Retention Initiatives Rise as Physician Turnover Concerns Increase
May—June 2006
Findings of a physician retention study
concluded that turnover is a growing
concern at medical groups nationwide,
while targeted initiatives to retain doctors
are on the rise. The survey, conducted by
Cejka Search, a nationally recognized
physician and healthcare executive search
organization, and the American Medial
Group Association (AMGA) was based
upon 95 responses representing medical
groups of varying sizes throughout the
country. For the second consecutive year,
the survey examines recruitment and
retention trends at AMGA-affiliated medical groups.
Tracking Shows Significant Increase
The survey revealed a significant
increase in the number of medical groups
that reported they are tracking turnover.
Overall, 90% of the respondents said they
monitor turnover, which is a 23% increase
over last year. When segmented by practice
size, all medical groups with more than
500 physicians said they track turnover, as
do 80% of the smallest groups — those
with fewer than 50 physicians.
“This survey highlights medical groups
growing concern about turnover. It also
shows how this concern is being translated
into action, with more groups reporting
they are formalizing their retention
efforts,” said Carol Westfall, president of
Cejka Search.
Joseph Scopelliti, M.D., president of the
AMGA member group, The Guthrie Clinic
in Sayre, PA, feels turnover is one of the
most important issues facing group
practices. “In todays competitive healthcare
marketplace, all eyes are on turnover and
retention. Retaining quality and highly
motivated physicians will increasingly
become a benchmark measure of truly
outstanding medical group practices.”
Turnover Rate Is a Growing Concern
The study determined the turnover rate
by asking the groups to report the highest
number of physicians they employed
during the last 12-month period and to
report the number of physicians who left
during that time period. Using those
reported numbers, turnover rates were
calculated on a numeric base of physicians
totaling 13,893.
Average annual turnover was 6.4% for
all medical groups responding to the
survey — 5.2% for medical groups with
more than 500 physicians and 6.9% for
those with less than 500 physicians.
Nearly half (47%) of the respondents
reported being highly concerned about
turnover, and more than one-third (36%)
placed turnover among the top three
critical issues facing their group practice.
To address these concerns, 58% of the
groups stated they have designated
retention initiatives compared with 48% in
2004, an increase of 21%; 41% reported
having written materials that are used for
retention compared with 27% in 2004.
In addition, most respondents believe
that during the next two years the national
rate of physician turnover will greatly
outpace that of their own practice. Sixty
percent (60%) said the national turnover
rate will increase, but only 20% said their
own practices turnover rate would grow.
Physicians are most vulnerable in the
early years. The survey found that, among
the physicians leaving a group, 47% left in
the first three years and 60% left in the
first five years.
Group Size Influences Turnover
A number of the survey findings
revealed directional trends that highlight
differences in how groups approach
recruitment and retention based on their
size and resources.
Groups with more than 500 physicians
reported less concern about turnover and
assign a lower priority to turnover on their
list of critical issues. But at the same time,
they reported more concern about
recruitment, are more heavily focused on
interviewing techniques, and employ a
diversity of resources in recruitment.
By contrast, smaller groups emphasized
retention efforts centered on communication
and engagement with leadership,
flexibility in work arrangements, and
earlier advancement into partnership and
profit-sharing arrangements, which are
also important to retention.
Building a positive environment for
physicians begins when a physician signs
with a group practice. More than eight of
ten (81%) of all groups begin retention
efforts between signing and starting date.
The Effects of Turnover
The survey showed that physicians leave
for various reasons. Seventy percent (70%)
left under voluntary resignation, while 16%
left due to termination. Thirteen percent
(13%) retired. Of the voluntary
resignations, practice issues were cited 44%
of the time, followed by compensation and
location issues (21%). Spouse issues
followed at 14%.
Because of these changes, groups were
asked to identify factors related to turnover
affecting their group during the last 12
months. Seventy-six percent (76%) of the
respondents identify stress on remaining or
current physicians due to increased
workloads. Burden on senior leadership
due to re-recruitment and increased
interviewing schedules (46%) and
decreased morale (40%) follow in
frequency of selection.
New Initiatives to Counter Turnover Being Introduced
The study showed that groups have
introduced innovative techniques to
counter turnover. The most frequently
mentioned initiatives are expanded mentor
programs and orientation programs.
According to the groups, another effective
technique is to recruit physicians prior to
the actual need, so when an opening
becomes available a potential candidate is
targeted.
“Retention starts with recruitment,”
Westfall added. “Clearly understanding
your groups culture and pursuing the
candidate who fits, can ensure a longer,
more productive relationship and can help
to sustain an environment that attracts
new candidates to support the growth of
your practice over the long term.”
Other groups offer flexible work hours,
deferred compensation plans, loan
repayment bonuses, and other benefits.
“Taken together, the findings and
directional trends in the survey may tell us
that devoting additional resources to
formalized retention programs and
focusing on cultural and behavioral issues
during recruitment can be effective in
lowering turnover,” said Westfall.
Groups did have a chance to address
ineffective methods for retaining
physicians. Although only a few issues were
mentioned, the groups pointed out that
mentoring needs solid participation. In
order for mentoring to be effective, it
needs formal mentors to be assigned and
mentors must follow through on their
commitments.
Other groups mentioned that focusing
on compensation alone as a way to retain
physicians can be ineffective.
Survey Methodology
The Cejka Search and AMGA 2005
Physician Retention Survey was distributed
in September 2005 to 275 AMGA member
medical groups. All survey respondents
(95 medical groups) were compiled for this
survey (a 35% response rate). The turnover
rate was calculated based on the number of
physicians leaving, divided by the highest
number of physicians present, over the
same 12-month period.
Source: To
obtain a copy of the Cejka Search
and AMGA 2005 Physician Retention Survey,
please visit www.cejkasearch.com.
