As organizations increasingly feel the impact of the physician shortage, the competition for physicians coming out of training intensifies. Organizations are pulling out all the stops, such as big signing bonuses, loan repayments, and never-ending salary guarantees to sign residents and fellows, some of whom still have two or more years of training to complete before they can start. The promise of bonuses and salaries is extremely effective in attracting residents and fellows; however, research from MGMA and Jackson Physician Search suggests it may not be enough to keep physicians for more than two years.
The joint study, conducted in the fall of 2023, sought physicians’ and medical group administrators’ views on the top factors influencing residents and fellows to accept and stay in their first jobs. Not surprisingly, the resulting report, Early-Career Physician Recruiting Playbook, confirms that compensation is the number one factor driving first-job decisions. However, when physicians were asked what made them leave their first jobs, the most commonly cited reason was the “practice ownership/governance model.” The report concludes that new physicians may be following the money without fully understanding how their new organization will be managed – and how that may impact their job satisfaction.
Shrinking Tenure Among Early-Career Physicians
The biggest takeaway from the data is the trend of shrinking tenure among young physicians. According to the research, physicians who completed training in the last six years stayed in their first jobs for an average of only two years. When the question was asked of all physicians (regardless of how long ago they completed training), the average first job tenure was six years. Several reasons may have contributed to this shift – shifting generational views, the impact of the pandemic, the increased prevalence of recruitment bonuses – but whatever the reason, today’s newly trained physicians are spending significantly less time in their first jobs than their older peers once did.
When you consider the length of time it typically takes for new physicians to reach productivity, it’s easy to see why healthcare employers are concerned by the trend of shrinking tenure. While organizations explore strategies to improve retention among newly trained physicians, the most impactful change may be one made during the recruitment process. If practice ownership/governance models are truly a driving force behind early-career physicians’ departures, then increasing candidates’ understanding of how an organization is run should improve the chances they will stay. That is, if newly-trained physicians know what they are signing up for, they will be more likely to remain in the role.
Interestingly, when administrators were asked what they think drives residents’ and fellows’ first job decisions, “practice ownership/governance models” was among the top two factors, second only to the “organization’s reputation.” Thus, it seems administrators recognize the importance of alignment in the area of governance, and yet they may not be effectively evaluating candidates’ understanding of this area.
Retention Begins at Recruitment
At Jackson Physician Search, we often say, “Retention begins at recruitment,” and this scenario provides a relevant application of this advice. Identifying a good match during the recruitment process significantly increases the chances that both parties will be happy as the relationship progresses. To evaluate for organizational alignment, administrators should strive for transparency in all areas, especially regarding what it’s like to work at the organization. Resist the temptation to tell candidates what you think they want to hear, and instead, be upfront about how the organization is managed and how they can expect their careers (and compensation) to progress. In the aforementioned study, other common reasons early-career physicians cited for leaving their first jobs were “career track/advancement” and “compensation.” So, it’s crucial to discuss candidates’ expectations and share what the typical path and earnings might look like. Offer to connect them with other physicians at various stages of their careers to hear about their experiences directly.
Administrators must realize that newly trained physicians don’t always know what they don’t know. It may not occur to them to ask detailed questions about how decisions are made or career advancement options. However, even if they don’t ask, these are certainly areas that will be useful to cover. Candidates may come to the conversation with various assumptions, and it is often up to the interviewer to adequately set expectations. The idea that if the candidate doesn’t ask, the interviewer shouldn’t share is not helpful in determining the candidate’s fitness for the organization.
Compensation & Transparency
Of course, candidates who work with Jackson Physician Search recruiters are prepped about what to expect in the interview and will come with questions about the factors most important to them, be it a partnership track, physician autonomy, or practice ownership/governance models. However, even if interviewers are fully transparent, candidates may still believe they can accept ill-suited circumstances if the price is right. They may be able to stick it out beyond the average two-year period; however, it will benefit all parties involved if the physician is well-matched to the role. Thus, while competitive compensation and recruitment bonuses are essential to attracting newly trained physicians, organizations must be aware that a physician solely motivated by compensation is unlikely to stay. Focus on transparency in the recruitment process to more effectively identify early-career physician candidates who fully understand your organization and want to be a part of it for the long term.
If your organization is struggling to attract and/or retain early-career physicians, a change to your recruitment process may be the solution. The recruitment team at Jackson Physician Search works with residents and fellows daily and can help you connect with those best suited for your organization. Reach out today to learn more.