Despite popular belief, compensation isn’t everything to today’s physicians. As more physicians move from private practice to an employed model, health care organizations will be challenged to integrate new physicians with different expectations related to cultural attributes such as accountability, autonomy, work environment and communication styles.
How important do you think culture is to the physicians in your organization? Do you think there are any gaps in how you and your physicians view the culture in your organization? Do you believe it is necessary to invest in assessing and developing cultural fit?
You might be surprised by what we learned in our recent survey conducted in partnership with Physician Wellness Services. The survey examined the influence of 14 cultural attributes on physicians’ overall satisfaction, and their perceptions about their organization’s performance related to those cultural attributes.
We discovered gaps between physician satisfaction and their organization’s performance. Many of the attributes that physicians ranked as most important to their overall satisfaction (rated 8 or above on a scale of 1 to 10) were ranked relatively low in terms of organizational performance with the attribute; the most substantial gaps occur with:
- Transparent communication
- Collaborative leadership style
- Organizational adaptation to change
We were particularly concerned to learn that administrators underestimate the frequency with which physician respondents said that lack of cultural fit has prompted them to leave or decline a position. Since the cost of turnover and prolonged vacancy can cost a practice as much as $100,000 per month, it is vital to understand the influence of organizational culture and its impact on a physician’s decision to join – and stay – with your practice. This is especially critical in the first three years of joining a practice, when recruits are highly vulnerable to turnover.
Physicians want to know that their organization is progressive, particularly in today’s evolving health care landscape. The survey makes it clear that a significant number of physicians are not satisfied with their organization’s ability to communicate effectively and transparently, provide collaborative leadership, and adapt to changes.
Organizations can help fill these gaps by more objectively assessing cultural fit of physician candidates with these simple steps:
- Define the attributes that make physicians successful in your organization.
- Screen effectively for those traits and beware of red flags that might indicate a poor fit with your culture.
- Conduct behavioral interviewing to evaluate teamwork and team leadership qualities.
- Onboard effectively to educate new recruits on your organization’s day-to-day culture.
- Assign a mentor and create a formalized program.
- Offer flexibility and work/life balance.
- Identify your organization’s physician leaders to champion transformation and promote positive cultural changes.
For more information on workplace culture and its influence on physician recruitment and retention – or to request a full copy of the survey report – click here or contact Emily Velders at (800) 296-2698 ext. 64508 or email@example.com.
It’s no surprise that debt is one of the largest issues facing medical school students after graduation. It’s even less surprising that with an average debt of $162,000, these grads seek some sort of loan repayment program as part of their recruitment package.
World-renowned Princeton University economics professor Uwe Reinhart evaluates the subject in a recent post with the New York Times Economix blog and references a Cejka Search survey. In Dr. Reinhart’s article, he discusses the range of physician compensation and whether or not medical education should be government subsidized as a public good.
According to our annual Resident and Fellow Survey, recent graduates are looking for loan repayment in their starting compensation packages. In fact, 48% of respondents ranked educational loan repayment as important or very important when deciding upon a practice opportunity.
According to the 2011 Cejka Search and AMGA Physician Retention Survey, about 60% of medical groups offer loan repayment, a majority of who believe this incentive acts as a differentiator.
But size matters. For many medical groups, this is not a practical incentive to offer. Midsize groups were much more likely to offer this incentive as a part of their compensation package. Half of respondents from both small groups and large groups reported that loan payment isn’t applicable within their organization.
This mirrors the trends our search consultants are seeing in the field. We’ve found that small group clients often don’t have the resources to offer loan repayment. Large groups, on the other hand, don’t have to offer loan repayment because they are either in a desirable location or they are the primary employer in the area, so their job openings aren’t as difficult to fill.
Medical education debt load can thus be seen as a contributing factor to the demise of the small, independent medical practice. It’s apparent that the cost of medical education deters students and exacerbates the growing physician shortage.
Part of the current debate in the medical community revolves around the size of the role the government should play in subsidizing medical education. This debate will surely continue as the industry and government formulate solutions to offset the high cost of medical care.
Should America continue to let the private sector address the high cost of medical education in this way or follow the lead of other countries that make medical education affordable or free? In essence, who should pay for medical training?
Congratulations to Linda Van Winkle, CPMSM, CPCS, manager of medical staff services at Christus St. Patrick Hospital in Lake Charles, LA! Linda wins one free seat to the 2011 Credentialing Resource Center Symposium for her entry of a medical executive orientation package.
We just did our first annual MEC orientation program. In the past, we have been fortunate to be able to take our leaders to national MEC leader conferences (The Greeley Company one year, a Horty-Springer conference the next, alternating between the two every other year). We were unable to do that this year due to budget constraints so we decided to do our own. The orientation lasted four hours and packed with information, but it went well.
Linda Van Winkle, CPMSM, CPCS, manager of medical staff services at CHRISTUS St. Patrick Hospital in LakeCharles, LA, sent in this tip.
“This is just a little thing, but I started doing it at the beginning of the year. I can generate this from my credentialing database. I have a report that shows birth dates in chronological order. . . I generate this quickly and e-mail it to him, blind copying pertinent people in the hospital so they will also know it’s his birthday and can wish him a happy birthday if they run into him. The doctors have loved this! And it only takes a second each morning. I also send them to our allied health professionals credentialed through the medical staff.”
