According to an August MGMA STAT poll, 40% of medical groups had physicians retire early or leave the practice in 2022 due to burnout. This figure grew from a similar poll conducted a year earlier, in which 33% of practice leaders reported physicians leaving. Certainly, the ongoing pandemic pressure, coupled with staff shortages and other challenges, is causing physicians to seek greener pastures at higher rates. Instead of merely recruiting to replace these departing physicians, healthcare leaders must develop a formal physician retention plan to address these issues if they hope to maintain or potentially grow their patient population and meet the healthcare needs of their communities. 

The Importance of Physician Retention Plans

A new whitepaper from Jackson Physician Search and MGMA, Back from Burnout: Confronting the Post-Pandemic Physician Turnover Crisis, documents the results of a study exploring the steps medical groups are taking to improve physician recruitment, engagement, retention, and burnout. According to their findings, despite the rising statistics on physician burnout and turnover, only 19% of administrators in the study said they have a formal physician retention plan, and only 8% of physicians think their organizations offer one. 

Among those administrators who report having a formal plan, nearly 8 in 10 say it is at least somewhat effective. Among physicians, 62% pointed to retention programs as somewhat or very important to their satisfaction, up from 59% in 2021. So why aren’t more leaders taking the time to create a formal plan to address one of the most pressing issues healthcare organizations face? Whether they don’t feel they have the time or don’t recognize the potential impact of formal retention plans, leaders must rethink their approach to retention plans and develop a written plan that outlines everything the organization does and plans to do to retain physicians at their organizations.  

6 Components of an Effective Physician Retention Plan

So, what does an effective physician retention program look like? While physicians at each organization will have unique needs, the JPS-MGMA research reveals the latest data on what is most important to physicians across the nation. While nothing on this list is likely to surprise you, it is important to formally address each issue in a written physician retention plan that is introduced to physicians during recruitment and revisited with physicians throughout their tenure.   

Develop a physician retention plan that addresses the following:  

Two-way communication with management — According to the JPS-MGMA research, two-way communication with management received the highest number of votes for the most important factor in physician job satisfaction. This was also true in 2021. This means providing a foundation of trust where physicians have regular access to leadership is critical to their satisfaction. So, commit, in writing, to providing those opportunities on a regular basis. Go beyond traditional one-on-one meetings and offer forums and panels to enhance discussions and improve transparency. Document these efforts as part of your physician retention plan. 

Detailed compensation information — Compensation was second on the list of factors contributing to physician job satisfaction. Of course, physicians want to be fairly compensated for their work, but due to the often complicated structure of physician compensation plans, they may feel left in the dark about how their paychecks are calculated. Document the details of the compensation structure in a written retention plan so that every physician knows exactly where they stand and what criteria they need to achieve in order to reach the next level.

Equity in workload — Physicians, like most people, want to feel that everyone they work with is carrying a fair share of the burden. In the JPS-MGMA study, “equity in workload” ranked #3 on the list of factors contributing to job satisfaction, with nearly half of respondents saying it is “very important.” To meet this need, be thoughtful, fair, and transparent about how things like new patient distribution, call schedules, and miscellaneous responsibilities are decided. Document these processes so there is no misunderstanding and reference it in the physician retention plan. 

Reduced administrative burden — Physicians want to treat patients, and yet, much of their time is spent on administrative tasks such as charting and other paperwork. In fact, some studies have found that physicians spend twice as much time doing administrative work as they do seeing patients. In multiple studies, physicians point to excessive administrative burdens as the source of their burnout, so organizations must find ways to improve in this area. In the aforementioned MGMA poll, some leaders report making improvements to EHR workflows and hiring scribes to help with notation. Document the ways leadership is committed to reducing administrative burdens and provide a process physicians should follow if they feel administrative duties reaching unacceptable levels. To retain physicians, leadership must prioritize keeping administrative burdens manageable. 

Additional time off — The importance of work-life balance is increasing among physicians of every generation, and physicians need time away from the stressors of work to recover and relax. In the JPS-MGMA study, time off was among the top five factors impacting physician job satisfaction. As part of an effective physician retention plan, detail the amount of time off physicians receive annually and the specifics of when their allotted time increases. In addition, consider offering medical mission opportunities or sabbaticals after a specified number of years. 

Strategic physician recruitment — When physicians are overworked, it is often due to the organization being understaffed. Comprehensive medical staff planning helps to project departures and anticipate growth, allowing the organization to begin the recruitment process long before a vacancy arises. As part of your physician retention plan, make a commitment to strategic physician recruitment. You should also be willing to leverage locums if necessary to keep the burden on your physicians manageable. 

