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Should Healthcare Adopt Netflix's 'Keeper Test'?

Analysis  |  By Amanda Norris  
   July 03, 2024

Workforce challenges are running rampant in healthcare, could Netflix's buzzy employment strategy be the answer?

Netflix has provided the world with hours of binge-worthy content—is it now providing us with a successful healthcare workforce strategy?

What am I talking about? As you may or may not know, to stay competitive, the company has a unique termination policy called “The Keeper Test” which ends employment relationships “with employees whose managers wouldn’t fight like Cobra Kai to keep them onboard.”

The Keeper Test, which recently came back into the spotlight online, encourages managers to ask themselves whether they would rehire a current employee if they came in this morning looking for a job. If not, managers are encouraged to let the employee go. Netflix also recommends paying a severance and getting a release.

Netflix says this policy promotes transparency. Because there are no formal reviews, managers are encouraged to discuss performance openly and consistently. The approach, Netflix says, allows employees to know where they stand compared to their peers so they can make any necessary adjustments to stay on top.

While this strategy can work well in certain industries,

Would it work in healthcare?

Eh, I’m not so sure. But there are some pros and cons to consider anyway.

Implementing Netflix’s “Keeper Test” in a healthcare setting would certainly be met with mixed reviews—especially given healthcare’s already-shaky workforce. While the policy has proven successful in the entertainment industry, healthcare is a different beast altogether.

Let’s take a closer look at why or why not the “Keeper Test” may work in healthcare.

How this strategy could potentially work:

It could provide transparency and open communication: The keeper test promotes transparency and open communication between managers and employees. This can be beneficial in healthcare settings where feedback on performance is crucial for providing quality patient care.

It encourages personal growth: Just like in the entertainment industry, healthcare employees may have a great job but it might not be the right fit for them or the organization. The keeper test can help healthcare employees identify areas for growth and development.

It could reduce turnover: By implementing a policy that requires employees to continuously work at their best, healthcare organizations may see a reduction in voluntary turnover. This can lead to a more stable workforce and better patient outcomes.

It could boost productivity: The competitive nature of the keeper test can drive employees to be more productive and innovative in their roles, ultimately benefiting patient care.

Where this strategy falls short in healthcare:

It could create a fear of job loss: Whether at the forefront of patient care, patient registration, or behind the desk dealing with payer denials, all healthcare employees already operate in a high-stress environment, and the fear of losing their jobs may cause additional anxiety and tension in the workplace. This could potentially impact patient care and employee morale.

It could be perceived as a lack of investment in employees: Some healthcare employees may perceive the keeper test as a lack of investment in their professional development and well-being. Healthcare organizations often prioritize continuous learning and career advancement for their staff.

There are of course legal considerations: Healthcare organizations must navigate complex employment laws and regulations, especially when it comes to termination practices. The potential for discrimination claims or legal issues may deter healthcare leaders from adopting the strategy.

The unique challenges in healthcare: The healthcare industry has its own set of challenges and dynamics that don’t totally align with the competitive nature of the keeper test.

Not only that, the vast differences in roles across healthcare make this strategy impossible to implement evenly across the board. Should physicians be held to productivity standards like revenue cycle staff are? Patient care, ethical considerations, and teamwork are crucial components of healthcare that may not fit well with a cut-throat employment strategy.

So, what do you think?

Workforce challenges are running rampant across the board for healthcare leaders, and it’s true that new strategies need to be crafted, but is this one a little too much?

While the strategy has proven successful for Netflix and other industries, balancing the need for transparency, productivity, and personal growth with the unique challenges of healthcare is essential to maintaining a positive work environment and delivering quality patient care.


Amanda Norris is the Director of Content for HealthLeaders.


Implementing Netflix's "Keeper Test" in healthcare may promote transparency, communication, personal growth, and productivity among staff.

However, the strategy may also create a fear of job loss, be perceived as a lack of investment in employees, and present legal challenges in the healthcare setting.

Would you still choose to implement a similar strategy?

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