The Growing Problem of Physician Turnover

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High turnover rates are a growing problem across the healthcare industry, and physicians are no exception. Burnout, red tape, lack of mentorship, and other workplace frustrations can drive physicians to job-hop and change fields altogether, particularly in the early years of their career. Physician turnover is costly and inconvenient for both doctors themselves and the hospitals and medical groups that employ them. Moreover, low morale and high turnover amongst doctors can create serious gaps in care for patients and can affect the access and quality of healthcare overall. Understanding the problem of physician turnover, its causes, and effects are key to avoiding the pitfalls that reduce doctor retention rates.

 

How Common is Physician Turnover?

A study from National Healthcare Retention & RN Staffing Report found that turnover rate in the healthcare industry has risen nearly 5% across all jobs over the past 10 years. In 2017, the hospital turnover rate was over 18%, and the typical hospital has turned over 85% of its staff since 2013.

For doctors specifically, the turnover rate is estimated at around 7% annually for physicians in medical groups and a staggering 28% for physicians at hospitals.

A 2018 report from Merritt Hawkins Physician Foundation found that 46% of doctors surveyed plan to leave their current position within the next three years. More than one in ten of the respondents indicated that they plan to seek non-clinical jobs in healthcare or change fields entirely.

By the time they begin to practice, doctors have spent tremendous amounts of time and energy to pursue careers in medicine, prompting the question: why are so many physicians so dissatisfied with their jobs?

 

Why do doctors change jobs?

It’s hardly unusual for doctors, like any other professionals, to change jobs a few times over the course of their careers. But the growing trend of job-hopping among young physicians warrants an investigation into the reasons that so many doctors end up leaving their positions after only a short time. Research has identified several common trends among the reasons doctors most often cite for leaving a job.

  • Excessive Workload
    Many doctors decide to change jobs when they feel that their patient load has become unmanageable. Changes to healthcare policy have caused many practices to be overwhelmed by new patients, and physicians have to shoulder the resulting increase in paperwork, appointments, and workload. In the Merritt Hawkins report, 23.9% of doctors surveyed said they are currently overworked, while 55% said they are at full capacity. At these rates, any increase in workplace responsibilities can be a tipping point for a physician considering a job change.
  • Mismatched Expectations
    In today’s job market, hospital recruiters are under enormous pressure to place candidates quickly, and new physicians are extremely eager to land their first positions. This combination often results in a rushed hiring process that shortchanges important conversations about career goals, performance expectations, and institutional priorities. These early miscommunications can create serious problems for physicians who later find themselves struggling to figure out new EHR systems, pressed to meet strenuous performance metrics, or unable to pursue their own professional programs of interest. Such critical lapses in communication leave physicians and their employers on completely different pages, and prompt many young doctors to begin job hunting again within a few short years.
  • Salary Issues
    High salary expectations and financial security are often key motivating factors doctors when they choose their career path. As a result, it’s all the more distressing when insufficient compensation prompts physicians to leave a position. Most new doctors graduate with formidable student debt, and many walk into their first job interviews unprepared for salary negotiations. This can lead them to accept low-salary offers that don’t meet their financial needs. According to a 2018 Medscape Physician Compensation report, 45% of physicians surveyed do not feel fairly compensated for their work. Salary frustrations are one of the most common reasons that young doctors choose to leave a position


What is the cost of physician turnover?

Across the industry, healthcare turnover rates generate millions of dollars of in costs, and physician turnover in particular has a serious impact on a hospital’s bottom line. When a doctor leaves unexpectedly, the remaining physicians have to increase their workload causing further stress and dissatisfaction. Hospitals have to pay for the resulting overtime costs, as well as the training costs necessary for a new hire.  Between recruiter costs, onboarding costs, and lost revenue, it’s estimated that turning over a single physician can cost a hospital between $400,000 and $600,000.

For physicians, job-hopping in the early years of their career can be both stressful and costly. With loan payments looming, most young doctors can’t afford any gap in employment, and starting all over again a new position every few years can set doctors back financially. Frequent changes to bonuses and compensation plans can make it difficult for physicians to maintain a consistent financial plan necessary to pay off loans and save for retirement.  Moreover, the process of finding a new job, which often requires prolonged negotiations or relocation, can put undue stress on doctors and their families.

Finally, physician turnover has adverse effects on the people that doctors care for. Physician turnover has created a shortage of healthcare providers in certain regions, leading to increased wait times and forcing many patients to travel exorbitant distances to see necessary specialists. Doctor turnover interrupts continuity of care, and the physicians that are available to patients are often exhausted and overworked by the increased workload.

 

How to Prevent Physician Turnover

The incentives to reduce physician turnover are high for all parties involved, and there are several proactive strategies that have proven effective at increasing physician retention rates.

For employers, it’s important to scrutinize your hiring practices to ensure that new hires are fully aware about critical aspects of their position that can affect job satisfaction.  Increased transparency in negotiations and interviews can help hospitals find the right candidate for open positions and avoid the excessive costs of turnover later on. Learn what motivates your employees, foster personal connections, and look for opportunities to support their goals and needs. It’s also possible to minimize workplace frustrations by allowing plenty of time, training and support as doctors learn new software and protocols. Finally, clear and effective communication (hint: not endless emails) is key to ensuring that your staff has the information they need to succeed and that employers can receive critical feedback. Open communication gives employers the opportunity to address the causes of doctor dissatisfaction before they result in resignation.

For physicians, the key to finding a rewarding long-term position lies in a careful contract review and thorough negotiations before accepting a new role. Here are a few guidelines:

  • Ask explicit questions about performance goals regarding productivity and patient satisfaction, and determine whether an employer can honor your preferences with regards to scheduling, workload, and support staff.
  • Make sure you fully understand any “value-based” metrics in your compensation. Be sure to ask how often doctors actually receive specific bonuses. It’s possible that heavy workload or other workplace challenges make it virtually impossible for doctors to meet the requirements necessary to receive their bonuses.
  • Clearly state your interests in leadership positions, program development, or other initiatives, and inquire about opportunities to pursue these interests.
  • Have an attorney and a financial advisor review your contract prior to signing it to ensure your compensation meets both industry standards as well as your personal financial needs.
  • Negotiate your salary. Salary negotiations are a completely normal part of the hiring process for doctors, so arm yourself with the information you need to effectively advocate for yourself.

Physician turnover is a serious detriment to the healthcare system and reflects common causes of deep dissatisfaction amongst doctors. By understanding the underlying causes of physician turnover, it’s possible to prevent and reduce the turnover rate significantly. It pays off for both doctors and employers to take the necessary time and steps to establish a successful and lasting professional relationship.

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