Formalize Your Physician Retention Plan

You may find yourself reviewing this list and thinking, “Well, of course, these are important issues, and my organization is already working to improve in these areas.” However, while awareness and informal steps are a good start, documenting your commitments in a formal physician retention plan is important for 1) making physicians aware of your intentions, and 2) holding leadership accountable for following through on intentions. 

Knowing what needs to happen and taking steps to make it so are two different things. By documenting a formal, written plan to improve retention at your organization, all parties will know where they stand and what needs to happen to move the needle on this critical metric.  

If your organization is focused on recruiting physicians simply to keep up with attrition, it can be difficult to find the resources to think about a formal physician retention plan. Perhaps it’s time to partner with a national physician recruitment firm so that you can focus more on retention. Reach out to the team at Jackson Physician Search today.  

One notable finding of the joint study is the ongoing importance physicians place on two-way communication with management. For the second year in a row, physicians ranked this the most important factor in job satisfaction—above compensation. In fact, 85% of physicians said two-way communication with management was “very” or “somewhat important” to their job satisfaction. However, when asked to rate their employers in this area, just one in four said two-way communication at their organization was “good” or “very good.”

The Relationship Between Trust and Communication

Open communication with management is critical to a physician’s job satisfaction, and currently, most organizations aren’t meeting expectations in this area. Healthcare leaders must create an atmosphere of trust and transparency if they hope to improve communication with physicians and increase job satisfaction.

Unfortunately, trust in leadership is low among physicians. According to a survey commissioned by the American Board of Internal Medicine Foundation, in 2021, 30% of physicians reported they do not trust their healthcare organizations’ leadership. Another 17% said they neither trust nor distrust their employer. What’s more, one-third of physicians said they lost trust in the healthcare system as a whole during the pandemic. 

This lack of trust is crippling communication between physicians and leadership, but it is detrimental to other aspects of the organization as well. According to research from Gallup, across industries, one in three employees would stay with their employer longer if leaders kept their promises, and when trust is high, organizations have 50% higher employee productivity. When employees trust their employer, 74% experience less stress and 40% report less burnout. Additionally, 96% of engaged employees trust management compared to 46% of disengaged employees.

So it seems, trust is not only the key to improving physician communication, but trust is also critical for improving engagement, retention, and burnout. Thus, establishing a foundation of trust has never been more important in healthcare organizations.

How to Build Trust and Foster Communication with Physicians 

How do you know if communication and trust are areas of concern at your organization? The first step is to evaluate the current level of perceived transparency among physicians and staff. A survey may be useful in gathering data, however, one-on-one conversations will provide more qualitative information. Pay attention to what’s not being said as well. In the meeting described above, Dr. L sat silent while his supervisor talked. Dr. L didn’t feel psychologically safe enough to speak frankly, and yet, his silence was the only indicator of this lack of trust. Is this happening in your meetings? Ask yourself other questions as well, such as: “When was the last time a physician came to me for help?” and “How often do I sit down one on one with physicians?” and “Who does most of the talking in my conversations with physicians?”  

Regardless of your answers, there is likely room for improvement. In the blog post, 4 Ways to Improve Communication and Increase Physician Engagement, we discuss the importance of talking to physicians, encouraging honesty, inviting participation and solutions, and measuring results. However, all of this requires a foundation of trust. The new JPS and MGMA whitepaper details five aspects of building “psychological safety” in your organization. Keep reading for an introduction to creating an atmosphere of trust that fosters communication. 

1. Be accessible — Most organizations recognize the need for regular one-on-one meetings between physicians and leadership, but as was the case for Dr. L in the above scenario, those meetings are often the first to be rescheduled when conflicts arise. In addition to scheduled meetings, make yourself available in a more casual setting. Walk the hallways, get coffee in the break room, and otherwise create opportunities for physicians to approach you. 
2. Invite participation — When the meetings do occur, make sure communication goes both ways. Ask the physician to bring a list of items to discuss and start with those before getting to your agenda. If the physician brings up a problem, encourage them to bring several potential solutions to the next meeting. Don’t wait for formal, one-on-one meetings to ask for input, make it a habit to ask open-ended questions and spend more time listening.    
3. Display fallibility — Sometimes leadership implements policies or systems that don’t work. Occasionally, problems arise that aren’t handled well. Be able to admit when you’ve made a wrong turn and specify how you plan to correct the course. It’s much easier to forgive mistakes when the offender accepts culpability. 
4. Fail forward — In addition to admitting your mistakes, learn from them. If you’re running into resistance on the new physician wellness program, figure out why. Perhaps you’ll discover that in-house yoga and a mental health hotline are not what physicians actually want or need to mitigate physician burnout. Accept the mistake and vow to listen more and discover what exactly they do want. 
5. Set clear expectations — In your conversations with physicians, work together to set clear expectations and boundaries, and be prepared to hold people (including yourself) accountable. Physicians need to know that leadership notices when someone disregards the rules and there are consequences for transgressions. 

