| - Physicians go where they are invited. | | | | physician to everyone in the group one week |
| - Physicians stay where they are well treated. | | | | prior to their start date. |
| - Physicians grow where they are cultivated. | | | | - Recruiter follows up with the Physician Mentor |
| Is a Formal Physician Retention Plan really | | | | via Evaluation Form and/or telephone call to |
| necessary? | | | | ensure that bi-monthly calls to the new physician |
| Physician recruitment and retention is becoming | | | | are being made. |
| increasingly difficult each year. More hospitals, | | | | Year 1 |
| group practices, and managed care organizations | | | | - Recruiter calls to welcome physician and their |
| work harder to recruit and retain the best and | | | | family within the first week of relocation. Sends a |
| brightest physicians. As competition continues to | | | | "Welcome" basket to the home on the new |
| grow, we are seeing more aggressive physician | | | | physician's first day of work to include the family |
| relations programs to strengthen relations with | | | | in the feeling of celebration. (Include: Local |
| physicians. With 84% of the hospitals and | | | | activities, sparkling apple cider, bread sticks, |
| thousands of group practices and most managed | | | | specialty coffee, Starbucks gift card, local cookies, |
| care companies in America recruiting, many feel it | | | | a card listing store recommendations & local |
| has become a recruitment war. (In 1999, with | | | | services (i.e. Babysitters, swimming-pool service, |
| 6000 physicians graduating from Residency | | | | churches, social & cultural activities, parks |
| programs, there were over 18,000 practice | | | | & recreation, etc.) |
| opportunities available.) | | | | - Spouse Buddy calls to welcome spouse/family |
| Direct recruitment costs average $30,000 per | | | | within the first week of relocation |
| physician (This does not include relocation | | | | - Physician Orientation on the new physician's first |
| expenses). Additionally, the following costs | | | | day of work |
| associated with physician turnover should be | | | | - Physician Mentor meets with new physician on |
| considered: | | | | Orientation day and checks in daily for the first |
| - Patient Access | | | | week of employment to provide information, |
| - Patient Turnover | | | | guidance & support. |
| - Gross Billings Lost | | | | - Recruiter welcomes the new physician to his/her |
| - Inpatient Revenue Lost | | | | office: Hangs a welcome banner, plant or flowers |
| - Specialty Referrals Lost Average annual | | | | for desk, etc. |
| turnover was 6.4% for all medical groups | | | | - New physician (& family) attends a small |
| responding to the survey conducted by the | | | | dinner party at the Physician Mentor's home within |
| American Medial Group Association - 5.2% for | | | | 2 weeks of the new physician's start date. |
| medical groups with more than 500 physicians and | | | | - CEO introduces the new physician at the |
| 6.9% for those with less than 500 physicians. | | | | General Membership meeting (biography to be |
| Causes of Provider Turnover | | | | included on the agenda) & a token gift is |
| It is rare for a provider to have experienced one | | | | presented by the Recruiter. |
| catastrophic event that causes them to seek | | | | - Physician Mentor introduces the new physician to |
| other employment. Most typically, it is a | | | | the group & Independent physicians at |
| combination of several things that build over time. | | | | weekly CME. If possible, the Physician Mentor |
| Typical causes of turnover: | | | | takes the new physician to any Satellite clinics to |
| - Lack of or "bad" chemistry with the partners | | | | introduce and to facilitate networking between the |
| (#1 reason nationwide) | | | | satellite clinics and main clinic. |
| - The practice didn't fulfill their professional needs | | | | - Recruiter works with the Spouse Buddy to |
| (i.e. multi vs. single specialty group, group too big | | | | organize a Spouse Networking Luncheon within 2 |
| or too small, etc.) | | | | weeks of the new physician's start date. |
| - The practice was different than expected (i.e. | | | | - First Three Months: Monthly meetings with group |
| longer hours, weekend hours, evening hours, | | | | CEO and the new physician to get feedback on |
| outreach expected, in-patient duties expected, | | | | practice development & discuss problems or |
| number of patients seen per day, etc.) | | | | any other topics relevant to their situation. To |
| - Absence of feedback during the critical time of | | | | provide feedback "interventions" over a period of |
| the honeymoon | | | | time, foster on-going communication & to |
| - Desire to be closer to family | | | | ensure that the new physician feels valued to the |
| - The physician and family never become a part | | | | group & community (by giving positive |
| of the community | | | | feedback from patients, other physicians, & |
