The Practice of Physician Retention
Most medical groups and healthcare organizations strive for stability within their medical staffs, and stability is predicated on physician satisfaction. That means satisfaction in work product, satisfaction in work environment, satisfaction with patients, satisfaction with colleagues, satisfaction with support staff, satisfaction with organizational leaders and organizational objectives, and satisfaction with remuneration.
Giving Physicians Control
​
​
Having worked with physician satisfaction for more than 40 years, I can distill all those diverse areas into what makes physicians satisfied and what leads to their dissatisfaction into one word - Control.
​
Physicians who are happy and productive, and successful, feel they are in control of the most critical elements of their work and their practice. Those who are not, feel out of control.
​
Today, physician burnout - the antithesis of satisfied physicians, is taking center stage in many organizations as a critical issue of organizational success. And, various strategies are invoked by organizations to address their perception and their definition of Burnout. However, nearly every one of these approaches is predicated on one fallacy - that physicians think and act in a monolithic and homogeneous manner. Fact: the opposite is true. Physicians think and act individualistically, and for physician retention programs to be successful and to mitigate issues of Physician Burnout, physicians must be approached as individuals who respond to work, environment, patients and objectives individually and differently, and their work environments must be structured around them as unique individuals.
​
Taking this approach offers physicians to be in control of their own environments and practices within reasonable parameters as established at the organizational level, but with enough flexibility to meet individual physician objectives and needs.
​
Such things as daily and overall work schedules, patient profiles, and staff relationships can all be built around individual physicians. And when coupled with effective, objective based recruiting will allow both individual physician and organizational goals to be achieved.
​
Further, in today's highly incentivized work environment, incentivizing physicians to meet specific performance goals is not unreasonable, but incentives, like practice environment need to be personalized in order to be successful. Offering a range of incentives can be more widely appearing, than a single monetary or other reward.
​
The Broad View
While individuality is the key to overall physician retention, some structural elements can form a solid foundation for the individualized approach. Among these are onboarding programs to build initial assessments of new physicians and lay the ground work for both understanding their needs and inculcating them to the organizations mission and vision, mentoring programs that interlace with the onboarding but go beyond that to create
The Broad View
While individuality is the key to overall physician retention, some structural elements can form a solid foundation for the individualized approach. Among these are onboarding programs to build initial assessments of new physicians and lay the ground work for both understanding their needs and inculcating them to the organizations mission and vision, mentoring programs that interlace with the onboarding but go beyond that to create a sounding board environment that eliminates the often isolated feeling physicians experience in practice.
​
Physician control can be addressed through the type of organization and bylaws adopted by the group that creates inclusion among the staff for decision-making that affects the group as a whole. And ongoing structured interactions, such as annual reviews and lessons learned sessions following significant events or changes in the practice afford physicians the opportunity to be heard and participate in areas outside direct patient care.
​
Lastly, there will be staff turnover, regardless of the success of retention efforts by the organization. Physicians will retire, pass away, relocate for various reasons, it will happen. Exit interviews afford all parties the opportunity to learn about the pluses and minuses of the practice and work environment.
​
And finally, time away from practice needs to be compensated at the same rate as time in practice. If physicians are to be expected to participate in non-patient care activities, a compensation scale should be developed to pay for "Administrative Time" at a rate comparable to patient care.