Deb Collier, DirectorMichigan Health Council

Discuss the impact of physician turnover on your practice and the community.

Learn why the Patient Portability and Accountable Care Act and the projected physician shortage matter.

Consider the top10 reasons why physicians leave.

Review how to recruit to retain.

Realize what to expect without a retention plan.

After enduring almost 4 years of recession, downsizing, budget cuts and lowered morale, many doctors are restless to move on.

As many as two thirds of the US Workforce would like to change jobs.

Who are the 20 % of your physician workforce who bring 80% of the value?

Each physician generates an average of 1 to 1.54 million annually in health related revenue including inpatient and outpatient revenue, and related medical services i.e. nursing home, pharmacy and therapies.

According to Press Ganey, the total cost of replacing one physician is over $250,000.

Survey results indicate that there is a 900,000 to 1 million dollar economic impact to the community by each physician per year. Jobs created by the physician as an employer.Related jobs in the community which studies state at 8 – 13 per physician.The impact of the physicians family spending which includes education, housing, retail and entertainment expenses.

Uncompensated Care An additional factor frequently overlooked, is the care which is delivered to disadvantaged patients by physician practices.

A study by the Michigan Emergency Physicians, estimated over 56 million dollars in non-reimbursed care was delivered by their members.

Negative reflection on the organization. Reduced referrals within health organization –

keep the patient in the system, keep the specialists busy.

Direct recruitment costs ($22,500 plus). Patient access suffers. Patient Turnover. Gross Billings & Inpatient Revenue lost. Quality and continuity of care are impacted.

30 million uninsured people will have access to our medical system

in 2014 - 1 million in Michigan.

Over 50% of primary care physicians in Massachusetts are closed to new patients.

The Association of American Medical Colleges predicts a shortage of 159,300 doctors by 2025.

The US population grew 30% in the past 25 years. The older population in 2030 is projected to grow

from 35 million to 72 million and represent nearly 20 percent of the total U.S. population.

The number of physicians graduating from medical school has remained at 16,000.

43,562 Physicians Licensed in Michigan

27,008 Active Physicians in Michigan (35% are primary care physicians)

46% of active physicians will retire within 8 years.

47% of Michigan’s physicians are 55 years or older.

260 PCP jobs for in Michigan today. Time to fill for FP & IM positions average 180

days. Many specialty searches take 2 or 3 years. 68% of Hospital CEOs say access to care is

compromised by a shortage of physicians.

GENERATION BORN AGE %

Traditionalists 1922-1943 85-64 7

Baby Boomers 1943-1960 64-47 42

Place a heavy emphasis on work and climbing the corporate ladder.

Generation X 1960-1980 47-27 29

They enjoy work, but are more concerned about work-life balance.

Millenials or Y 1980 – 2000 27-07 22

With technology can work anytime, anyplace. Most want long-term work relationships, but favor more family time, less career ambition.

62% don’t get enough feedback. (9 out of 10 millennials say they expect feedback once a day.)

50% left because the practice was a poor cultural fit. (poor hiring practices.)

32% want to be closer to their families.

26% sought more money – low reimbursement.

26% not feeling valued – lack of respect.

22% seeking a better community fit.

18% left because of lack of trust in senior leaders.

8% want a work schedule that is more compatible with their lives.

6% felt call requirements were excessive.

6% Not using their talents, not learning/growing, and/or not seeing a realistic future.

Define the practice opportunity. Define the qualifications necessary, work

expectations, work duties, compensation and benefits.

Really interview the candidate. Why do they want THIS job? What do they bring to the position? Why are they looking and what do they really

want?

Recruit the family◦ Screening the spouse for career objectives.◦ Identify educational needs.◦ What do the kids need? Sports? Music? ◦ Are Grandma and Grandpa coming too?

If Mama ain’t happy …

A thorough orientation to your practice and the hospital will:

Set the stage for a smooth beginning. Establish the office culture and expectations for

performance. Begin the relationships which are critical to build

support, referrals and success. Create a welcoming environment.

“As the economy perks up, it appears that rates of physician turnover

rise with it….improvements in the marketplace make it more conducive for physicians to retire or

relocate.”American Medical Association, 4/2011

Since 2005 , the part-time workforce has grown by 62%.

Medical groups who are successfully hiring and retaining physician are the ones who provide flexible practice models that support lifestyle choices made by physicians throughout their

career.

83% of medical groups will hire more physicians indicating an already competitive market will be

come more so.

Turnover is lower for medical groups who assign a mentor with written goals and guidelines.

Decreased morale. Reduced productivity. Increased performance issues. Declining patient satisfaction. Negative practice image. Inability to recruit. Lack of physician leadership.

◦ Community◦ Hospital◦ Staff

Trinity Mother Frances Hospitals and Clinics; Tyler, Texas◦ Set aside $100,00 for a retention program - $300 per

physician reducing turnover to less than 4%.

Memorial Healthcare, Owosso, Michigan◦ Two years after implementing a full retention program,

increased physician satisfaction by 20%.

Banner Healthcare; Phoenix, Arizona◦ Turnover was at 10%!◦ One year after implementing an “On Boarding” program,

not a single new physician left BMG.

“A company with a high inspiration factor attracts and keeps good talent and it’s employees forge long-term profitable relationships with customers.”

Terry Barber is the Chief Inspirator for Gizzard Communications Group

Deb Collier800-479-1666Deb.Collier@mhc.org

Kimberly Benjamin517-827-0468kbenjamin@mpca.net