In recent articles, we’ve discussed the importance of physician succession planning as a way to defend against the negative impact of physician turnover. We discussed the 3 types of succession plans every organization needs as well as the 8 steps to physician succession planning. Here, we will review what we’ve learned and discuss common mistakes to avoid when developing physician succession plans.

Physician Succession Planning: Why, What, and How

Nothing raises the temperature in a practice like a physician giving notice. The burden is felt at every level of the practice. From office staff calling patients to reschedule future appointments, to physicians taking on additional responsibilities, to leadership screening and interviewing candidates – everyone feels the stress of physician turnover. A physician succession plan allows organizations to prepare for turnover before it happens. By forecasting physician hiring needs and detailing the actions required when a physician gives notice, the organization lessens the burden felt throughout the practice and ensures continuity of patient care.

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. Creating the plan is a multi-step process, primarily involving researching and forecasting trends, crafting detailed job descriptions, pairing potential leaders with mentors, and partnering with a recruitment firm. The process will look a little different for every organization, though there are some common mistakes you’ll want to avoid.

3 Common Physician Succession Plan Mistakes

1. Thinking It’s All About Recruiting

While it’s true that successful physician recruitment begins with succession planning, don’t make the mistake of thinking a physician succession plan is all about recruiting. Research and forecasting is a critical first step that will allow you to better understand your physicians’ retirement timelines. Gathering information to create job descriptions and implementing a training or mentor program are also important pieces of physician succession planning that organizations often forget. In the MGMA and JPS study, fewer than half of those administrators who reported having a succession plan, said the plan included a mentorship program. Succession plans that only focus on external recruitment will come up short when it comes to promoting internal candidates and developing leaders.

2. Not Partnering With a National Physician Recruitment Firm

On the other hand, while it’s not all about recruiting, you don’t want to overlook the need for a respected, national recruitment partner. Having an established relationship with a physician recruitment firm allows you to nurture a pipeline of candidates and launch a search quickly if needed. Using your research and retirement timeline, your recruitment partner can also advise on how long it takes to recruit and hire physicians in a variety of specialties and levels of leadership, so you will know when to launch the search. (Spoiler alert – it’s likely much sooner than you think.)

3. Underestimating the Duties of Physicians

When a physician resigns, the immediate concern is coverage for that physician’s patients, however, chances are good that your physician wears a lot more hats than you realize. A critical part of succession planning involves collecting detailed information about what each physician does so that you know 1) what responsibilities will need to be delegated or outsourced until a replacement can be found, 2) what kind of training is needed for potential internal candidates, and 3) what exactly should be listed in the posted job description. This step is important not only for physicians in leadership positions but for physicians at every level. Most physicians do a lot more than treat patients, and it’s best to know exactly what they are juggling before those balls are dropped.

Of course, the biggest mistake of all is not having any kind of physician succession plan in place. Even prior to COVID-19 and the recent surge in retirements, the average rate of physician turnover was estimated at 7%. That means 7% of physicians leave their jobs each year, so it’s likely that every practice will be impacted to some degree every year. Why wouldn’t you want to prepare for the inevitable? By forecasting likely turnover and charting the course of action accordingly, healthcare organizations can avoid a disruption to patient care and ease the additional stress placed on physicians and staff, ultimately improving their job satisfaction and retention.

If you are seeking a recruitment partner as part of your physician succession planning, 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.

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.

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.