Sourcing top talent, neighborhood tours and BBQ dinners are all important parts of recruiting physicians to join hospitals and practices in Memphis. After all the hard work to “sell” candidates and their families on Memphis, the crucial question becomes: Does the city retain physician talent?
The New England Journal of Medicine estimates that 25 percent of voluntary turnover occurs during the first three years of physicians’ joining a practice and the cost of hiring is approximately $30,000 per physician. That price tag, combined with the importance of the continuation of care for patients, makes it vital for Memphis hospitals and practices to attract the right physicians and retain them.
In the Memphis area, as well as nationally, the top reasons for voluntary turnover are:
- Work shifts (changing patient populations, increased/decreased patient load)
- Changing expectations (often due to a merger)
- Compensation
- Lack of team chemistry or fit
Industry-wide, if practice dynamics change significantly or there are unexpected or potentially negative shifts in compensation or benefits, it can create issues that lead to dissatisfaction and turnover. Priorities change and evolve when groups merge with a clinic or hospital, and it’s important that physicians/stakeholders share the same vision and commitment.
Chemistry of the team, one of the intangible facets of a physician’s proclivity to stay in a position, is one of the most essential factors for retention. Recruiters arrange multiple meetings with leaders and staff but say the way a team of physicians, nurses and support staff work together is crucial to high satisfaction and retention. Having a positive environment and work culture, trust and communication are keys for long-term success.
Physicians may move to a new region or city thinking they will enjoy the location but occasionally find the city is too far from family. For Kathy Hunt, regional director business development/physician services at West Cancer Center, experience and data have shown that candidates having personal ties within 150 miles of an opportunity is an ideal range (particularly when children or grandchildren are involved). Any further, in distance or in different stages of careers, families may consider a job change and move.
It is also important to note that the prestige of clinics can be a double-edged sword – often attracting talent while simultaneously gaining attention from top-ranking hospitals that poach physicians. As practices, hospitals and clinics in Memphis gain national recognition and awards, turnover may increase.
Jon McCullers, pediatrician-in-chief at Le Bonheur Children’s Hospital, views this type of turnover as “another sign that we are doing a good job attracting and developing top talent.” Hunt agrees with McCullers, adding that it is becoming more difficult to find the right candidate when replacing a high performer who leaves for a larger opportunity.
Melissa Purcell, recruiter at Saint Francis, has seen only a few physicians voluntarily leave the hospital during her five years there. She attributes the high retention to having strong support staff along with the low cost of living in Memphis. While she finds it is not always easy to recruit to Memphis, “once (physicians) are here, they love it.”
Another trend to consider is the growing percentage of physicians who are aging and retiring. The NEJM saw a 50 percent increase between 2012 and 2013 with a rate of retirement of 18 percent in 2013. Uncertainty around federal healthcare changes and the Affordable Care Act could explain some of the retirement rate, along with higher compensation as buyouts are accepted as part of mergers. However, the Journal of Medical Regulation wrote in 2015 that “the nation, on average, added 12,168 more licensed physicians annually than it lost.”
In 2015, Charles Krauthammer, a physician and columnist for the Washington Post, said physicians were leaving because of the electronic medical records (EMR) mandate. Aging physicians were frustrated about the change, leading them to retire early. Many were critical of this opinion, including Forbes magazine, which claimed doctors were leaving the field because they are simply aging, not because they were frustrated with the shift to EMR.
Overall, that trend does not seem to be the case in the Mid-South. The University of Tennessee Health Science Center College of Medicine saw 268 more applicants for the 2016 entering class than the 2015 entering class (although the class size remains about the same year after year).
What’s changing physician retention? Healthcare organizations nationally continue to experience tremendous change due to increased mergers and acquisitions, and ongoing high demands associated with financial, quality and regulatory pressures.
“Physicians value visionary leadership and business partners, and a team, plan and infrastructure in place to support the highest levels of quality, innovation and stability,” Hunt said. Integrated delivery systems allow physicians and organizations to elevate the standard of care, doing together what they often struggle to accomplish alone.
Memphis hospitals and practices are also growing and hiring. In April, the Memphis VA, Methodist Le Bonheur Healthcare and Church Health all held job fairs to fill dozens of new positions. Today the hospitals are hoping they have found good matches.
RELATED LINKS:
The New England Journal of Medicine
University of Tennessee Health Science Center
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