Physician Retention – Get a Plan!

Physician     recruitment and retention is becoming increasingly difficult each year. More hospitals, group practices, and managed care  work harder to recruit and retain the best and brightest physicians. As competition continues to grow, we are seeing more aggressive physician relations programs to strengthen relations with physicians. With 84% of the hospitals and thousands of group practices and most managed care companies in America recruiting, many feel it has become a recruitment war. (In 1999, with 6000 physicians graduating from Residency programs, there were over 18,000 practice opportunities available.)

Direct recruitment costs average $30,000 per physician (This does not include relocation expenses). Additionally, the following costs associated with physician turnover should be considered:

Patient Access
Patient Turnover
Gross Billings Lost
Inpatient Revenue Lost
Average annual turnover was 6.4% for all medical groups responding to the survey conducted by the American Medial Group Association – 5.2% for medical groups with more than 500 physicians and 6.9% for those with less than 500 physicians.
Causes of Provider Turnover

It is rare for a provider to have experienced one catastrophic event that causes them to seek other employment. Most typically, it is a combination of several things that build over time.

Typical causes of turnover:

Lack of or “bad” chemistry with the partners (#1 reason nationwide)
The practice didn’t   their professional needs (i.e. multi vs. single   group, group too big or too small, etc.)
The practice was different than expected (i.e. longer hours, weekend hours, evening hours, outreach expected, in-patient duties expected, number of patients seen per day, etc.)
Absence of feedback during the critical time of the honeymoon
Desire to be closer to family
The physician and family never become a part of the community
The physician and/or spouse never became comfortable with the environment
Lack of control over their practice (i.e. Scheduling, referral   being excluded from the decision making process, etc.)
Lack of two-way communication
Lack of appreciation
The feeling of abandonment.
Physician Retention Begins During Recruitment
Physician retention really begins early in the recruitment process. Retention efforts that should be included during the recruitment/interview process include:

Screening candidates for the best all around “fit”
Establishing mutual expectations during the interview & reiterating these before an offer is made (i.e. Patient load, call schedule, committee time  to a full practice, etc.)
Ensuring that candidates know exactly what to expect
Screening the Spouse for career objectives or requirements
Integrating “retention” into the interview process. Communicating to candidates upon interview that one of the primary goals of the recruitment process is retention
Justification for a Three Year Plan
The highest turnover is during the first three years on the job among well-paid professionals in all industries, including medicine, and is especially high during the first year. To retain the highest percentage of new physicians,   should plan to work with them for three years.

Continue to build relationships with the physicians
Help them adjust professionally & develop their practices
Help them adjust personally to their new environment
The key to physician retention is to maintain regular contact with physicians and their spouses to stay abreast of how they are adjusting, and to anticipate any problems that may develop. The most critical element in any retention plan is a mechanism to “check in” on the physician’s expectations.
Recruiting cannot be considered completely successful until the physician is on staff and productive to the point of providing a service to the community and producing enough revenue to pay back recruitment. Therefore, the recruitment function should include responsibility for seeing that the physician and his or her family are not only recruited, but are successfully acclimated to their new location.



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