The challenges associated with today's complex medical environment are well known and widely discussed—declining reimbursements, increasing uncompensated care, additional government intervention, and a troubled economy all require a tremendous amount of focus from the individuals in the C-level of any healthcare entity. All too often the demands required in these areas distract administrators from perhaps the most critical issue facing healthcare over the next 10 years—retention.
The shortages in the physician marketplace have been debated for some time, but ask any CEO who is recruiting internal medicine, neurology, or otolaryngology if there are shortages in these specialties and the resounding answer is yes. In 2010, there are a total of 210 physicians transitioning from training in otolaryngology to the full time practice of medicine. With over 5,700 hospitals in operation nationwide, (90+% of which are actively recruiting) the magnitude of the problem becomes clear. As a national physician placement firm that conducts well over 750 assignments annually, it seems clear to us that a comprehensive, well thought out retention plan will be critical for all facilities wishing to succeed in the future.
In 2008, Delta Physician Placement accepted a consulting assignment with a hospital system located throughout the Midwest to review and evaluate both their recruitment model and their retention plan for existing physicians on staff.
Of the hospitals surveyed, every facility indicated that their retention practices lacked structure, focus, and content. In fact, most of the facilities surveyed did not have a formalized retention plan on paper that was communicated across all organizational levels. This is not meant to convey that it wasn't an issue of importance for the system; instead it was not given the level of priority tasking necessary in today's environment.
Following completion of the consulting assignment, several key points were outlined as being critical in establishing a successful retention program:
A Formalized O3. (One on One) This process should be implemented during the first year of service. These sessions should take place at the 30, 60, 90, 180, and 365 day marks. It is important to note that these are not intended to be performance reviews. Instead, these are meetings designed to "check the pulse" of the physician and gain an understanding of the good, the bad, and the ugly from his or her point of view. The keys to good 03 sessions are simple: they are regularly scheduled; never missed; the primary focus is on the new physician; and careful, complete note taking and follow up is essential. By approaching the one-on-one process in this manner, facilities will see greater engagement and more collaboration from their new hires.
On Board for Success. Define and document a formalized on-boarding process for new physicians. Set them up for success from the beginning and you will be rewarded with a long-term provider. Successful facilities recognize that not one person can oversee the recruitment and liaison functions. This liaison function oversees both the physician's integration into the medical community and makes certain that the spouse and children are integrating into the community as well.
Don't Forget the Better Half. Formalized O3 meetings with the spouse/partner of the physician are also critical. While these do not need to occur with the same regularity as the physician, they should still be implemented at three month intervals over the first year of service.