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8 Steps to Create a Physician Succession Plan

Jackson Physician Search
November 10, 2021

Across industries, the global talent shortage is disrupting business as usual. However, it’s nothing new to the healthcare industry, specifically as it relates to physicians. Concerns about a physician shortage have been mounting for decades, but an aging and increasingly burned out physician workforce may be creating a spike in physician turnover and making physician recruitment more challenging than ever.

Getting Ahead of Physician Turnover in Medical Practices, a whitepaper by MGMA and Jackson Physician Search, shares the results of a recent survey covering physician recruitment, engagement, retention, and succession planning. The findings make it clear that while healthcare administrators are worried about rising physician turnover, very few (16%) have a formal physician succession plan in place to address the issue.

If it’s true that “the best defense is a good offense,” then succession planning is the best, most proactive way to defend against the negative impact of rising physician turnover. But what exactly is a physician succession plan and why is it so important to have it in the playbook? More importantly, how does one create an effective physician succession plan?

In a previous article, 3 Types of Physician Succession Plans (And Why You Need All 3), we explored the “what” and “why” of physician succession planning. Here, we’ll review what we learned and then outline 8 steps for creating this essential physician recruitment tool.

Physician Succession Planning: What It Is & Why It’s Important

When a physician leaves – for any reason – it creates stress in the practice. How quickly can they be replaced? Until then, who will cover their patients? How will other responsibilities be delegated? Physician succession planning addresses these questions before the physician leaves. It is a written plan that both forecasts physician hiring needs and details the actions required when a physician gives notice. By planning for inevitable turnover, the organization does not have to sacrifice continuity of care or burden the other physicians with additional stress when a physician leaves.

Organizations should have three types of succession plans: 1) a physician leader succession plan, 2) a general succession plan, and 3) a short-term/emergency plan. The first accounts for what happens when a board member or C-suite physician retires or departs for other reasons. The second, general plan addresses the departure of physicians with few or no management responsibilities whose absence would still disrupt the organization. The third, emergency plan serves as an interim plan for when, despite best efforts, an organization is still left with a gap in coverage.

With these three different types of physician succession plans, organizations experience fewer and shorter gaps in coverage, so the business of patient care continues without placing additional stress on physicians. In this way, succession planning not only saves the organization money but also protects its physicians from increased burnout.

8 Steps to Create a Physician Succession Plan

Now that you know what it is and why you need a physician succession plan, it’s time to create one.

Step 1: Goal Setting

Identify the goals of succession planning in order to make a business case for why it is important for your specific organization. In the MGMA and Jackson Physician Search survey, the most common objective of a physician succession plan was to meet patient demand. While this is obviously important, a succession plan can also serve to alleviate the burden felt by remaining physicians when one departs. In this way, succession planning is also an element of a good retention program.

The scope of this early stage will largely depend on the size of the organization, how many people need to buy into the process, and what resources are required to proceed. If everyone is on board with the need for and purpose of succession planning, the process can get underway.

Step 2: Research and Forecasting

Conduct an environmental scan to forecast recruitment needs. Gather data on physicians currently on staff to understand their demographics, specialties, skill sets, and patient volumes. Use the data to create a timeline that estimates the number of physicians likely to retire in each specialty for the foreseeable future. Consider industry data on physician turnover trends to help estimate non-retirement turnover.

Prioritize and forecast recruitment needs based on these estimates, as well as the organization’s plans for growth. Physician recruiting serves to both replace departing physicians and grow the practice with new physicians. Recruitment forecasting should consider both goals.

Step 3: Meet with Stakeholders and Develop Job Descriptions

Succession planning requires consistent and transparent communication with stakeholders. Reach out to physicians nearing retirement age to gauge their short- and long-term plans. When do they expect to retire? Before or after 65? Are they interested in transitioning to part-time or a more consultative role as they ease into full retirement? Make sure they feel supported in their choices and encourage them to be open with you as their timeline and intentions change.

Of course, the physicians left behind when others leave are also stakeholders. Be sure to seek input from them on how they feel about turnover, what they would like to see happen when one of their colleagues gives notice. Seek out their opinions and use these conversations to identify future leaders who may be interested in stepping into a bigger role when a physician in a leadership role retires. Consistent communication with physicians may also help gauge individual job satisfaction and thus allow you to identify those physicians most likely to leave.

As part of the ongoing communication with stakeholders, be sure to develop a complete understanding of the responsibilities each physician holds. Create job descriptions containing the full scope of what each physician does. The written description could be used by a recruiter to quickly post the role to a network of physician job boards. More importantly, the full list of responsibilities will guide what training is required to get potential internal successors ready for the job.

Step 4: Implement Mentorships and Leadership Training Programs

The term “succession” suggests one physician taking over for another, so it is surprising that most succession plans do not include a mentor or training element. In the MGMA and JPS survey, only 43% of the administrators who reported having a succession plan, said their plan included a mentor program.

This element is critical for smooth transitions. In an article for the Jan/Feb 2020 Physician Leadership Journal (published by the American Association of Physician Leadership), Quint Studer, healthcare consultant and founder of the Studer Group, noted that most of the nation’s leading healthcare systems develop their leaders internally: “All of them have a wide, aggressive, robust leadership development [program] that creates a wider pipe-line than others. That’s really the key.”

A robust leadership and mentor program is something to strive for, but it’s okay to start small. Use the job descriptions created in step 4 to identify where training is needed and focus on filling in those gaps.

Step 5: Identify a Physician Recruitment Partner

Even if your program is successful in replacing physician leaders with internal candidates, those physicians who are promoted will need to be replaced. Having an existing relationship with a national physician recruitment partner will ease (and speed up) this process.

A recruitment partner can also advise on the time it takes to fill roles depending on specialty and level of leadership. Using the data gathered in your environmental scan, the recruitment partner can help create a timeline for when to begin recruiting for key positions.

Step 6: Seek Legal Advice

For more complicated transitions, legal assistance may be necessary to outline the expectations and obligations of all parties. The legal advisor may need to draft a letter of understanding that includes requirements with respect to medical records, notification of patients, disclosure of financial statements, and more.

Step 7: Create a Transition Checklist and Timeline

A thorough physician onboarding program will help newly hired physicians quickly reach productivity. However, the additional responsibilities that come with taking over for a departing physician may not be addressed in the onboarding process. The transition checklist and timeline should cover the specific actions required to transition patients and other responsibilities from one physician to another. It should be used in conjunction with the onboarding program when hiring a new physician or used alone when promoting a physician already on staff.

Step 8: Have a Contingency Plan

These steps outline the process for creating a physician leader succession plan or general succession plan. However, even with a well-thought-out plan, gaps in coverage may occur. It’s critical to have an emergency or interim succession plan that can be activated immediately if necessary. Ideally, you have an existing pipeline of potential candidates who are ready to work, but it’s important to also have an established relationship with a locums agency that can quickly fill the short-term need.

Effective Physician Recruitment Begins with Physician Succession Planning

A good succession plan includes a timeline of projections for what kind of physicians will be needed and when. As the physician shortage continues, having this timeline, and planning adequate time for recruitment, becomes increasingly important. Planning for eventual turnover and recruiting accordingly prevents a disruption in the delivery of patient care and also minimizes the stress placed on other physicians in the organization.

If you need a physician recruitment partner to assist with succession planning, Jackson Physician Search is ready to learn about your needs and share our expertise in this area. Contact us today.

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