Your new medical assistant was hired in the spring. She interviewed well, shadowed for three days, got her EHR login and a seat on a busy provider’s team. In week seven she gave notice. The exit email said the role “wasn’t a good fit.” Her supervisor was surprised.  

Nobody had sat down with her since orientation, so nobody knew she had been rooming patients for a physician whose preferences she had never been taught, guessing at the intake checklist and assuming that asking for help would make her look bad. 

That is the most common way new hires fail. The new person arrives with energy, runs into confusion or thin support, does not ask, and disengages quietly before anyone schedules a formal review. 

In a May 2026 MGMA Stat poll, about 3 in 10 medical groups reported staff turnover was higher than the year before, while 39% said it stayed the same and 30% reported it lower. Across all three groups the churn concentrated in the same roles: MAs, front-desk and patient access staff, nursing and clinical support. Practices reporting lower turnover more often described deliberate investments, onboarding and training among them, while practices with rising turnover more often described scrambling to backfill. That is a correlation, and a telling one: the practices doing better had something specific to point to. As MGMA Acting CEO Akash Madiah put it after the 2026 Annual Conference, "retention often provides a better return than recruitment." 

Three conversations in 90 days 

Orientation ends in the first week. Onboarding runs through the first 90 days, when a new hire builds competency and decides whether to stay. The structure that works is modest: three scheduled conversations, each with a different job. 

Day 30: “What have you been guessing at?” 

Ask every new hire that question, then ask what is still unclear, what training or system access is missing, and which provider preferences nobody has explained. For an MA, that means the rooming routine for each physician supported. For a front-desk hire, it means the eligibility check and the handful of payer portals that never work the way the training said. Treat the answers as friction to remove, not the hire's shortcomings: the Day-30 conversation is the frontline friction audit that Terra Bruns, DBA, urged during MGMA's Annual Conference, done for one person. 

Day 60: Course corrections while they are cheap 

Give performance feedback and look for the signals from the role: rooming time, provider complaints about intake, registration errors that come back as claim rejections, how long calls wait when someone is on the phone. 

Day 90: Compare performance to the position description 

Confirm or end any probationary period, and set the pattern for how you will keep talking. Document each conversation at a level you could reconstruct if the hire does not work out. Where possible, a peer mentor working with the new hire across the same 90 days will catch what the supervisor misses. 

Three numbers that tell you whether it worked 

1. Track early-tenure turnover separately from overall turnover: departures inside 90 days as a share of hires.  
2. Track time to competency for the roles you hire most, such as the week a new MA rooms solo at the team’s normal pace.  
3. And track whether these three check-ins happened for every hire.  

If overall turnover looks fine while early departures stay high, the problem lives inside your first 90 days, whatever the labor market is doing. If the check-ins happened and early departures still did not move, the conversations are taking place but the friction is not being removed. “Not a good fit” usually means nobody asked. 

Before you decide it’s a pay problem, rule it out 

Sometimes staff find the grass is greener elsewhere. To ensure your offers to top talent are competitive, get the 2026 MGMA Management and Staff Compensation Data Report for our industry-leading benchmarks and trends on several of the key staff roles in your medical practice. 

Keep reading 

• MGMA’s Staffing and Retention Hub includes our latest resources, member-exclusive staffing playbooks, and toolkits on building practice culture, interviewing, recruiting, and onboarding.