Like the key actors in a play, physicians are paramount to successful health care delivery. Their roles are central to patient care quality, patient satisfaction, disease management and population health. Their responsibilities are both clinical and operational, and the reputation and fiscal health of hospitals and health systems rest primarily on their shoulders. “Health systems and hospitals cannot exist without physicians,” said Kelly Rakowski, president of leadership and search solutions for AMN Healthcare. “They are the greatest and most critical asset health systems have.” It doesn’t matter how modern the hospital is or how large the endowment at the clinic if the physician staff is not fully on board, loyal and engaged. Thus, physician retention efforts need to be a top priority, in order to improve physician satisfaction and performance, and reduce costly turnover. The clinical and economic impact of physicians As important as they are to patient care, physicians are just as vital when it comes to the economics of health care. For instance, physicians direct 87 percent of health care spending, according to a 2016 white paper from Merritt Hawkins, the nation’s leading physician search firm and a company of AMN Healthcare. They also generate a healthy amount of net revenue, averaging $2.4 million per physician in 2018, according to a recent survey conducted by the firm. While the average amount generated varied by specialty, researchers noted that physicians’ overall worth to a hospital or practice is hard to measure. In reality, they are indispensable. “Given the value they contribute, you want to put considerable resources, thought and time into keeping physicians happy,” said Phil Miller, vice president of Merritt Hawkins. Physicians are also in short supply, which makes retention even more critical. In fact, the next eight years are expected to be the toughest physician recruitment market ever, according to Travis Singleton, Merritt Hawkins’ executive vice president. “You cannot recruit your way to salvation; you are going to have to retain physicians,” Singleton said. With this reality in mind, these physician recruitment and retention experts share the following guidelines for boosting physician satisfaction, improving their longevity and avoiding excessive turnover. 10 keys to keeping physicians happy and improving retention 1. Address physician burnout and give freedom to practice As health care delivery has become more complex and the demands on the physicians have increased, many have experienced physician burnout. “Health systems need to address that by balancing the workload, providing a support system and simplifying administrative processes,” Rakowski said. Many physicians feel under siege; thus, it is important to give them autonomy to practice, grow, and serve their patients and community, she added. 2. Support leadership and professional development Rakowski reports a new call to action for physicians to lead. Hospitals and health systems can help their physicians to grow and develop a career path, which will help with physician retention. Physician executive is one of the fastest growing roles in medicine, Singleton added. 3. Offer good compensation and benefits Fair compensation and benefits rank high on the list of some physicians’ priorities. Physician incentives should align with organizational goals, quality of outcomes and productivity, Rakowski said. “The compensation formula is important,” Miller added. “Doctors may be unclear or dissatisfied about how they are getting paid. The compensation formulas are tied to different metrics.” Those metrics may include patient satisfaction, adherence to guidelines, appropriate use of electronic medical records, and other things beyond clinical decision-making. 4. Develop a formal physician retention program Hospitals and practices should create a formal physician retention program, which outlines compensation plans, physician incentives, recognition programs, feedback and support plans, performance reviews and leadership opportunities. “When you have a formal retention program, it shows physicians that you care about them and are trying to make them happy,” Singleton said. 5. Assign someone to oversee physician retention Instead of simply assigning retention goals to the human resources department, designate one person who will be responsible for overseeing these efforts. That person, such as a physician liaison, should then have the authority and resources to carry out the formal physician retention plan, Miller advised. 6. Facilitate physician feedback and boost communication It is important to use both formal and informal communication to receive physician feedback, Miller noted. Formal methods should include a survey, asking about how busy the clinician is and how satisfied the physician is with the practice and compensation. Leaders and staff should also take time to simply talk with physicians, on an ongoing basis. The health system or practice may want to conduct a short, scheduled “stay interview” 90 days after a physician has come on board to ask how things are going from his or her perspective. 7. Recognize the importance of recruitment “Retention and recruitment are two sides of the same coin,” Miller said. “If you recruit the doctor effectively, that will have a lot to do with whether they stay.” The description of the practice, compensation, physician incentives, number of patients, call hours and negative things about the community should be honestly portrayed, Miller advised. If not, the physician may start looking for another opportunity soon after they arrive. “It’s all about setting up accurate expectations,” Miller said. “Put in the time, effort and attention to detail.” Be straightforward as you answer key questions from physician job candidates about their expected role and the work environment. Once a new physician shows up, it’s equally important to ensure that he or she has an adequate orientation, ongoing support and does not feel ignored, Miller added. 8. Offer flexible scheduling “Today’s physicians want more flexibility and work–life balance in their schedules,” Rakowski said. “Health systems should understand those needs and be able to provide for them.” Doctors may want more time with their children or to pursue a personal passion. Employers should consider the possibility of hiring part-time physicians. Leaders should keep in mind that today’s new physicians may not be as productive as those retiring, because newer physicians place a higher premium on quality of life, Singleton said. 9. Create a sense of belonging Develop a culture of community among physicians, other caregivers and the support staff. “Create a sense of belonging, so physicians are establishing roots and surrounded by a community they enjoy being a part of,” Rakowski said. Little things are important, too, like adding the physician’s name to the sign. Miller knows of one physician who left a practice due to that oversight. 10. Develop a positive, well-functioning workplace “We call this ‘the primacy of the workplace,’” Miller said. “Just create a place doctors like to work.” Also needed are an adequate nursing staff, fast test turnaround time, easy access to patient data, emergency department and hospital efficiency, current equipment, reasonable call schedules, and flexible scheduling for work–life balance. Additional suggestions include bringing in locum tenens during peak usage periods to prevent burnout and a scribe to enter data in the EMR. “Make their lives easier,” Miller said. “Your grass has to be greener.” Source