| - The physician and/or spouse never became | | | | community members, etc.). Also, to build goodwill |
| comfortable with the environment | | | | between the new physician & Administration. |
| - Lack of control over their practice (i.e. | | | | As information becomes available, tracking of |
| Scheduling, referral authorization, being excluded | | | | patient volume, revenue and expenses. After |
| from the decision making process, etc.) | | | | three months, Quarterly meetings for the |
| - Lack of two-way communication | | | | remainder of the first year. 15 minute meetings. |
| - Lack of appreciation | | | | - Physician Mentor meets with new physician |
| - The feeling of abandonment. | | | | monthly to continue to provide information, |
| Physician Retention Begins During Recruitment | | | | guidance & support. Meeting times to be |
| Physician retention really begins early in the | | | | determined between the two physicians. |
| recruitment process. Retention efforts that should | | | | - Practice marketing. Marketing & |
| be included during the recruitment/interview | | | | Communications issues a press release to the |
| process include: | | | | local newspaper, places print & radio |
| - Screening candidates for the best all around "fit" | | | | advertising, introduces the new physician on the |
| - Establishing mutual expectations during the | | | | telephone on-hold audio, in the Main Clinic elevator |
| interview & reiterating these before an offer | | | | display cases, Satellite Clinic bulletin board/waiting |
| is made (i.e. Patient load, call schedule, committee | | | | room displays, Group Internet website (posting of |
| time, timeframe to a full practice, etc.) | | | | biography card), other advertising, promotions |
| - Ensuring that candidates know exactly what to | | | | & special events as appropriate. CME |
| expect | | | | presentation through Medical Staff Services if |
| - Screening the Spouse for career objectives or | | | | appropriate. |
| requirements | | | | - Recruiter calls the Spouse on a monthly basis to |
| - Integrating "retention" into the interview process. | | | | see how she/he & family are acclimating to |
| Communicating to candidates upon interview that | | | | the community & new lifestyle. |
| one of the primary goals of the recruitment | | | | - Spouse Buddy calls the Spouse on a monthly |
| process is retention | | | | basis to see how she/he & family are |
| Justification for a Three Year Plan | | | | acclimating to the community & to informally |
| The highest turnover is during the first three | | | | (as seems appropriate) help with introductions |
| years on the job among well-paid professionals in | | | | & information about the community, social |
| all industries, including medicine, and is especially | | | | events, shared recreational activities. Also, to |
| high during the first year. To retain the highest | | | | continue to answer questions, provide information |
| percentage of new physicians, organizations should | | | | & personal support. |
| plan to work with them for three years. | | | | - Spouse Buddy sends birthday cards to Spouse |
| - Continue to build relationships with the physicians | | | | & children on respective birthdays (Optional). |
| - Help them adjust professionally & develop | | | | - Recruiter surveys the new physician after 2 |
| their practices | | | | months to see what improvements could be |
| - Help them adjust personally to their new | | | | made in the Orientation process for future |
| environment | | | | implementation. |
| The key to physician retention is to maintain | | | | - Recruiter surveys both new physician & |
| regular contact with physicians and their spouses | | | | spouse after 6 months to see what |
| to stay abreast of how they are adjusting, and to | | | | improvements could be made in the relocation |
| anticipate any problems that may develop. The | | | | & practice orientation processes for future |
| most critical element in any retention plan is a | | | | implementation. |
| mechanism to "check in" on the physician's | | | | - Recruiter surveys the new physician after 6 |
| expectations. | | | | months to see what improvements could be |
| Recruiting cannot be considered completely | | | | made in the Physician Retention Plan for future |
| successful until the physician is on staff and | | | | implementation. |
| productive to the point of providing a service to | | | | - Recruiter surveys the Spouse after 6 months |
| the community and producing enough revenue to | | | | to see what improvements could be made in the |
| pay back recruitment. Therefore, the recruitment | | | | Spouse Buddy Program for future implementation. |
| function should include responsibility for seeing that | | | | - Annual meeting with the System CEO. |
| the physician and his or her family are not only | | | | - Recruiter surveys the new physician after 1 |
| recruited, but are successfully acclimated to their | | | | year to see what improvements could be made |
| new location. | | | | in the Physician Retention Plan for future |
