While much attention has been paid to recruiting top talent amid workforce shortages, retaining physicians later in their careers is also a key focus for health systems.
Mentorship, flexible scheduling and leadership development opportunities can help energize experienced physicians and reduce burnout in the years leading up to their retirement, health system CEOs told Becker’s.
Physician CEOs are uniquely positioned to understand the challenges around burnout and retention.
Sunny Eappen, MD, president and CEO of The University of Vermont Health Network in Burlington, practiced clinically until two years ago. That experience builds credibility among physician colleagues, he told Becker’s.
“Having experience being in front of a patient and having to either have difficult conversations or make difficult decisions is at the core of what we do,” Dr. Eappen said. “People understand that I can really speak from the heart and truly be in their shoes.”
The lived experience offers a different lens on workforce and operations from leaders without medical backgrounds, Marlon Levy, MD, senior vice president for VCU Health Sciences and CEO of VCU Health in Richmond, Va., told Becker’s.
“Administrators, as they should, tend to look at the financial lens first — for example, productivity metrics,” Dr. Levy said. “I think physician executives probably bring a more nuanced perspective on that and will make both workforce and sometimes investment decisions that wouldn’t completely make sense in a purely financial lens.”
With that nuance, physician CEOs have identified several initiatives to better support physicians later in their careers.
Mentorship and career development
“My colleagues who are fully engaged with their younger colleagues are more energetic, more enthusiastic, and frankly, better physicians,” David Herman, MD, CEO of Duluth, Minn.-based Essentia Health, told Becker’s. “I also think that the perspectives they share with their younger colleagues make their colleagues better physicians as well. That interaction, whether formal or informal, is truly a virtuous cycle that helps us support retention.”
Danbury, Conn.-based Nuvance Health created a mentorship program that pairs more experienced physicians with early career colleagues to discuss topics such as research, work-life balance and compensation. Several times a year the mentors meet with President and CEO John Murphy, MD, to anonymously share physician concerns as well as the areas leadership should address.
“It gave the senior docs an enormous amount of pride and respect that they were helping build bridges based upon the wealth of experience that they have,” Dr. Murphy told Becker’s.
Another well-received initiative at Nuvance is direct coaching in the simulation lab, where experienced physicians provide feedback on how younger colleagues take patient histories or deliver difficult news.
At Essentia, section heads meet twice a year with their colleagues — regardless of career stage — to discuss development. One physician considering retirement said they would prefer to focus on inpatient work, while another at a similar stage in their career wanted only outpatient work. Essentia then restructured their duties to meet their needs.
“Suddenly they both said, ‘I think I have another five years left in me,'” Dr. Herman said. “The things that create energy are different for everyone.”
Flexible scheduling
Understanding a physician’s career stage is key, Dr. Herman said.
“When I talk with some of my colleagues, we say we’re just as excited and engaged at 8 a.m. as we were when we were 20, but we may not have as much left in the tank at 8 p.m. as we did 30 years ago,” he said. “We need to fully design the work and the social aspects of healthcare for all age groups.”
UVM Health Network also offers part-time roles and flexibility to meet physicians’ evolving needs.
“It’s important to value the experience senior physicians bring and give them great flexibility in where they can provide care,” Dr. Eappen said. “You can’t cheat that experience. Flexibility and understanding goes a long way in keeping them in the workforce and keeping them content and resilient.”
Continuing education and leadership
Many physicians who are late in their careers are not looking to leave entirely, Dr. Levy said.
“They want to continue to participate — often not either administratively or clinically, but both,” he said. “It’s incumbent upon administrative teams to understand that doctors feel like they may have more to contribute in the administrative or leadership space than they had in the past.”
VCU Health strives to create opportunities for physicians pursuing MBAs or transitioning into leadership roles, as their experience offers a greater understanding of structures and priorities within the organization.
“One of my greatest responsibilities as health system CEO is to prepare for the future,” Dr. Levy said. “That means developing people, making sure physicians who want to move into administrative and leadership roles have the necessary mentorship and educational backgrounds to get that done.”
It is important that experienced physicians have the ability to influence the direction of an organization, Dr. Murphy said. Aside from teaching and mentorship opportunities, Nuvance is doubling down on its endowed chairs — currently looking for its 19th — which allows physicians to make meaningful changes in the system’s approach to patient care, research or teaching.
“It gives them a degree of autonomy,” Dr. Murphy said. “Also, when it comes to that particular field, I’m very interested in having them help me make decisions or formulate policies.”
Addressing burnout
Technology has played a key role in retention at UVM Health Network. The system uses ambient voice-to-note technology from Abridge that has been widely praised by clinicians, Dr. Eappen said.
“They were getting so burnt out, they were ready to stop,” Dr. Eappen said. “That tool has directly lengthened their careers.”
UVM’s electronic consults have also been successful. Primary care physicians can send questions to specialists, who respond within 48 hours on whether a patient needs to be seen and any advice they have. This has been helpful for primary care physicians, patients, and especially the specialists later in their careers, Dr. Eappen said. About 80% of the time, that specialist does not think they need to see the patient.
“The surprising part is the specialist has been so pleased,” he said. “The patients that are then coming to see them really need to see them, so they feel like their expertise is really being used in the best way.”
