Pinnacle Health Group

PHYSICIAN RETENTION PLAN
Does Your Organization Have One?
By Wendy Abdo, Staff Writer and Michael P. Broxterman, COO

Does your organization run like a hamster on a wheel? You know what I mean—one physician walks out the door just as one walks in. This constant game of catch up is likened to a linebacker who's trying to stop a runningback that's five times faster from making a touchdown. So what's the key to breaking this continuous chain of events? A well-planned physician retention strategy.

Let's back up a minute and focus on why physician retention is important. As a leading physician recruitment firm, most doctors come to us because they are unsatisfied with their present job situation. In fact, annual physician turnover rates for the United States stand at 10 to 15 percent—the greatest turnover usually occurring within the first 3 years of the job. Why do physicians leave? There are a combination of factors involved (see previous article entitled, "Reasons Why Physicians Change Jobs—Results From Pinnacle Health Group's 2nd Annual Survey").

When a doctor drops out, the costs associated with this deficit can be very great. Physicians are the revenue builders for a practice. As such, a loss of physicians equates to a loss of revenue. In addition, steps must then be taken to find replacements, and the longer a position goes unfilled the more money it costs the practice.

On a higher level, patient care must be considered. Having to turn away critically ill patients because your only cardiologist has left is a disheartening task and does not send the right message to a small rural community that must drive 50 or more miles to find the needed specialists.

It takes teamwork between the recruiter and the practice to improve physician retention. As a recruiting firm, it is our responsibility to bring in the physicians, but it is up to the practice to keep them there. If a hospital/practice can keep their physicians happy, they will not suffer the setbacks associated with the loss of a doctor. That is where the physician retention plan comes in. Surprisingly, 90 percent of our clients do not have a formal physician retention plan in which personnel are dedicated solely to physician retention activities. This proves counterproductive, as it is much more costly to recruit a new doctor than it is to save a physician already onboard.

GOOD RETENTION BEGINS WITH GOOD RECRUITMENT

The best retention strategy is to hire the right physician in the first place. To do this, a recruiter must engage in an extensive process of candidate screening.

Good recruitment means defining mutual needs and expectations and matching the shared values and beliefs of the physician and the organization. Professional isolation is a big concern to physicians in rural areas, and the community and organization involved must be compatible with the physician's culture.

The physician's family must not be neglected. The spouse's career should not be trivialized. Furthermore, quality educational facilities must be available for children.

THE RETENTION PLAN

By developing a physician retention plan, a practice can reduce turnover, increase revenues, and improve their perceived image.

Relating to physicians on a personal level goes a long way in keeping them happy. A physician's unrealized expectations can raise concerns that may eventually lead them to other employment.

Depending on the individual circumstances, one person on staff can be dedicated to physician retention or have a committee of people that meets once a month to plan, discuss, and evaluate relevant issues.

To often, medical organizations look only at the professional aspects of the physician's situation. It is crucial to remember that personal needs are just as important. Here is a list of both professional and personal issues that should be kept in mind when implementing a physician retention plan:

PROFESSIONAL ISSUES	PERSONAL ISSUES
Access to referral physicians	Quality schools
Availability of medical colleagues	Adequate housing
Adequate call coverage	Employment opportunities for spouse
Competent medical staff support	Cultural/Religious activities
Continuing medical education	Adequate shopping facilities
Up-to-date equipment/facilities	Recreational/Social opportunities

Additionally, a system should be set up that periodically checks the physician's patient load and makes sure referral patterns are established and appropriate.

The physician relationship should not end when the doctor signs the contract or begins their first day on the job. It must be an ongoing process of continuous relationship building activities that will help them adjust and develop their practices and personal lives.

Here are some suggested items that may be included in a physician retention plan:

Before Relocation:

Complete a family profile
Prepare a customized orientation plan
Assign responsible parties to intermittently call physician and spouse to help them with the move
Send them a complimentary subscription of the local paper
Send pertinent information based on profile
Invite them to major group functions
Keep the physician informed of new group directives
Ensure realtor is meeting housing needs
Prepare a press release introducing the new physician to the area
Have the CEO welcome the new physician by sending a handwritten note and calling him/her after signing the contract

After Relocation:

Deliver a welcome basket and card to the physician and family at their new home.
Conduct an orientation for the physician on the first day of work including meetings with key doctors, administration, and other personnel.
Set up a mentor relationship between an established physician and the new recruit. Be sure the mentor regularly checks in with the physician and provides needed information, support, and guidance.
Have periodic performance reviews
Provide information to the family on schools, special programs, babysitters, recreational attractions, religious facilities, and shopping.

SEASONING THE PLAN WITH PERKS

Little things mean a lot. Here are a few rewards that can help retention rates:

Set up a doctors' lounge equipped with newspapers, television, DVD/VCR equipment, computer with Internet access, fresh coffee and a well-stocked refrigerator
Offer free cafeteria meals
Provide designated parking spots
Give Christmas and Birthday gifts
Provide recognition on National Doctors' Day
Coordinate an annual social event and ceremony in which physicians who have been onboard for 5, 10, 15, 20, etc. years are given awards of appreciation and recognition for length of service to the practice and community

Finally, exit interviews should always be conducted with physicians who voluntarily leave to determine if there are any related patterns that need to be rectified. This form of monitoring will help spot reoccurring problems that may not otherwise be evident.

While there are many reasons physicians choose to move on, explanations such as, "I feel unappreciated and undervalued," or "I don't have enough support" should cause the medical organization to think seriously about establishing a sound retention strategy. Good compensation and benefits may initially attract physicians, but a well-designed retention plan is what will keep them hanging around.

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This eNewsletter, developed by Pinnacle Health Group, is intended to provide information to physicians, residents, and clients to better understand physician employment and recruiting issues. Most of the information provided is authored by Pinnacle Health Group employees and affiliates. Some information comes from outside resources, including nationally recognized healthcare resources, organizations, and professional groups. We apologize if you received this in error. To unsubscribe, email tmartin@phg.com.

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Editor/Staff Writer, Wendy Abdo, wabdo@phg.com
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