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Insights on Reducing Physician Turnover

Improve Physician Retension and Boost Your Bottom Line
In Their Words: The Real Story on Physician Turnover

Table of Contents:


Supporting Work-Life Balance

More critical today than ever before, supporting physicians' needs for work-life balance can improve their satisfaction on the job. "When we fail to recognize the importance of worklife balance for employees, we lose a tremendous opportunity not only to demonstrate understanding and compassion, but to provide appreciable help in what has become a significant challenge for most people," author Manion observes.

Many of them have based their practice decisions primarily on financial factors, and they realize the satisfaction just isn't there. A number of them would trade many financial rewards of their current practices for greater autonomy or flexibility in how those practices are run. Some even expressed desires that administration would hire locum tenens physicians to cover for them more often so they could achieve more well-rounded lives.

  • "All physicians should be able to direct the pace, intensity and productivity of their professional lives. This is really all that is needed for practice satisfaction and sustenance."
  • "Basically, physician retention has more to do with control of hours/time off/coverage for call/reimbursement for CME and leave for same not counted as vacation…"
  • "The most important factors for a growing practice would be an increase in salary as patient load increases, and a guarantee of vacation, even if it means hiring more locum tenens physicians…"
  • "Every effort MUST be made to retain a physician. Incentives like extra pay, leave, flexible work hours, manageable case load, light call, major rural allowance per year to retain a physician in a rural community with extra leave."
  • "Physician recruitment and retention needs to be more than just salary. With over 50% of the primary care physician force soon to be female, there must be increased attention to flexibility that recognizes the phases of a physician's life and career."

- 2006 LocumTenens.com physician survey respondents

Creating a Positive Workplace

When managers ensure that individuals are able to fulfill both physical and emotional needs in the workplace, they increase the likelihood of employee commitment to the organization - and organizational commitment is critical to employee retention.

Essentially, experts say, there are 5 things administrators must do to create a "culture of retention" in a healthcare workplace:

  1. Value employees as people - respect, appreciate and support them
  2. Build strong teams - create a sense of community with employees and have fun together
  3. Support employee development - set high standards and support/motivate achievement
  4. Empower employees - involve employees in decisionmaking and provide adequate resources
  5. Lead - be visible and accessible, maintain clear boundaries, communicate openly and honestly

CEO survey results published by Quorum Health Resources

(QHR)22 offer insights into methods hospital CEOs are using to attract and keep good employees. These include:

  • Offering better pay and benefits and checking regional salary scales frequently to keep salaries and benefits competitive with other area employers (35% of respondents).
  • Offering training and education reimbursement programs to assist employees in professional development (about 33% of respondents).
  • Some have established full-time recruiting offices to boost their hospitals' images.
  • Some are offering progressive benefits like childcare, no mandatory overtime or scheduling flexibility in lieu of higher pay scales.
  • A number are working to create "a culture of respect and ownership" through surveying employees and responding to their concerns, involving employees in decision-making, offering mentoring and employee recognition programs, etc.

Still others are using advertising, PR, employment fairs, industry Web sites and connections with educational institutions to get applicants to come and see their hospitals.

Not unlike these CEOs, permanent physician recruiters rely heavily on the strategy of getting recruits to come and see the facility and local community first-hand, then letting the people and environment do the rest. This makes every day of supplemental physician coverage a potential recruiting opportunity.

Likewise, expert recruiters and healthcare executives generally agree that helping both the physician and his or her spouse and family connect with the local community is critical to retaining the physicians they work so hard to recruit.

An effective human resources function that supports the physician throughout the "employee life cycle" also is critical to physician satisfaction and retention.

Locum Tenens Use Assists in Physician Retention

Practicing medicine is among the most stressful occupations in the world today. Even the most dedicated physician needs work-life balance to help relieve the pressure. Here are just a few comments from respondents to LocumTenens.com's 2006 physician retention survey:

  • "The ideal situation would provide for both reasonable compensation with CME benefits and flexible work hours which allowed for extended leave for vacation, mission, work, sabbatical or crises."
  • "The 2 most important elements are time and money."
  • "…If physicians are not satisfied or do not feel appreciated for the hours they work, they will look for another position. Money isn't everything, quality of life counts more."
  • "As physician reimbursement continues to dwindle, we will need other incentives to stop our exodus from the medical field. These will include monetary and lifestyle benefits including insurance, CME, paid call coverage, retirement plans, and predictable time off work with shorter work weeks."
  • "Most places that I have worked really don't care about retaining physicians. This is sad as there is now a physician shortage and it will be worse as the baby boomers retire."

- 2006 LocumTenens.com physician survey respondents

Physician recruiters are beginning to acknowledge increasing acceptance and use of locum tenens physicians as a way to

  1. provide care needed by the community and
  2. prevent outflow of patients and loss of revenue.

Considering workforce trends-and in light of what physicians are telling us - wise healthcare organizations also will begin assisting physician retention through more proactive staffing that allows staff physicians to have lives away from the practice.

"In the long run it's a lot more cost-effective to utilize 'relief physicians' periodically than to recruit new staff physicians continually," LocumTenens.com's president says. Building locum tenens physicians into a healthcare organization's staffing plan is one way to begin improving physician retention and alleviating the physician shortage at your healthcare facility.

Customized, Flexible Packages Ideal

Based on physician survey responses to LocumTenens.com, it probably would be impossible to design a perfect, one-size-fits all retention plan within reasonable financial limits. A strong human resources function that includes monitoring of physician expectations (starting at the interview stage) and satisfaction is a critical first step.

Unlike most other healthcare employees, physicians have invested a decade in their education and medical training. They didn't do so to become "just another cog in the wheel." They want to feel respected and valued as "partners" of management.

In the words of physician survey respondents:

  • "…No formal plan for retention puts my group on a shaky ground. The result is one-half of doctors left the group [in the] past 3 years."
  • "'Retention' is bi-phasic (sic): The employer must do those things which assure the physician that he adds value to the organization; the physician must find himself/herself in an environment in which effort and creativity are rewarded by the employer."
  • "I think this is becoming critical. My employer didn't have one and I am leaving. It would not have been hard for them to keep me."