Of course, building trust takes time. Begin with scheduling and attending regular one-on-one meetings with your physicians. Encourage them to participate and listen to what they have to say with an open mind. Ask for solutions, and if possible, agree to try them. Acknowledge your mistakes and learn from them. Set clear boundaries and expectations for yourself and others, and then hold people accountable.

Focusing on these things will help you build trust within the organization and ultimately improve communication between physicians and management. By doing this, you will address a core need resulting in improved physician engagement, retention, and recruitment. 

If your organization is struggling to retain and recruit physicians, building an atmosphere of trust is a critical first step, but you’ll also need the advice and counsel of a national physician recruitment firm like Jackson Physician Search. Contact us today.

Financial Incentives

While throwing money at the problem may not seem like the most creative approach, there are ways to creatively use compensation to make physician jobs more attractive. Many organizations are offering flexible recruitment bonuses to be used for loan repayment, housing assistance, or other needs. Of course, compensation can also be used to persuade your current staff to stay. Physicians may respond to retention bonuses that reward the additional work and stress they’ve taken on in recent years.

In a recent JPS survey, physicians overwhelmingly ranked “increased compensation” first when asked what would motivate them to stay with their organization for another 5 or more years. So, while healthcare providers certainly care about more than compensation, it still plays a significant role in their recruitment and retention.    

Lifestyle Improvements

One crucial aspect to recruiting and retaining healthcare workers is lessening the job’s negative impact on well-being. The pandemic caused workers in every industry to reevaluate the way they were spending their time, and in many cases, people came to the realization that their jobs were not bringing happiness or fulfillment. This was especially true in the healthcare industry, where the stress of the pandemic was disproportionately felt, causing healthcare providers of all types to seek jobs with lower stress and a better work-life balance.   

Organizations must find ways to offer exactly this — less stress and more balance. In the aforementioned JPS survey, the second most common response to the question “What would motivate you to stay with your employer for the next 5 years?” was “the ability to work part-time or have a flexible schedule.” From 4-day work weeks and flexible schedules to work-from-home options and unlimited paid time off, employees increasingly expect their employers to offer benefits that promote work-life balance. 

When Possible, Outsource 

Study after study points to administrative burdens as a primary cause of physician burnout. What administrative tasks are your physicians doing that could be outsourced or delegated? Of course, the salary of a scribe or medical transcriptionist may not be in the current budget, but if it can prevent one or more physicians from leaving, it will be well worth it compared to the cost of a physician vacancy. What other burdensome tasks could be outsourced or delegated to improve the well-being of your staff? 

Leverage Technology

Technology provides one of the most tangible ways of addressing the staffing crisis and offers a multitude of options for relieving staff at every level. Perhaps making the greatest impact is telehealth technology, which allows physicians and APPs to treat patients from anywhere, partner with providers in other locations, and see more patients with less time between appointments. 

Technology may also be used to speed onboarding, training, or CME. Software that logs patients’ questions and requests may decrease the amount of time physicians spend responding to individual patient calls. Organizations can also leverage their websites and social media channels to address frequently asked questions and provide patient education on common topics such as vaccines and the community’s spread of flu and other viruses. Even small optimizations like this can make a big difference.  

Identify a Recruitment Partner

Organizations facing staffing shortages also need a permanent physician recruitment partner to serve as an extension of your team. A full-service physician recruitment firm can help you create a recruitment timeline based on your medical staffing plan and provide market data on time-to-fill for various physician specialties. Recruiters may even have creative alternatives for those positions that seem impossible to fill.     

Staffing shortages are impacting organizations of all types, sizes, and locations. In order to lessen the negative impact on your organization, it’s critical that you consider employing some of the ideas listed here — financial incentives, lifestyle improvements, outsourcing, technology, and a recruitment partner. If you are ready to move forward with the latter, the team at Jackson Physician Search can offer powerful expertise and an action plan to help you meet your staffing goals. Contact us today.

