5 Next Steps for Hospitals After Losing a Key Aligned Physician

Competition for physicians has become fierce. The increasing number of hospitals employing physicians, coupled with the impending physician shortage, has led to physicians having multiple lucrative affiliation or employment options available.

With a growing number of new alignment options (both employment and other models), some physicians may leave their current position for new, greener pastures. Therefore, some hospitals may see a few physicians leave their organization for a new system, and then wonder what to do next.

Here, Aimee Greeter, MPH, senior manager at Coker Group, and Max Reiboldt, CPA, president and CEO of Coker Group, discuss the five best things for hospital executives to do when one of their physicians leaves for another system.

1. Work to keep physicians from leaving in the first place. Ms. Greeter says it is important for hospitals to understand the drivers of physician departures and to attempt to avoid them. According to Ms. Greeter and Mr. Reiboldt, the two main reasons physicians will leave a hospital are related to compensation and lack of support.

There are two compensation-related issues that can drive physicians to leave their job. The first is non-competitive compensation. Ms. Greeter says this can happen when physicians are paid on a straight salary with no incentives or upside for the physician. The other compensation-related issue would be the value of compensation. If physicians feel they are being undervalued or could make more money elsewhere, that is a huge driver for them to leave.

The second main reason for physicians leaving is lack of support. This could be executive or administrative lack of support or lack of operational support, according to Ms. Greeter and Mr. Reiboldt.

"If a CEO overlooks physicians or takes them for granted, when a new opportunity comes along, the physician [may] leave," Mr. Reiboldt says. Also, when physicians feel as though their clinical support staff is ill trained or not operating efficiently, they are more prone to look for other opportunities.

Along with being aware of these drivers, Ms. Greeter also recommends being consistent in the application of rules, regulations and policies from physician to physician. "Don't make one-off exceptions for physicians in order to recruit or retain them," she says. "The medical staff is a small community…and people will know."

2. Review the hospital's physician-relation functions. Ms. Greeter states because hospital employment has become popular, hospitals feel as though they no longer need a physician liaison. "We view that as a mistake," she says. "We think it is necessary to have a physician relations component to ensure consistent communication and feedback between hospitals and physicians."

Mr. Reiboldt says hospitals should have good customer service, and think of physicians as customers. "That can be overlooked when hospitals are fully aligned, but they still need customer service to physicians," he says.

Overall, Ms. Greeter and Mr. Reiboldt agree that employed physicians need just as much attention as non-employed physicians; as result, the physician relations function should not be overlooked, even in an organization where many physicians are employed.

3. Learn from whatever mistakes were made. Not every physician leaves because of a hospital mistake, according to Ms. Greeter. However, she says if a mistake was made, hospitals should identify the mistake and learn from it. "Have an exit interview [with the departing physician] if possible," she says. "Figure out why [he or she] is leaving and what you can change in the future to be responsive to that issue."

4. Communicate appropriately with patients. Ms. Greeter says the most important thing to tell patients is that there will not be an interruption in the services they receive from the health system.

"Reassure the patients that there is not going to be a lack of quality or drop-off in service," Mr. Reiboldt says. Ms. Greeter encourages hospitals to market other physicians at the hospital or in the system.

Both Mr. Reiboldt and Ms. Greeter say it could be more difficult for rural hospitals to maintain service. "As hard as that is, the hospital will have to admit there will be a break in service," Mr. Reiboldt says. "If that is the case, it is best to admit it and detail plans that are being made to repair this lapse."

Another part of communication Ms. Greeter emphasized is the importance of training the "front-line" staff, like receptionists. "Invest in the front-line staff so they know how to respond when patients ask about the physician that left," she says. "As much coaching as you can provide that person will be an asset to the organization."

5. Communicate appropriately with the remaining medical staff. When an exiting physician is a substantial revenue generator for the hospital or health system, there can be a perception that the loss of that physician will impact the medical staff by putting the hospital in a weak financial state, according to Ms. Greeter. "It is important that there be reassurances that this won't sink the hospital," she says.

"Trying to be as transparent as possible is extremely important," Mr. Reiboldt says.

He recommends that hospitals be as forthright as they can be, within legal and regulatory restraints.

While departing physicians are a reality for many organizations, the impact of their departure can be minimized through consistent messaging to the medical staff, support staff and community.

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