How Effective Physician On-boarding Can Improve Long-Term Retention

Losing a physician is painful — and costly — for hospitals and health systems. The cost of replacing a physician can exceed $250,000, according to various estimates. While it is nearly impossible to retain every physician, hospitals and health systems can improve their retention rates through a strong physician on-boarding and navigation program.

"Long-term retention starts way before and goes way beyond recruitment," says Tammy Tiller-Hewitt, FACHE, chief motivation officer at Tiller-Hewitt HealthCare Strategies and a physician relations and retention expert. "Effective on-boarding shifts the focus from recruitment to retention, the new paradigm for long-term success.  It's about recruiting to retain, not recruiting as a numbers game."

Here, Ms. Tiller-Hewitt shares some components and traits of successful physician on-boarding programs.

On-boarding team

The key to successful long-term results start with a strong on-boarding team — the Tiller-Hewitt HealthCare Strategies' On-boarding Wheel [right] provides an outline of who should be involved on the on-boarding team.

While an effective team should be a cross-functional initiative, it must have a strong strategic leader and a scribe. The strategic leader, typically a team member, is someone who is capable of leading and reporting the progress and results to senior leadership, and the scribe is responsible for coordinating schedules and recording minutes to keep the team accountable, Ms. Tiller-Hewitt explains.


Another key component to a successful physician on-boarding program is creating operational and family "roadmaps" for each new physician. According to Ms. Tiller-Hewitt, a roadmap should be customized for each incoming physician based on their specialty and tie to a strategic initiative. Among other functions, roadmaps lay out times for a physician to meet with relevant service line leaders and referring physicians in the area.

"Often the lack of coordinated on-boarding and strategic mapping is what fails our physicians. A slow start induced by poor on-boarding and mapping for a busy-natured physician is likened to stabling a thoroughbred for months and then wondering why they aren't winning races," Ms. Tiller-Hewitt says. The ultimate goal of the operational roadmap is to get physicians busy in their new practice as quickly as possible.

On the personal side, a roadmap for the physician's family is an important component of the on-boarding process. This is often a missing piece and unfortunately not discovered until it's too late, according to Ms. Tiller-Hewitt. Creating a family roadmap helps ensure that the family's needs are met and family members are acclimated to the community.

Roadmap implementation usually lasts for a year and is typically managed by a physician liaison or navigator. After a year, Ms. Tiller-Hewitt recommends the physician liaisons then shift their focus to monthly calls with the physician and his or her family to make sure the physician remains happy and busy.  

Building an effective physician on-boarding program may seem like a daunting task, but hospitals and health systems can get major payoffs from the programs because they lower attrition rates.

More Articles on Physician Retention:

CEOs Share Strategies to Employ, Align Physicians
10 Questions to Address in a Hospital Strategic Plan
5 Components of Developing a Medical Staff Plan

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