’Don’t forget you liked me’: 6 reasons physicians leave

I remember this as if it happened yesterday. Earlier in my career as a physician recruiter, I received a phone call from a newly placed doctor. She was an Internist and a good one. I felt terrific about this placement. She had just finished her residency training in Texas, and I placed her in a large system she wanted in Missouri.

Everything for her arrival, orientation and onboarding was all set. She relocated and started her new position, with licensing and credentialing in hand, on her contracted start date of July 1 (a rarity). I checked in with her after Day One, and she told me everything went great. She was happy and shared with me some of the details of that day’s events.

After her week of orientation was over, I called the physician on Friday night to check in with her. She said she was finished with “training,” had the weekend off, and would be able to start seeing patients on her own on Monday.

Here is how this physician’s week went beginning on Monday. First, she had seen only

one patient. She would come to the clinic, introduce herself, and the receptionist told her the first day to have a seat in the conference room, and the office manager would get with her. It was lunchtime before someone had spoken to her again. Then she received a clinic tour and was directed that she could go ahead and go home. She told the office manager she had seen the clinic before, but the office manager was unsure what was supposed to occur and told the doctor the tour was an excellent place to start.

The next day, the receptionist instructed the physician to report to the hospital’s human resources department to fill out forms; despite already completing them a week before, HR was unsure where they were. Still, no one had reached out and said hello except for the receptionist, office manager and HR department.

On the third day, the receptionist showed her the clinic’s corner where she could place her belongings while deciding where her office might be. She then introduced her to a doctor in the clinic who she could shadow for the rest of the day. He allowed her to see one new patient, and that became her patient.

She finally called me that Thursday and said, “Can you please call the CEO and remind them that they liked me?” I asked her what had happened. She told me all the things that had happened, and I called the in-house recruiter that I had been working with and shared her experience with them. Their process was smooth and routine, but they had no procedure to follow when something fell through the cracks.

This doctor was ready to quit and was understandably emotional. She was not only upset with herself, but with me. She thought the promises I made to her were exaggerated. Thankfully, the in-house recruiter was seasoned, and he got on the phone with the physician right away, and several other people also called the doctor. Things were corrected immediately, and she never had a problem from then on. This physician ended up being the first to volunteer for the hospital’s physician mentor program.

This scenario had a good ending, but its beginning could have been a complete failure of the expensive recruitment process the hospital system had begun. This system had a large budget for recruiting, paid an agency fee, relocation and signing bonus. They had a team dedicated to recruiting and onboarding, but the doctor still did not feel like she belonged there after orientation because their process failed, and she did not know where to turn. This experience left her wondering if she made the right decision in accepting the role.

Setting the right tone upon their arrival can be an essential step to retaining them long term. Here are six reasons physicians leave their jobs - and how you can help.

1.    Feeling too new to be included. Many newly recruited physicians feel left out if they do not have colleagues with whom to connect. They may not have an outgoing personality, or maybe the staff has been together for a long time and has not brought in someone new for a while. Make sure to have another physician in the organization that the new physician can use as a resource.

2.    Feeling left out of the process and decision making. This can create a toxic culture. There is no voice, no one respects each other, and people’s opinions and concerns do not count. When possible, use a consensus to make decisions and not just rely on the longest-serving or oldest employees. Everyone should have a vote on the process.

3.    Having a difficult supervisor. Make sure the person who is over the physician you are recruiting can work well with the physician. This may be the department chair, the chief of staff, the CEO or the hospital administrator. Be sure to include them in the interview process. Have other people give you feedback on the supervisor’s style and personality.

4.    Doctors want to practice, not do paperwork.Ask what electronic medical record (EMR) system your potential hire has used. It is OK if they do not use your current system, but it is a plus if they do. Make sure you plan for plenty of training on the EMR system before the physician starts seeing patients. Remember, you are hiring the physician based on their training and skills as a doctor, not data entry.

5.    Compensation is not what was expected. A lot of times, during the interviewing process, words like bonus or relative value unit are thrown out, but it is more realistic for you to provide the recruit with an excellent salary and benefits package than for you to promise or have the first-year employee think they are going to achieve a bonus, as this rarely happens. This leaves the physician automatically feeling like they failed the hospital or practice, and their family as well.

6.    The work schedule is worse than described. I never recommend placing a schedule or a call schedule in a contract because these are doctors, and their schedules are unpredictable. I do recommend being honest with the interviewing physician regarding their potential call schedule.