The down economy has forced more healthcare organizations to create customized work plans to hold on to their existing physicians. With reduced operating revenues amid a national physician shortage, more healthcare organizations are thinking creatively about recruitment and retention strategies.
According to the recent "2009 Physician Retention Survey, Supplemental Edition," from physician search firm Cejka Search and the American Medical Group Association, the majority of intuitions are changing their recruitment strategies (85% of respondents) and retention tactics (76%). In the survey of 73 respondents that represent nearly 12,500 employed physicians, medical organizations said they are offering a variety of compensations, benefits, and flexible schedules, in addition to implementing more mentoring and orientation plans and leadership programs.
"Before, it was 'Here is the package. This is what we offer everybody. We can't change it. Take it or leave it,'" said Lori Schutte, MBA, president of Cejka Search in St. Louis. But that isn't the case anymore, according to Schutte.
Today, retention starts with recruitment.
"All physician candidates are not created equally," said J. Gregory Stovall, MD, senior vice president of medical affairs and director of organization development at Trinity Mother Frances Hospitals and Clinics in Tyler, TX, and co-presenter of a March 19 talk, "A Commitment to Retention: Recruiting best practices and highlights from the 2009 Physician Retention Survey" with Schutte. "Your strategy in attracting them has to have variety based on their needs and wants. It's a competitive marketplace out there, and to get the best candidates for your health system, you have to tailor your offerings to their needs and desires," he said.
Today's physicians call for more individualized plans than in previous years. That means evolving retention strategies based on where the doctor is in his or her career. Rather than a one-size-fits-all plan, according to Stovall, more organizations are hiring for fit.
"The most successful groups…look at where people are in their career, and the needs of those individuals may change over time," said Schutte.
Physicians early in their career tend to look for security through guaranteed compensation, loan repayment, and availability of advanced technology, according to the survey.
People in the middle of their career tend to seek opportunities for compensation expansion, partnerships, and even leadership paths. This group of mid-career physicians prefers compensation opportunities, either fixed stipends or salaries, depending on administrative duties.
And for those in the later stages of their career, they seek flexibility as they tend to wind down their hours and take less call, according to Stovall.
In fact, more than 1/5 of the workforce is working part time, with a 7% increase during the last four years (21% in 2009 compared to13% in 2005), according to Schutte. Made up of the two fastest growing segments of part-timers, women under 44 and older men approaching retirement show that part-time work has been increasingly common during the last two decades.
Even though turnover has been slightly lower than it's been in the past four years—5.9% in 2009 compared to 6.4% in 2005—more and more institutions might consider adjusting their recruitment and retention plans if they aren't already.
Known as the "vulnerable years," there is a retention drop-off from the second to fifth years of physician employment in which doctors tend to leave their institutions. For example, the highest peak of turnover (11%) is during the second and third year that physicians work, according to the survey.
What's the risk? Money can be one great cost.
"Physician turnover is very expensive," said Stovall. In fact, losing one physician could cost up to $1 million, he said. At Trinity Mother Frances Hospitals and Clinics, a physician is responsible for $900,000 of potential downstream revenue. Combined with the $60,000 in basic recruiting costs when losing that physician and another $250,000 for startup costs for a new doctor, that can add up to a hefty chunk of change.
"In general, you're talking over a million dollars for every physician that you have to replace. Therefore, if you can lower your turnover rate, for example from 7% to 5%, you may be saving your organizations hundreds of thousands of dollars," said Stovall. "The obvious conclusion is that its makes sense to be intentional about strategies that enhance retention and invest resources, in your budget, that enhance retention; there's a tremendous return on that investment."
Karen M. Cheung is associate editor at HCPro, Inc., contributing writer for HealthLeaders Media, and blogger for MedicalStaffLeader.com. She can be contacted at kcheung@hcpro.com.