By Lori Schutte, President, Cejka Search
The ability to balance time in clinical practice with personal interests and commitments is becoming an increasingly important factor of physician job satisfaction. It is apparent that this trend will continue to shape the future of medical practice for many years to come. Medical groups will need to understand the realities of today’s workforce and find the best way to maximize the contributions of every physician – at every stage of his or her medical career.
According to the newly released 2008 Physician Retention Survey from Cejka Search and the American Medical Group Association, 48% of medical groups responding agreed that options for part-time practice encourage physicians to stay in practice while meeting personal or family needs. The challenge will be how to address staffing models so as to retain these physicians and ensure a satisfying and rewarding career, while also meeting increasing patient demands for healthcare.
Medical groups who keep an eye toward the future will recognize that they can sharpen their competitive edge in finding and keeping physicians by instituting flexible work schedules that allow work/life balance consistent with these physicians’ respective career stages. Formalized mentoring and retention programs and job satisfaction surveys that facilitate communication and feedback will also support this approach. The end result is a workplace environment that allows for both professional growth and personal satisfaction.
Greater numbers of physicians are receptive to part-time employment
Over the course of the last decade, there have been significant generational and gender shifts among physicians. As the predominantly male Baby Boomer generation approaches retirement, a younger, more diverse generation of physicians, who are just as likely to be female as male, are entering the workforce.
Consider these statistics:
– According to the American Medical Association, nearly half (46%) of all physicians are over the age of 50.
– The emerging generation of physicians who are 39 years of age and younger represent 28 percent of the physician workforce and are nearly equal in numbers of men and women with 55 percent male and 45 percent female.
– The Association of American Medical Colleges reports that today’s medical school enrollment is 50/50 male and female. And, even as the U.S. population grew 15 percent from 1996 through 2008, the number of doctors graduated each year remained essentially flat, at approximately 16,167 physicians annually.
– Between 2005 and 2007, the percentage of all physicians practicing part-time increased by 46% overall from 13% (5% men and 8% women) to 19% (7% men and 12% women) as reported in the 2007 Physician Retention Survey from the AMGA and Cejka Search.
Flexible work options keep physicians in practice
According to the 2008 Retention Survey, among all male physicians who leave a practice, it is those physicians who are age 55 or older who are most likely to leave the practice (30%). Among all females, those under the age of 39 are more likely to leave (46%) than their male counterparts.
When these turnover trends are combined with current physician demographic trends in today’s economic environment – it appears that there is an even greater opportunity to keep physicians in practice by offering flexible hours, particularly to pre-retirement and early-career female physicians.
Nearly two-thirds (62%) of respondents to the survey said they believe that physicians are delaying retirement due to the economy and almost half (49%) find that part-time options are enabling physicians to delay retirement. As a result, medical groups appear to be adjusting their staffing models to meet these physicians’ needs. Respondents indicated a general willingness to modify work schedules of pre-retirement physicians to encourage them to stay longer. Seventy-three percent of respondents offer their pre-retirement physicians reduced hours, 56% allow for no call responsibility and 20% allow for specialization with certain patient groups. Alternative approaches include extended vacation periods of up to several months at a time and flexibility to modify job descriptions, as appropriate.
Today’s younger physicians – female and male – are also increasingly seeking flexible work arrangements. With more equivalent numbers of women entering the workforce, female physicians are more inclined to expect work-life balance concessions from employers, especially part-time schedules. Among those female physicians who practice less than full-time, the vast majority (70%) cite family responsibilities including pregnancy, followed by those who are pursing unrelated professional or personal interests (22%). Even the younger male physicians are more likely than their predecessors to prefer lighter schedules. Male physicians offer a greater variety of reasons for pursing part-time employment. Approximately 31% are engaging in unrelated professional or personal pursuits, 20% are preparing for retirement, and another 20% cite administrative or leadership duties as their reason for seeking part-time employment.
Part-time trends sharpen the focus on retention
Organizations will need to constantly explore innovative ways to position their individual practices to focus on market realities. Physician turnover cannot be completely eliminated, but medical groups can help minimize the impact of turnover with positive efforts by leaders to appreciate the needs and expectations of their physicians.
With the expected departure of a significant number of retiring physicians and the certainty that today’s generation of physicians are focused on being content in both their work and personal life, medical groups should continue to expand and focus on developing their recruitment and retention programs.
Year to year, respondents have reinforced the effectiveness of mentoring as both a recruitment and retention strategy. A majority of member groups (65%) assign a mentor to newly recruited physicians citing that these programs help younger physicians adapt to the rigors of a demanding profession while maintaining a fulfilling personal life. Of these, nearly half (48%) offer written guidelines for their mentors.
Assigning a mentor increases retention and facilitates early identification of new physician issues and problem-solving. Job satisfaction surveys and exit interviews are another method for gaining a more complete understanding of the needs of today’s physicians. Among the member groups polled, two-thirds (66%) conduct regular satisfaction surveys of their physicians. The information gathered is used for a variety of purposes, among them being to monitor trend information (67%), create action plans (58%) and communicate to departments (52%).
One respondent cited: “We have a good handle on physician issues based on our medical director and physician evaluation program. When a resignation occurs it is not a surprise, as we would have been engaged earlier and trying to manage the physicians’ expectations and needs.”
Member groups have greater pressure to meet the demands of patient care
The increase of part-time practice arrangements is changing the makeup of the physician staff and placing greater pressure on medical groups to meet the demands of patient care needs and growth initiatives. In order to attract and retain physicians in this changing environment, medical groups need to be flexible with physicians about their schedules and call requirements.
There is no “one-size-fits-all” formula for the success of a model that includes physicians practicing part time. Although dependent upon business needs, one way is to use non-physician providers to enhance efficiency and augment organizational capacity of healthcare services.
Medical groups appear to be increasing their reliance on advanced practitioners such as physician assistants and nurse practitioners in their practice models. Nine out of ten medical groups reported use of advanced practitioners to help attract and retain primary care physicians and are either actively expanding their number of advanced practitioners (46%) or maintaining current levels (50%) to help extend and leverage their physician staff.
Rethinking staffing models offers potential for increased staff and patient satisfaction
Forward-thinking medical groups can view this challenge as an opportunity to develop effective workplace environment strategies that foster professional growth and personal satisfaction. Those who follow best practices will be rewarded with a competitive advantage: a loyal physician workforce.
Whether male or female, in early career or approaching retirement, physicians have changing needs and expectations about how to balance time in clinical practice with personal interests and commitments. The need to have work/life balance is growing in importance. The fact remains that this is an opportunity for medical groups to rethink staffing models in order to retain experienced physicians approaching retirement and explore new ways to attract and retain younger generations of physicians.
Medical groups today are paying more attention to physician recruitment and retention efforts throughout the physician’s career cycle, including those times when options for part-time practice make sense and create continuity for delivery of healthcare. As evidenced from the Cejka Search and AMGA 2008 Physician Retention Survey, leading medical groups are committed to creatively and effectively developing practices and programs to address the challenges of physician retention – while ensuring a satisfying and rewarding career for physicians.