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Culture and Physician Retention

Jackson Physician Search
September 14, 2018

Imagine a workplace where medical professionals at all levels are highly respectful.

Too many hospitals today are losing valued physicians due to toxic environments. A recent study estimates that “for hospital medicine, the overall cost of turnover is probably at least $400,000 per provider and could easily be $600,000 or more”.

The relationship between culture and physician retention is straightforward. Making a smart hiring decision is just the beginning. Once a physician is recruited, onboarded and in place, the challenge to keep them begins.

Jackson Physician Search did a study in 2016 (The Engagement Gap) revealing a significant difference in how executives and physicians rated their workplace culture.

One example of a gap between physicians and executives revealed their attitudes when asked their level of agreement with the following item:

“Always treats physicians with respect”

  • 48% of physicians agreed
  • 78% of executives agreed

Conflict and communication breakdowns are inevitable.

Toxic cultures

What exactly is a toxic culture? Based on my research working with physicians, physician executives, hospital executives, and support teams, toxic cultures often include:

  • Punitive, old-school leadership
  • People are judged quickly, labeled and “singled out”
  • Factions/cliques are strong and you see “in-groups” versus “out-groups”
  • Strong, long-held beliefs about “right and wrong” regarding how physicians should manage patients and nurse practitioners
  • Senior-level physicians or leaders prone to outbursts, yelling, profanity, name-calling and throwing things, creating an intimidating environment
  • Ineffective leadership skills at the highest levels (poor management skills)
  • Unclear vision and performance expectations
  • Low-trust issues; gossip is rampant
  • Power struggles

I’ve observed cultures first hand through my consulting and executive coaching. I’ve conducted 360 leader assessments, including verbal interviews with bosses, peers and direct reports of executives/physicians in healthcare organizations.

I’ve also conducted culture assessments and gained an in-depth look at the inner workings of how things get done behind the scenes.

Culture Assessment

Few organizations stop to assess their culture. The cost of ignoring a toxic culture is devastating in terms of turnover, morale and profitability. Patient care also suffers as a result.

Where do you begin to measure your organization’s culture?

Finding a valid and reliable assessment tool is the first step. I prefer an assessment tool called “LEA Culture Survey” from MRG. The result of the assessment is a report that paints a clear picture of “what it’s like to work here”. Leaders shape the culture. They determine what gets noticed, rewarded . . . and in many cases what gets ignored or even punished.

I facilitate the culture assessment process using the following 10 steps:

  1. Identify a sponsor and/or culture project team
  2. Identify critical leadership practices for achieving the mission
  3. Select the best culture assessment (online preferred)
  4. Communicate to all what’s coming and how they’ll be involved
  5. Administer online culture assessment
  6. Preview results with culture project team
  7. Plan roll-out of results to all; hold group feedback sessions
  8. Explain next steps and form action teams
  9. Close the gaps to reach top workplace benchmarks
  10. Re-survey in 12 – 18 months

Invest in your most valuable resource—your people. Rather than guess at what it’s like to work in your organization—measure it. Help shape the culture that helps you achieve your mission.

Kathy Cooperman is President and Founder of KC Leadership Consulting, LLC. She specializes in Leadership Development through executive coaching, consulting and facilitation. Her passion is helping organizations accelerate excellence in their leaders—engaging everyone to work together to achieve the business strategy while applying the core principals of Positive Psychology.

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