Why One New Hospital CEO is Prioritizing Physician Succession Planning

Rural providers especially need to be proactive in addressing physician turnover, says this incoming hospital leader.

Though succession planning is often considered in relation to the C-suite, it's also a term providers should be emphasizing for replacing departing physicians.

Particularly for rural hospitals, the impact of losing physicians can be devastating, potentially leading to a shuttering of services and a loss of care. As more physicians leave their organization, retire, or exit the industry, providers must take the long view in building up a pipeline of candidates.

That's where Cole Stockton has placed much of his focus after taking over the reins of Highpoint Health – Riverview and Highpoint Health – Trousdale. Stockton, who was appointed CEO of the Tennessee-based hospitals in February, recognizes the challenges that are specific to rural providers and the importance of physician continuity in the communities they serve.

"When you look at rural communities and rural hospitals, what you see a lot of times is you have a provider that's been in that community and has been a staple for that area for long periods of time," Stockton told HealthLeaders. "Often, you'll see that they tend to get closer to retirement and you really have to start thinking about and planning ahead for what that succession plan looks like.

"A lot of those providers also wear many hats, so many are primary care providers, they're OB providers, they can even dabble in general surgery at times. That generation, they're multifaceted in their skillset, which is really, really impressive, but you have to start thinking about what that succession plan looks like and dive deep into the provider recruitment side."

When physician retention drops, it can lead to care deserts in rural areas. For example, research by healthcare advisory firm Chartis found that between 2011 and 2023, 293 rural hospitals stopped providing obstetrics, representing 24% of the country's rural OB units.

"It is a common thing for when providers do roll off, it is very easy for a service to fall by the wayside if you don't look at trying to recruit somebody else," Stockton said.

Pictured: Cole Stockton, CEO, Highpoint Health – Riverview and Highpoint Health – Trousdale.

Rural hospitals face an uphill climb and are often at a disadvantage in comparison to larger hospitals in urban areas, but CEOs like Stockton can still improve the sustainability of their organizations by strengthening workforce strategies.

It starts with being proactive, according to Stockton. By identifying if physicians will roll off in the next five or 10 years, providers can get ahead of the problem instead of having to play catch-up when the time comes for a physician to leave.

Even in cases where ending a service line is unavoidable, leaders can find ways to fill in the gaps.

"If we are going to look to draw down that service line, maybe it's a mid-level model where we have telemedicine capabilities with an actual MD provider," Stockton said. "There's different ways you can be creative, but it starts with being proactive with your planning and also tapping into the resources that you have within your organization like we have."

Stockton's hospitals have a luxury that many rural providers aren't afforded by being jointly owned by Lifepoint Health and Ascension Saint Thomas as part of their joint venture.

Through its connections, the Riverview and Trousdale hospitals can offer telemedicine and leverage technology, while also utilizing Ascension's providers for outreach to clinics, Stockton highlighted.

Making use of every resource is a must for rural CEOs, but even when hospitals can't rely on affiliations with larger health systems, there are other strategies they can employ to fortify recruitment and retention efforts.

One of those strategies for Stockton at his hospitals is to address workplace safety and culture. The Riverview and Trousdale locations use Lifepoint's Culture of Safety and Engagement (CoSE) survey, designed to help leaders understand how they can create a better working environment for staff.

"We have our CoSE survey, that Lifepoint provides to all our facilities, so staff can showcase and share a lot of their positives, but also some of the negatives and things that they want us to work on as a hospital administration team," Stockton said.

After all, ensuring a steady stream of providers isn't just about bringing enough physicians through the door, but also about keeping them satisfied enough to stay.