Five Questions

TO: CHIEF RETENTION OFFICER
FROM: CHIEF EXECUTIVE OFFICER
RE: DON’T LET DOCS GET AWAY

The looming physician shortage isn’t just hearsay any longer. In fact, the healthcare industry is already dealing with the effects of a dearth of docs. With Congress’ Council on Graduate Medical Education projecting even greater shortages for the future and baby boomers transitioning into Medicare, the tipping point is at hand.

Your community can’t afford any doctor defections, so it’s time to get serious—and creative—about your physician retention efforts. In other words, it’s time to answer some tough questions.

Do we understand what we’re facing?

Hospitals and systems should focus their efforts on continual needs analysis, says Jennie L. Campbell, shareholder with Pershing Yoakley & Associates, a healthcare consulting firm headquartered in Knoxville, Tenn. If you want doctors to stick around, you need to understand the environment in which they are working. That means being familiar with the patient population and projected growth, the community’s medical demands, and physician professional trends such as case loads, average salaries and the cost of malpractice insurance. Staying informed helps you react to these conditions before you’re in dire straits.

Why do docs leave?

Some common reasons physicians give for leaving a community include general work pressures, disappointment with call coverage, and dissatisfaction with the group, peers or leaders. As best as possible, you should find out why physicians have chosen to leave. Look for trends and brainstorm about opportunities for improving the culture of the community’s healthcare organizations, says Campbell.

Steve Sinclair, associate administrator for the 51-physician, multispecialty Graves-Gilbert Clinic in Bowling Green, Ky., says as a direct response to the threat of losing physicians, hospitals should work to respond to complaints and technical needs and quickly correct deficiencies.

What steps can make the difference?

Many hospitals or systems provide physicians with management services, such as practice startup, billing services, EMR systems and credentialing support. Campbell is starting to see some creative solutions, as well. For instance, a client contacted her about a disruptive doctor who had trouble working with his peers. “In the past, the client might have just cut that physician,” she says. “But now we’re working on providing the physician with a career coach and providing some professional development.”

How can we work with physician groups?

Creating joint ventures with physician groups or paying for call coverage can be delicate issues, but organizations need to assess these possibilities before area medical groups decide to go it alone. Campbell has noticed more of her clients exploring formal alignments with physicians, but these should not be done in a slapdash, reactive fashion. Instead, create a formal, methodical process to ensure you’ve done your due diligence before entering into a business agreement, says Campbell.

Sinclair agrees with this assessment. He has observed hospitals becoming more active in recruitment efforts for specialists who fit with their service lines. “It’s getting harder to get subspecialists in the recruiting battle,” he says. “So you can’t afford to lose the ones you have.”

Are we keeping docs in the strategic loop?

Do your physicians feel connected to the strategic direction of your organization? These days, many physicians want inside information about the business of the hospital where they practice, says Campbell. Gone are the days when white coats left the business decisions to the suits. They want to know what the hospital is up to—and how it will affect them.

Obviously, retaining physicians is a complex issue. Some systems have gone as far as creating a formal office of physician relations that is separate from recruitment, says Campbell. But one thing is clear: Keeping physicians will become more costly and time-consuming as the industry realizes the shortage so many are predicting.

—Rick Johnson