HomeLearnPhysician Retention: Keeping it Consistent and Effective Through an Innovative “Non-Program”

Submitted Courtesy of Kurt Scott
Physician Search and Consulting Division
VISTA Staffing Solutions

Front-line recruiters are acutely aware of the factors that make physician recruitment a full-time job, and often a very stressful process. These include internal issues specific to your healthcare organization as well as national conditions such as the growing physician shortage and the tendency of physicians in some specialties to move their practices more often.

Hospitals and medical groups across the country are also “feeling the pain.” It is probably not news to you that the average cost of recruiting a physician is approximately $30,000 per candidate, which leads to the expenditure of millions of dollars annually for healthcare organizations. These organizations also suffer an average revenue loss of $1.5 million each year per vacant physician position. Other detrimental outcomes, including low morale and decreased efficiency, can result in a decline in the quality and continuity of patient care. Overall, these troubling results can significantly contribute to the sense of urgency you experience when your organization is short-staffed. It is no wonder that you often feel pressured to find and recruit physicians to fill open positions — right now!

Regardless of the reason, physician turnover can create an increased and sometimes overwhelming demand on a staff physician recruiter’s time. That’s why it is so critical to create an effective physician retention program aimed at decreasing turnover and preserving a stable physician workforce. In fact, hospitals and medical groups in the United States are spending thousands of dollars developing complicated retention programs. However, despite the best intentions, many of these programs only look good on paper and too often fizzle out for lack of active participation.

Based on more than 18 years of experience in physician recruitment, I recommend that healthcare organizations implement what I like to call a “non-program” — comprehensive and proactive initiatives designed to modify the organization’s day-to-day behavior and become an integral part of the organization’s daily workflow.

The key is to consistently apply the initiatives you put into place. Doing so will assure that you are doing everything you can to enhance physician retention and reduce recruitment needs. Also, keep in mind that the foundation of every successful retention plan is hiring the best candidate available. Many of the initiatives included in the following “non-program” can help your organization thoroughly focus on the hiring process. Through consistent use of these “tips and tools,” ASPR members can develop a strategic and effective non-program for their organization.

1) Position your organization as the “employer of choice”

  • Make the decision to become a premier workplace for physicians and state it publicly.
  • Create a benefit committee to research “no-cost” benefits that will show how your organization goes the extra mile for its employees.
  • This initiative will attract highly qualified applicants and increase your candidate pool.

2) Doctors love details. So, prior to commencing every physician search, create a site/practice profile that provides specific information about the position and the practice.

  • The practice profile should include the following information:

— Job title and position description

— How you are going to source this candidate

— Number of providers (names and background)

— Number of active charts

— Description of the facility, including equipment, technology,
and  procedures

— Hours of operation, including weekend hours, call schedule, outreach
expected, and details about the admitting hospital, if applicable

3) Select a group of “model” physicians

  • Identify a group of physicians who you consider “model” staff. Research the group’s attributes and similarities, such as work ethic, attitude, and interpersonal skills, and create a picture of the model candidate.  This process, known as profiling, is not conducted on the basis of gender, race, ethnicity, nationality or religion.
  • Once you have completed the profiling process, provide a list of positive attributes to your in-house recruiters, leadership team and participating interviewers so they can use the material to evaluate candidates during on-site interviews.

4) Conduct high level interviews and establish comprehensive selection processes

  • It is critical to include this physician group in your interview processes whenever possible.
  • Make sure to heavily recruit the physician’s spouse. More often than not, the spouse is a determining factor in whether or not a physician will accept a position.

5) Hire the right people!

  • The most important component of the recruitment process is to interview thoroughly and hire the most-qualified person for the job — in the first place.
  • It is equally important to make sure of a “good fit” with your organization’s culture.
  • Play up the benefits offered by your organization and play down the downside, but be sure to “paint the real picture” of the position. This allows physicians to “self-select.”
  • Establish mutual expectations that will fulfill the needs of both the physician and the facility. Openly discuss expectations for working longer hours or weekends and define in-patient duties as well as the anticipated number of patients per day. “Forgetting” to provide these details can result in another physician turnover.
  • Develop an interview evaluation form that allows the recruitment team to “share notes.”

6) Provide a mentor

  • Provide physician mentors who begin interacting with the physician as soon as possible – even before he or she begins working at your organization. This mentor can be a hospital leader or another physician interested in helping out a co-worker.
  • Mentors can help acclimate the physician within the practice and the community, as well as guide him or her professionally and personally.

7) Create a dynamic and well-defined orientation program

  • Address initial questions and concerns right out of the gate.
  • Don’t just say “hi” in the hallway. Schedule regular meetings with new employees throughout their first three months. This is an opportunity to address the physician’s concerns while obtaining feedback that will enhance retention efforts.

8) Help physicians to acclimate, acclimate and acclimate some more!

  • Create social events for medical staff and their families that build a sense of community.
  • Make a particular effort to help the physician’s children get situated in new schools and introduced to sports and community programs, based in their interests.
  • If budget allows, establish wellness programs that might include motivational speakers, psychological counseling and workshops on change management.
  • Partner with a provider and offer childcare onsite.
  • Develop a confidential Employee Assistance Program (EAP) through which physicians can get help with personal finances, marriage and family issues, etc.

9)  Develop enhanced, two-way communications

  • Establish channels that enable a real-time two-way “conversation” about physician questions, concerns and complaints on an ongoing basis, preferably via a Web-based and real-time program.
  • Communication programs should enable initial feedback and response as well as  provide a forum where established physicians can have a voice and virtually “get together” with colleagues.

10) Continuously evaluate and augment retention efforts

  • Ensure that the physician is being integrated into your organization’s culture.
  • Check to see if he or she and family members are joining the community.
  • Routinely hold interviews with long-term physician employees that ask, “Why do you stay?” and “What are we doing well?” This will help you to determine how to improve work relationships and increase the physicians’ satisfaction with your organization.
  • Conduct annual satisfaction surveys and commit to addressing any concerns and issues they reveal on a timely basis.

11) When all else fails and a physician resigns … don’t forget the exit interview

  • Take advantage of the opportunity to identify problems and enhance your non-program.
  • Sit down and talk with the physician about his or her experiences. This may reduce residual “negative” feelings toward your organization.
  • Combine a face-to-face interview with a post-employment survey that is sent to the physician’s home — no less than three-months but not longer than one year later. The survey may facilitate more honest feedback than an in-person exit interview.

Of course, the above-described “non-program” will only be successful if an organization is committed to consistently budgeting for and utilizing its initiatives as well as responding quickly to physician feedback. It is well worth the effort however; improved physician retention has proven to decrease turnover while increasing morale and efficiency, which can significantly improve the quality and continuity of patient care.

Submitted Courtesy of Kurt Scott

Mr. Scott is the division manager for the Physician Search and Consulting Division at VISTA Staffing Solutions. He has years of experience in physician retention planning and is also a past president of the Association of Staff Physician Recruiters.

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