In an era of physician shortages and value-based purchasing, retaining a core group of engaged providers is paramount. When a physician leaves, recruiting a replacement can be difficult and costly. "A lot of money, resources and effort go into recruiting a provider," says Randal Dabbs, MD, FACEP, FAAFP, president of practice development for TeamHealth, a Knoxville, Tenn.-based provider of physician staffing services.
On top of being expensive, recruiting a physician can be time consuming, which often results in a gap between when a provider leaves and when a replacement is brought on board. During this gap, remaining staff members have to work extra shifts to cover the gap, or organizations must use locum tenens replacements, making the process more expensive with less committed caregivers, and metrics and patient satisfaction suffer.
TeamHealth wanted to avoid the issues that come along with losing a physician, so the organization, which has about 8,900 affiliated healthcare professionals, created a program called Providers for Life. "The program promotes a culture that every physician, nurse practitioner and physician assistant who's worth recruiting is worth keeping," Dr. Dabbs says. The trademarked retention program has allowed TeamHealth to maintain a physician retention rate of 94 percent.
Here, Dr. Dabbs shares some ultra-successful aspects of the PFL program that have boosted TeamHealth's provider retention rate.
1. Focused, early community involvement. After recruiting new providers, it is important to get them oriented and engaged within the first six months. Dr. Dabbs likens it to gardening: "Early, frequent and timely watering allows roots to grow deep into the soil, which will help keep the plant alive even during tough weather. When our providers become part of the community, they are less likely to leave." In order for the provider to become engaged, the medical director makes an effort to connect the provider with other team members who have similar interests, like playing sports or attending family events.
2. Rounding. TeamHealth's medical directors are responsible for rounding on, or touching base with, all of their providers each month. The goal is for the medical director to connect with providers and see if there's anything they need or anything the medical director can do to make their lives easier. This aspect of retention is especially important when it comes to an emergency department or hospitalist program, since it is a rarity for all providers to be in a facility at the same time. "We must strategically plan to round on every provider each month, thus making rounding a necessity to keep in touch," Dr. Dabbs says.
3. Performance conversations. Physicians need feedback and coaching like any other employee, but holding a physician accountable for inappropriate behavior does not come naturally. TeamHealth has developed a Coaching Development Academy to train its medical directors on how to effectively deliver feedback, resulting in improvement and thus increasing retention, according to Dr. Dabbs.
4. Proactive retention conversations. This is one step above rounding in terms of provider engagement. When a medical director senses that a provider is becoming disengaged or is at risk of leaving, the medical director is trained and encouraged to speak with the provider, discuss potential problems and to help resolve the provider's issues. "Part of the retention program is addressing issues to encourage them to stay," Dr. Dabbs says.
5. Performing exit interviews. Though TeamHealth does boast a 94 percent retention rate, 6 percent of providers still leave the organization. Although they may not be enjoyable, exit interviews yield great information as to what the organization can do in the future to prevent attrition.
Conclusion
The medical director plays a key role throughout these retention-building aspects of the Provider for Life program. TeamHealth provides educational role-playing seminars for its medical directors so they feel comfortable rounding, leading exit interviews and initiating performance and retention conversations. "We believe that physicians prefer not to leave a good leader," Dr. Dabbs says, making the medical director role the linchpin of TeamHealth's retention efforts.
The use of these five engagement and retention techniques, along with streamlined recruitment processes, can help any hospital, health system or provider group keep more of its care providers in the organization, ultimately saving time and money.