended 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 should 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 and blinded (name removed) 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.
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.
Discuss all issues, evaluate recommendations, and 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 priority, so senior leadership should be driving it forward at every possible opportunity.
Following this process, Scott writes that 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.
As Scott notes, 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.
JOIN MGMA STAT
Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. Sign up by texting “STAT” to 33550 or visit mgma.com/stat and make your voice heard in our weekly polls sent via text message.
Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at email@example.com.