Here is a sample e-mail (HTML).
It’s a small thing to do to help with physician satisfaction and loyalty.
The trend for today’s newly minted physicians is to team up with a hospital rather than joining a private practice, according to an October 13 NPR report. Some of the factors for the trend include physicians who want to spend less time on administrative responsibilities that hospitals are willing to take over and who want to shoulder less of a financial burden for their practice.
After listening to the report, how do you think the trend of more physicians seeking hospital work will change the face of medical staffs? Will more physicians necessarily mean more medical staff members, or will the same factors driving physicians to the ease of hospital practice lessen the physician’s attraction to medical staff leadership roles? Leave your thoughts in the comment boxes below.
A group of 10 Florida pediatricians have switched hospital affiliations, but the reasons behind the move remain murky, according to an October 7, nwfdailynews.com article. The physicians previously held privileges at Fort Walton Beach Medical Center (FWBMC), but as of October 1, they are exclusively seeing patients at White-Wilson Medical Center.
According to FWBMC the physicians left to focus on their primary care role, but other sources told nwfdailynews.com there were other factors at play. Specifically, the pediatricians objected to FWBMC’s plans for pediatric emergency care services that they felt couldn’t be supported by the organization’s pediatric resources.
Question: Do you think the hospitals involved should fully disclose to the general public the reasons behind the physician’s move, or should the organizations’ let the public know a change has occurred and leave it at that? How would your medical staff handle the situation? Leave your answer in the comment boxes below.
When medical staffs face a legal problem, they have a choice as to whether they use the hospital’s legal counsel or secure their own counsel. The fact that there is a choice may seem obvious, however, in most instances this may be a hidden choice as medical staff may be likely to use whatever lawyer they used in the past, rather than exploring a new option. If the legal problem the medical staff is facing puts the medical staff at odds with the hospital, the medical staff may be more likely to pursue their own lawyer. Nevertheless it’s important for medical staffs to understand the differences between hospital lawyers and medical staff lawyers and which agent to call.
“The medical staff leadership should be able to get advice from a knowledgeable lawyer that they trust,” says Constance Baker, Esq., partner at Venable, LLP, in Baltimore, who represents hospitals and medical staffs. “I don’t think they generally need separate legal counsel except for these unusual circumstances where the culture may have been such that the medical staff simply cannot trust the hospital leadership or there have been historical reasons why the relationship is not going to work out with the hospital counsel and medical staff.”
One of the reasons why it may be easy for lawyers to play on both teams at once is because often the hospital and medical staff have closely aligned interests, from meeting accreditation requirements to serving the community.
“Any advice that any well-trained, seasoned, experienced hospital attorney can provide really benefits both sides—and in many senses there aren’t two sides, they really are the same side,” says Michael R. Callahan, Esq., partner with the healthcare practice group of Chicago-based Katten Muchin Rosenman, LLP, who represents hospitals and medical staffs.
Yet, there’s another school of thought that suggests medical staffs need their own lawyers who can solve problems solely from the medical staff’s point of view.
“[Hospital lawyers] represent the hospital so when they are explaining the impact of the due process procedures, how you request a hearing, and what the physician’s rights are, they can explain them without necessarily saying, ‘and if you’re the doctor at the other end of it, it’s a bad idea for you,’” says Michael Cassidy, Esq., of Tucker Arensberg, PC, in Pittsburgh, who represents medical staffs and practitioners. “They don’t go that last step because they’re not supposed to.”
Looking for more tips on OPPE, employed physician contracts, and ED coverage? Look no further than the Greeley Medical Staff Institute Symposium. This year’s theme is Practical Solutions to Today’s Physician-Hospital Challenges.
We hope you can join us June 8-9, 2010 in Chicago for this solutions-based conference.
(And don’t forget to check out the contest for free registration!)
Extending medical staff membership to practitioners who primarily work at satellite clinic locations is one way to ensure that those practitioners work as a unit with their hospital-based peers. But it’s not the only way.
Below are some tips medical staffs can use to build camaraderie between the two groups. Remember that building relationships today can pave the way for smooth working conditions in the future.
- Make medical staff meeting attendance mandatory, at least for some meetings. This guarantees that practitioners from multiple locations will gather in a central place to discuss issues that will affect all of them.
- Hold social events or departmental meetings at clinic locations. Some clinics may not have appropriate meeting space, but if they do, explore this option. It will help convince satellite practitioners, who typically travel to the hospital for meetings, to attend, and it will give hospital-based practitioners a clearer picture of the off-site facilities.
- Include news updates from the clinic in monthly medical staff newsletters. Additionally, if the newsletter features a practitioner of the month or highlights the cutting-edge work of a particular team, include a photo along with the article. This will help the hospital-based practitioners get to know the satellite practitioners better.
These tips are from the January issue of Briefings on Credentialing, archived online at www.CredentialingResourceCenter.com.
This week’s form offers a sneak peek at one of the policies from The Top 40 Medical Staff Policies and Procedures, Fourth Edition. It is an organizationwide conflict of interest policy and may be customized to fit your organization’s need.
The book is available online at www.HCMarketplace.com.