In a recent MGMA Stat poll, a panel of healthcare leaders was asked, "Have any physicians left your practice in the last year?" Of the more than 1,500 applicable responses, 59% responded yes and 41%, no. Let's take a deeper look at this data to reveal the potential impact on practices.
Why do physicians leave practices?
In the MGMA Stat poll, those who reported that physician(s) have left their practice noted retirement was the primary factor influencing physician turnover.
Today's workforce is multi-generational, so it is not uncommon for physicians to make retirement decisions based on factors other than their age, such as what's happening in the practice, their level of frustration and because they are burned out.
There are certainly other reasons for physician turnover, including better opportunities, family issues or simply being asked to leave. However, many respondents to the Sept. 18 MGMA Stat poll mentioned "lack of alignment," "unmet expectations," "frustration with leadership" or simply "burnout" as reasons physicians left their practice. Thankfully, all of these problems are fixable.
What is the cost to practices when physicians leave?
Calculating the actual cost to your practice is not an exact science. There are hard costs (costs based on time and resources) and a host of intangible costs such as lost productivity, lost quality of work and increased competition due to turnover from departing physicians.
- Recruiter fees
- Advertising, job posting
- Recruitment materials, including print, video, etc.
- Travel, lodging and entertainment
Time and resource costs
- Administrative and support team time
- Physician time
- Clinical support staff time
Relocation costs (once a hire has been made)
- Travel and lodging (while house hunting)
- Relocation (moving expenses)
- Sign-on bonus
- On-boarding costs (clinical and administrative time)
- When a physician announces his or her decision to leave, there could be a downward trend in productivity, so loss of revenue could begin prior to departure
- Potential loss of revenue after the physician leaves
- Potential loss of patients to another practice/provider
- Potential loss of revenue as the new physician ramps up his or her practice
- To other providers
- To referral patterns
- To clinical support staff
- In patient satisfaction
According to Christine Sinsky, MD, FACP, vice president of professional satisfaction for the American Medical Association (AMA), it costs anywhere between $500,000 to $1 million to replace an existing physician. However, there are steps your practice can take to avoid these costs by reducing physician turnover.
Ways to reduce physician turnover
These are steps you can take to reduce physician turnover in your practice.
- Develop a physician recruitment and retention plan.
- Know your practice culture, practice styles, core values and your community.
- Communicate your practice culture, core values, expectations and practice style with candidates.
- Understand how candidates align with your practice culture, core values, expectations and practice style.
- Pay close attention to the potential "fit" of the candidates' spouses in your community during the interview process.
- After hiring a physician, ensure that the onboarding process is thoughtful, well managed and exceeds the new hire's expectations.
- Develop a culture that is built on openness and trust.
- Ensure that you exceed the new physician's expectations during the first year.
- Ensure that you provide ongoing feedback to the new physician and the other physicians in the practice.
- Develop a culture that addresses physician burnout and develop processes and programs that can help prevent it.
- Look for ways to provide opportunities and innovative approaches, not ways to hinder the communications process.
When physicians leave a practice, the costs are high at many levels. Yet, there are steps you can take to reduce physician turnover and keep your practice running smoothly.
- Read "Employee turnover – how do you compare?" An MGMA Insight Article
- Read Reducing medical practice staff turnover, a Physician’s Practice Article
- Learn "10 golden rules for successful medical practice recruiting," an MGMA Data Story
- Learn more from MGMA DataDive Practice Operations
- The MGMA Research & Analysis report: Building a positive practice culture: Critical factors for success, releasing in November 2018 will also address how to improve practice culture to help prevent burnout
Kenneth T. Hertz, FACMPE