At just 42, retirement was not on Dr. M’s radar, and yet, after 10 intense years of treating cancer patients, her resolve had grown thin. A big career change was in the best interest of her and her young family, and yet her employer, an academic institution where Dr. M wore many hats, was blindsided by her resignation. Though she provided six months’ notice, they feared it was not enough time to hire an oncologist in her field who could take over her patients, not to mention carry out her many other responsibilities.
Dr. O hated to be asked about his retirement plans. Though he was approaching 65, he found the questions insulting and responded that on his last day, they’d have to carry him out on a stretcher. This always garnered a chuckle, but the message was received. Dr. O did not plan to retire as CMO any time soon. The board was confident that they had plenty of time–until of course, a sudden heart attack required a stretcher to be called.
Hired out of residency, Dr. T had been at a busy pediatrics practice for three years. He was building strong relationships with patients, bonding with colleagues and staff, and learning from several mentors. He was on the path to become a leader and mentor himself, until his cross-country parents grew ill, and as an only child, Dr. T felt he had no choice but to uproot his life and move closer to them. With very little notice (and heading into flu season!), Dr. T’s busy practice found itself down a pediatrician.
Physician turnover happens. Whether due to burnout, as with Dr. M; personal illness or death, as with Dr. O; or changing family circumstances, as with Dr. T; physicians leave their jobs every day–sometimes with adequate notice, but sometimes without. Studies estimate an average physician turnover rate of 7% annually. That is, 7% of all physicians will leave their jobs each year.
Recently, there has been an increase in discussions about a spike in physician turnover and physician retirements–some attributed to COVID’s impact on an already stressed physician population but most due to the high volume of physicians reaching retirement age. Experts will continue to debate the driving forces behind rising physician turnover, but regardless of the cause, administrators must prepare for it with 3 distinct types of physician succession plans: 1) a physician leader succession plan, 2) a general succession plan, and 3) a short-term/emergency plan.
2 Facts About Physician Succession Planning
Getting Ahead of Physician Turnover in Medical Practices, a whitepaper by MGMA and Jackson Physician Search, reports the findings of a survey covering physician recruitment, engagement, retention, and succession planning. With respect to succession planning, two things are overwhelmingly clear. First, administrators recognize the need for succession planning, assigning it a level of importance of 7.5/10, on average. More qualitative conversations with respondents reinforced the fact that the repercussions of a physician’s departure weigh heavily on the minds of practice and hospital leaders.
The second clear takeaway is that most leaders don’t have a succession plan in place to ease the problems caused by physician turnover. In fact, only 16% of administrators surveyed have a formal written succession plan. An earlier MGMA survey found 58% reported having no plan at all and 71% said they were not prepared for a physician departure.
Whether you plan for it or not, physicians leave. And with the data on the physician shortage increasingly dire, the time it takes to find a suitable replacement is likely longer and longer. Still, many administrators think the answer to physician turnover is simply recruiting, however, successful physician recruiting begins with succession planning.
So what is succession planning? And how does it impact physician recruitment? This article will introduce the three different types of succession plans while highlighting the importance of each type. In subsequent posts, we’ll dig into the how-to aspect of physician succession planning– including mistakes to avoid.
More Than a C-Suite Problem
Succession planning is important across industries, however, it is generally thought of and talked about with respect to high-level positions. Who will fill the shoes of a departing CEO or retiring President? In healthcare, these questions certainly apply to leadership positions, however, the shrinking physician workforce makes succession planning applicable to physicians at every level of an organization.
Who will see the patients of the departing physicians? How will other responsibilities be assigned or absorbed? An already overworked physician workforce may not have the bandwidth to take on the patients and other duties of departing physicians for any length of time, and if forced, it will likely increase physician burnout and negatively impact retention. The cycle perpetuates itself.
The need for succession planning is clear, but it is not a one-size-fits-all plan. Organizations should have three types of succession plans. One prepares for departing physician leaders such as a Chief Medical Officer or a Partner in a private practice; a second accounts for departing physicians in non-leadership roles. The third succession plan should address emergency needs in the short term.
1. Physician Leader Succession Plan
Succession plans for those in high-level leadership positions are not uncommon, however, as noted, very few healthcare organizations have any type of formal succession plan in place. Succession plans for physician leaders should include a comprehensive documentation of the duties and responsibilities of each leader. The physician leader should be actively involved in creating this list. They should also be mentoring physicians identified as potential leaders on the execution of these responsibilities. Additionally, to gauge the timing of future transitions, board members and other leaders should have regular conversations about estimated retirement plans, if applicable.
2. General Succession Plan
Succession planning for physicians at any level should include documentation of responsibilities and training and mentoring if needed. Having physicians who are able to step in seamlessly when another physician departs eases the disruption to the practice, but it doesn’t eliminate the need to quickly hire a replacement. For this reason, forecasting potential departures is a key part of general succession planning. Taking the temperature of physicians’ stress and burnout levels may help predict departures, as will factoring in average turnover rates.
Leadership should not only consider what level of recruitment is needed to replace departing physicians, but also, what level is required to grow the practice (if growth is, indeed, a goal). Many organizations find some level of ongoing physician recruitment is necessary to build a pipeline of potential candidates who can quickly fill a need. They may choose to partner with a national physician recruitment firm to ease the in-house burden and find physicians who are both a professional and cultural fit.
3. Short-term Succession Plan
Even with thoughtful succession plans in place, an organization may still experience unexpected gaps in coverage. An emergency succession plan addresses these short-term needs. If there is no established pipeline of candidates from which you can accelerate the recruitment process, then the short-term plan may be as simple as establishing a relationship with a locum tenens staffing agency. Alternatively, a short-term succession plan may include reassigning the departing physician’s patients and responsibilities to other staff, however, this method has its risks, specifically, increasing stress and burnout for remaining staff.
The Value of Physician Succession Planning
In each of the opening scenarios, healthcare organizations were forced to deal with an unexpected physician vacancy. If those employers had active succession plans, they might have detected Dr. M’s increasing burnout and addressed her waning resolve before she made a move. In Dr. O’s case, the board would have already identified physician leaders with the potential to fill Dr. O’s shoes. Despite his reluctance to talk about retirement, they would have insisted he document his responsibilities and mentor those potential leaders. For Dr. T’s practice, a short-term succession plan would have positioned them to easily request a locum as soon as Dr. T gave notice and activate an existing network of physicians in their search for a suitable replacement.
By utilizing the three different types of physician succession plans, organizations ensure the business of patient care goes largely uninterrupted without placing an undue burden on other physicians. In this way, succession planning not only saves the organization money but also protects its physicians from increased stress and burnout, thus improving retention rates.
If your organization seeks a physician recruitment partner as part of an effective physician succession plan, Jackson Physician Search is ready to assist. Contact us today.
Also, learn more about creating effective succession plans by downloading the whitepaper: Getting Ahead of Physician Turnover in Medical Practices.