The trend is especially concerning when you consider that women make up one-third of the physician population, and they outnumber male students in medical school. As female representation increases in medicine, this trend will cause an already dire physician shortage to get significantly worse.

Even before the pandemic, studies documented that women were more likely than men to leave the profession or decrease their hours. So the question is not if they are more likely to leave, but why? And what can be done to prevent them from leaving? 

Why Are Women Leaving Medicine?

The aforementioned article from Harvard Business Review explores precisely this question. The authors cite evidence to suggest medicine takes a greater toll on women for multiple reasons: 1) Women spend more time with patients and more time charting than men, 2) They have more obligations outside of work than their male peers, and 3) They receive less recognition, respect, and compensation for their efforts. Consequently, many female physicians would not choose the career again nor would they recommend it to a prospective medical school student.

It doesn’t have to be this way. By identifying–and addressing–the unique challenges women physicians face, employers can improve the female physician experience, increase retention rates, and take a critical step in combating the worsening physician shortage.   

How to Support Women in Medicine 

Work-life balance, equity, respect. While all physicians need these things, the data indicates women are more likely to report dissatisfaction in these areas, likely contributing to the elevated turnover among female physicians. Employers must adequately respond to the specific challenges women in medicine face by taking steps to improve in the following areas: 

1. Improve Work-Life Balance

The importance of work-life balance appears to be increasing with each new generation, but for women especially, who spend more time on non-professional work outside of the office, work-life balance often continues to be out of reach. The pandemic worsened the problem, with one study showing women physicians were more than 30 times as likely to be responsible for childcare and schooling during that time. Employers that recognize this challenge and offer ways to help women achieve their ideal work-life balance will be more likely to retain those physicians.

The ideal work-life balance looks different for everyone, so talk to your physicians–male and female–about what is most important to them. Some may prioritize a more flexible schedule, but here too, what is ideal will vary for each individual. Whether it’s a 4-day work week, 7 days on / 7 days off, job sharing, part-time, or working telehealth or admin days at home, employers must recognize that a flexible schedule is just that–flexible–and if they hope to improve work-life balance, employers will need to offer a variety of options. 

Of course, work-life balance isn’t only about the schedule. Providing increased administrative support can do wonders to improve a physician’s experience at work. Hiring a medical scribe to help with charting and other administrative burdens, will put precious hours back in a physician’s day.

2. Commit to Equal Pay and Opportunity

According to a December 2021 study published in Health Affairs, male physicians earn an average of $2 million dollars more than women over the course of a medical career. Additionally, women receive fewer awards, are invited to speak less often, are published less frequently, and hold fewer leadership roles. Studies suggest the COVID-19 pandemic worsened these disparities.

Organizations should commit to pay transparency and productivity models that factor in the nuances of treating different types of patients. The HBR article points out that female physicians are more likely than men to treat female patients, whose preventative care (pelvic and breast exams) require longer visits. Risk-adjusted panel payments should take these complexities into account.

Employers should also pursue diversity in leadership and ensure women have equal access to current leaders and the opportunity to train and learn from them. Develop a leadership program specifically for women and assign female mentors when possible. Additionally, provide coaching for male leaders and physicians so they learn to identify and overcome their own unconscious bias.

3. Increase Support and Respect

There’s no doubt that practicing medicine today is not easy for anyone. However, studies indicate the job may take a greater toll on women. Not only do women have a harder time decompressing outside of work, they often spend more time with patients, more time charting, and may experience more empathy for patients than their male peers. While some studies suggest these qualities may result in better outcomes, they can also take a greater toll and lead to higher rates of burnout. 

The solution here mirrors the prior points. Flexible schedules, help with administrative burdens, and a mentorship program will go a long way to decrease the toll practicing medicine takes on women. Show further support by encouraging them to take time off, pursue hobbies, or get involved with a charity–anything to help them disconnect from the stress of practicing medicine. 

And finally, in addition to your support, women physicians need your respect. Show it to them by asking questions and including them when making decisions.    

Taking steps to address these challenges will not go unnoticed by your women physicians. By providing improved work-life balance, equal opportunity, and increased support, you will lift job satisfaction, improve retention rates, and ease the impact of the physician shortage. 

If your organization is seeking physicians or advanced practice providers to support your current team, the Jackson Physician Search Recruitment team is happy to offer our expertise. Contact us today.