Listen to them.
I contemplated just “dropping the mic” and walking away after saying that, but felt compelled to explain.
In the last few months we’ve had numerous calls and emails from both health centers and PCAs looking for help with “creative ways to retain providers,” typically involving either incentives or some other kind of monetary inducement to stay (and preferably to improve productivity, since nothing comes for free). We’ve also read numerous articles and seen many webinars offered by experts on the subject telling health centers what they need to do (and usually what they need to pay). Before you worry about being creative, try something basic.
The truth is, the first and most important step toward improved provider retention is listening to them. Not talking TO them, but LISTENING to them. Whether you have externally facilitated focus groups or individual conversations, have a monthly CEO lunch or hire a “provider relations specialist,” there is nothing more important toward retention than asking your providers how they feel about their jobs. We recently held a series of focus groups with providers at a health center contemplating incentives to improve productivity. You may very well hear something about pay, because everyone has something to say about pay, but it’s more likely that you’ll hear the things that we did, like these:
- My work-life balance is out of whack — I work all day in the clinic and then spend another four hours every night closing my charts.
- The front desk can’t figure out how to set appointments — I get 15 minutes at the end of the day for a patient that I know needs an hour, or I get a parent who has to bring one kid in at 9 and the other at 3 even though they could both come in at the same time.
- I’ve had four MAs in the last six months, and the minute I get them halfway trained up they leave.
- Every time a patient has an issue they go to management who never has my back
- Decisions on clinical procedures and practices are being made by administrators with no input from clinicians, and the Medical Director isn’t even a part of senior leadership.
- My pay is a lot lower than the kids you just hired out of residency — I didn’t even care about what I made until I found out about that.
- I waste a ton of my time on things that can… and should… be done by other people.
Now there will always be exceptions in every organization, but for the most part what we hear is frustration. Frustration that they can’t get their jobs done. Sometimes frustration that gets to be far more than the desire to achieve the mission they signed up for. If you don’t want to believe them, that is, that it isn’t just a matter of throwing money at the problem, go to the Rand Corporation Study on physician work satisfaction. While money is mentioned, you’ll find many more things to consider when it comes to retention — from your Electronic Medical Records system to your ability to retain front-line staff because you don’t pay enough. But better yet, take some time out of the day to listen to YOUR providers, because they are the ones you need to retain.
Amen. Most organizations are badly run.