| At all times you should keep in mind the needs of | | | | implementation. |
| the physicians' spouses and families because | | | | - Recruiter surveys the Spouse after 1 year to |
| frequently physicians' satisfaction depends on their | | | | see what improvements could be made in the |
| families' adjustment. | | | | Spouse Buddy Program for future implementation. |
| Retention efforts will not be wasted because is it | | | | - Recruiter follows up with the CEO, Physician |
| is far less costly to save one promising recruit | | | | Mentor & Spouse Buddy via Evaluation Form |
| than to find another. | | | | or telephone call to ensure that schedule is being |
| Three Year Physician Retention Plan | | | | followed & to obtain feedback. |
| Initial activities | | | | Year 2 |
| - CEO calls & sends a handwritten note | | | | - Bi-monthly meetings with the Physician Mentor. |
| welcoming the physician to the practice upon | | | | - Quarterly meetings with the Clinic CEO. |
| receipt of the new physician's signed contract. | | | | - Spouse Buddy calls the Spouse on a bi-monthly |
| - Select Mentor for the new physician. Recruiter | | | | basis to "check in". |
| sends the Physician Mentor a copy of the | | | | - Recruiter calls the Spouse on a bi-monthly basis |
| Physician Mentorship Program Position Description | | | | to "check in". |
| and Schedule, a copy of the new physician's CV | | | | - Annual meeting with the System CEO. |
| and a brief memo regarding the physician, spouse | | | | - Recruiter surveys the new physician after 2 |
| family, start date, new address, hobbies, etc. | | | | years to see what improvements could be made |
| - Recruiter sends a note to the new physician | | | | in the Physician Retention Plan for future |
| advising them that a Mentor physician will be | | | | implementation. |
| contacting them. | | | | - Recruiter surveys the Spouse after 2 years to |
| - Offer Spouse Buddy program to the new | | | | see what improvements could be made in the |
| physician's Spouse. If interested in participating, | | | | Spouse Buddy Program for future implementation. |
| select a Spouse Buddy & let the spouse | | | | - Recruiter follows up with the CEO, Physician |
| know that their Buddy will contact them upon | | | | Mentor & Spouse Buddy via Evaluation Form |
| arrival to the area. | | | | or telephone call to ensure that schedule is being |
| - Recruiter sends the Spouse Buddy a copy of | | | | followed. |
| the Spouse Buddy Program Position Description | | | | Year 3 |
| and Schedule & a brief memo regarding the | | | | - Bi-monthly meetings with the Physician Mentor. |
| Spouse & their family (including start date, | | | | - Bi-annual meetings with the Clinic CEO. |
| new address, hobbies, Spouse/kids birthdays, etc.) | | | | - Spouse Buddy calls the Spouse on a bi-monthly |
| - Department/Division Interface - The Director of | | | | basis to "check in". |
| Clinical Services involves the new physician with | | | | - Recruiter calls Spouse on a bi-monthly basis to |
| issues regarding Equipment, Space, Scheduling | | | | "check in". |
| & Staff complement before their arrival. | | | | - Annual meeting with the System CEO. |
| - Administrative Secretary orders the physician's | | | | - Recruiter surveys the new physician after 3 |
| lab coat & business cards. | | | | years to see what improvements could be made |
| - Recruiter keeps in touch with the physician | | | | in the Physician Retention Plan for future |
| & spouse monthly to "check in" on relocation | | | | implementation. |
| preparations, send company newsletters, etc. Is | | | | - Recruiter surveys the Spouse after 3 years to |
| available to act as a resource for whatever is | | | | see what improvements could be made in the |
| needed in preparing the physician and family for | | | | Spouse Buddy Program for future implementation. |
| relocation, including Spouse employment. | | | | - Recruiter follows up with the CEO, Physician |
| - Physician Mentor should call the new physician | | | | Mentor & Spouse Buddy via Evaluation Form |
| bi-monthly to keep him/her informed of | | | | or telephone call to ensure that schedule is being |
| developments in the group and/or department | | | | followed. |
| before their arrival. | | | | Post-Employment Phase |
| - Director of Clinical Services ensures that the | | | | Exit interviews should be conducted by the |
| physician's office is cleaned & ready | | | | Executive Director - Administrative Services with |
| (furniture, telephone & computer lines | | | | all physicians who voluntarily leave the organization. |
| installed, starter office supplies, etc.), exam rooms | | | | If information revealed in these sessions indicates |
| are cleaned & stocked, mailbox in mailroom, | | | | a pattern of some kind, the Executive Director |
| & that appointment cards have been | | | | -Administrative Services can share it with the |
| ordered. | | | | recruiter if that information can be used to |
| - CEO issues a memo introducing the new | | | | improve the Physician Retention Plan. |