Physician Turnover Rates On An Upswing

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imagePhysician turnover has increased for the first time since 2008, according to the sixth annual Physician Retention Survey conducted by Cejka Search and the American Medical Group Association (AMGA). The survey, which takes into account responses from 62 medical organizations representing 17,624 physicians, reflects a total turnover rate of 6.1% in 2010, compared to 5.9% in 2009.

Executives of Cejka Search and AMGA say these results appear to track with reports of modest improvement in the U.S. economy. They also note that the increase is consistent with anecdotal reports and findings in the 2008 survey, which indicated that the worsening economy and plummeting home sales caused physicians to delay two key drivers of recruitment and activity—namely, retirement and relocation. Growth in the Gross Domestic Product and the leveling out of previous steep declines in home sales may have something to do with the uptick in turnover in 2010, the executives observe.

The composition of the respondent group reflects changes in the healthcare industry as groups consolidate, more physicians choose employed opportunities and women pursue careers in medicine. The average size of the groups responding to the survey has nearly doubled in the last six years, from an average of 146 physicians to 284 physicians. Female physicians comprised 34 percent of physicians represented in the 2010 survey, compared with 28 percent in 2005.

Interestingly, while a total of 51% percent of respondents claim they do not encourage physicians in their practices to delay their retirement, 49 percent do so under certain circumstances. A variety of incentives are offered to physicians to keep them in the fold; the top two such incentives include flexible hours (90.6% of respondents), no call (62.5%), and/or reduced call (65.6%). The majority of medical groups (73.8%) also believe mentoring reduces turnover, but a more modest 56.1% actually assign a mentor to newly hired physicians. Formalized mentor programs appear to be more effective here, the survey reveals, with the turnover rate coming in at 1% lower among the 5.3% percent of groups that have written goals and guidelines compared with the 6.3% that do not assign a mentor.

Survey results also underscore the growth of part-time practice and a pinpoint a trend among medical practices to add physicians in the short term. The part-time physician workforce has expanded in size by 62% since 2005. This trend, Cejka Search and AMGA executives say, is consistent with the change in profile of today's medical workforce, in which the two fastest growing segments are female physicians entering the practice and male physicians approaching retirement. A respective 13% and 36% of male and female physicians participating in the survey practice part-time, compared to 7% and 29%, respectively, in 2005. Moreover, the majority of responding medical groups (83%) say they will hire “more” or “significantly more” primary care physicians, indicating that an already competitive physician market may become more so. Nearly as many claim they will bring on board “more” or “significantly more” specialists (79% of resondents) and advanced practitioners (78%).

Nonetheless, 27% of respondents to the 2010 survey think physician retirement will increase, and 65% hold that it will continue at the current rate. This could alert medical groups to prepare for greater turnover in 2011 as improvements in the marketplace make it more conducive for physicians to retire or relocate, notes Lori Schutte, president of Cejka Search.

"Medical groups can prepare for increased turnover by identifying key demographics in which turnover rates are the highest and find ways to address the cause of turnover at its source," Schutte asserts. "In the past five years, we have seen turnover rates consistently trending higher for young, full-time female physicians and pre-retirement male physicians. Offering flexible work options can be effective in retaining a strong physician workforce and investing in the retention of physicians at all stages of their careers will pay long-term dividends for medical groups."