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Five Findings That Will Help Recruit and Retain Physicians
May – June 2009
Source: Brian McCartie is regional vice president of Cejka Search, a nationally recognized physician and executive search organization providing services exclusively to the health care industry for more than 25 years. Brian is frequently cited as an industry expert in health care and business publications on the topics of physician recruitment, retention, and leadership development. He can be reached at bmccartie@cejkasearch.com or (800) 678-7858. To receive a copy of the 2008 Physician Retention Survey, please visit www.PhysicianRetentionSurvey.com.
Economic pressures are causing organizations to tighten physician recruitment budgets. So, even as the physician shortage intensifies, so does the pressure to recruit efficiently and reduce the cost of turnover. Findings from the 2008 Cejka Search and AMGA Physician Retention Survey offer insight into ways that health care organizations can sharpen their competitive edge in finding and keeping physicians through flexibility, incentives, and retention initiatives. Here are five findings that reveal areas where focused effort and investment can produce a positive impact on recruitment and retention programs.
Finding #1: Fit and Family Priorities Are Among Top Reasons for Voluntary Separation
Fit and family continue to be driving forces in turnover rates. Nearly 50 percent of survey respondents cited “poor cultural fit with
the practice” as the single most frequently mentioned reason that physicians left practices voluntarily. However, combining “spouse’s job required relocation” (18 percent) and “relocated to be closer to family” (32 percent) makes family-related reasons (50 percent) equally as important as cultural fit with organizations.
Based on these factors, a robust interview process offers a great opportunity for recruitment and retention success. Behavioral interviewing, discovering family ties, and engaging the spouse or significant other during the interview process will provide an accurate evaluation of whether the professional motivations and personal relationships of both are likely to keep candidates in practice and in the community for the long-term
Finding #2: Incentives Aid Physician Retention in the Critical Early Years of Practice
Survey results indicate that those with tenure of three years or less are consistently the largest segment of physicians who leave practices (46 percent). If structured appropriately, incentives that are effective tools in the recruitment process also appear to have
a positive effect on retention in these critical first three years. For example, organizations offering educational loan forgiveness and retention bonuses reported that the percentage of departing physicians who left within the first three years was 33 percent and 29 percent, respectively, compared to the average of 46 percent.
It’s useful to access compensation surveys, as well as current, competitive anecdotes to understand what types of compensation and incentive packages are prevalent in today’s physician marketplace and to structure these incentives not only to attract but also to retain the candidate(s) of choice.
Finding #3: Staying Flexible Can Keep Physicians Working Longer
According to the 2008 Retention Survey, close to half (48 percent) of health care organizations responding agreed that options for part-time practice encourage physicians to stay in practice while meeting personal or family needs. Survey results further show that 30 percent of male physicians who leave a practice are age 55 or older. Among all female physicians who leave, 46 percent are under the age of 39. When these turnover trends are combined with current physician demographic trends, it appears that there is a growing opportunity to keep physicians in practice by offering flexible hours, particularly to preretirement and early-career female physicians.
Nearly two-thirds (62 percent) of respondents said they believe that physicians are delaying retirement due to the economy. Almost half (49 percent) find that part-time options are enabling physicians to delay retirement. As a result, health care organizations appear to be adjusting their staffing models to meet these physicians’ needs. Respondents indicated a general willingness to modify work schedules of preretirement physicians to encourage them to stay longer: 73 percent offer reduced hours, 56 percent allow for no-call responsibility, and 20 percent allow for specialization with certain patient groups. Alternative approaches include extended vacation periods of up to several months at a time and flexibility to modify job descriptions, as appropriate.
Health care organizations that creatively address flexible staffing models to retain these physicians and ensure a satisfying and rewarding career – while meeting increasing patient demands for health care – will gain a competitive advantage in attracting and keeping physicians throughout their career lifecycles.
Finding #4: Retention and Mentoring Programs Can Actively Address Causes of Turnover
With the certainty that today’s generation of physicians are focused on being content in both their work and personal life, health care organizations should continue to expand and focus on developing their retention programs. Forty-eight percent of respondents in the 2008 survey cited employing a defined retention program, as compared to only 40 percent in 2006. Of these health care organizations with defined programs, 61 percent stated that they have been formalized to include written plans, goals, and strategies.
Year to year, respondents have mentioned mentoring as both a recruitment and retention strategy. A majority of member groups (65 percent) assign mentors to newly recruited physicians, citing that these programs help younger physicians adapt to the rigors of a demanding profession while maintaining fulfilling personal lives. Of these, nearly half (48 percent) offer written guidelines for their mentors, and nearly all (96 percent) were likely to continue.
Assigning a mentor facilitates early identification of new physician issues and problem solving. Job satisfaction surveys and exit interviews are other methods for gaining a more complete understanding of the needs of todays physicians. Among the health care organizations polled, two thirds (66 percent) conduct regular satisfaction surveys of their physicians. The information gathered is used for a variety of purposes, among them monitoring trend information (67 percent), creating action plans (58 percent), and communicating to departments (52 percent).
Finding #5: Colleagues Are a Source of Satisfaction, while Busy Schedules and Compensation Cause Dissatisfaction
The most frequently referenced sources of job satisfaction among physicians were described as “relationships with colleagues” and “job flexibility.” Survey respondents reported that physicians highly value acceptance by their colleagues, opportunities to work with peers in a collegial manner, and the ability to network. Also important were job flexibility, work-life balance, clinical autonomy, involvement in decision-making, and access to an academic environment.
Common sources for job dissatisfaction among physicians were compensation levels, demanding work schedules, and call coverage. Other sources of dissatisfaction came from lack of trust, involvement, communication, and responsiveness to problem solving on the part of organizational leadership.
These findings are consistent with the earlier cited fact that “poor cultural fit” (50 percent) was identified nearly twice as often as “seeking higher compensation” (26 percent) among the top reasons for voluntary separation. Retention programs that take into consideration key sources of physician job satisfaction are more likely to have a longer and stronger impact on turnover rates.
Stay Competitive by Keeping an Eye to the Future
Health care organizations that keep an eye toward the future and explore innovative ways to position their organizations to meet the needs of physicians throughout their career cycles will develop competitive advantages for recruitment and retention.
Physician turnover cannot be completely eliminated – nor should it be. Organizations can help minimize the impact of turnover with positive efforts such as creating flexible work schedules to allow for work/life balance consistent with physicians’ respective career stages or further developing formalized mentoring and retention programs. Maintaining a full pipeline of candidates with personal and professional ties to the community, as well as employing best practices in behavioral interviewing and contracting, can ensure that the candidate(s) selected will continue to thrive and grow with the organization. Job satisfaction surveys facilitating communication and feedback – so that an organization has a better understanding of the points of physician satisfaction and dissatisfaction – will support the recruitment and retention of today’s medical workers and ultimately offer workplace environments that allow for both professional growth and personal satisfaction.
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