This post is the final installment in a series of columns on Onboarding, the process of acquiring, accommodating, assimilating, and accelerating new team members, whether they work within the organization or, in the case of physicians in private practice, are independent contractors. Today’s question is why would a health system or hospital invest in onboarding a physician they recruited for private practice?
There is obviously a host of reasons. For the purpose of this column, let’s focus on the obvious: that it makes economic sense. We are entering a healthcare era of increasing competition where the battle for talented physicians is intense and shortages are a reality. This competition will produce a new range of expensive challenges for health systems and hospitals that could affect market position or even their very survival.
While some hospital executives struggle with the question regarding who their customer really is – the physician or the patient – for the time being, we need to cut this debate short.
It is the physician. Occasionally the patient, but primarily most admissions come from physicians who are members of the active medical staff. Yes, these same physician customers can be our competitors, frequently in the same day. The physicians become our competitors when they actually admit patients to the specialty hospital, or ambulatory care or imaging center in which they have invested and realistically expect a distribution of profits versus the dreaded cash call.
This changing physician/customer landscape is frustrating for hospital CEOs. Hospital leaders seeking to solidify their physician relationships should focus on the physician’s underlying need – to improve financial security for their families and to enhance the quality of their medical practice experience.
While it is not realistic to assume that all of the physicians you recruit will forever resist the investor-owned lure of promises of higher profits and a more efficient work environment, CEOs are beginning to realize that an effective onboarding program – backed by a real commitment to a physician/customer-centered business model – will mitigate the risks. Like executive or employee onboarding programs, a physician program should not be a one-day, one-time experience. The first day should include a review of the hospital’s strategy, including their medical staff development plan, and a review of the organization’s mission, vision and values in terms of how those elements of the organization’s culture are integrated into all levels of the organization on a day-to-day operations and decision making. Meetings with key members of the leadership and management team with whom the physician will interact on an ongoing basis can be another productive part of a first-day schedule. Lunch with the Chiefs of Service and Medical Executive Committee who will emphasize the organization’s focus on quality and safety, and a special end-of-the-day dinner with key physicians, executives, and wives is a nice way to complete the first day of what should be an ongoing, relationship-centered process.
All physicians – but especially new recruits – should be assigned to a member of the executive leadership team who will take ownership of the relationship, much like bank officers nurture customer relationships.
Physicians, especially younger physicians and those who are starting out in practice are typically not equipped with necessary business skills. They do not always understand the importance of banking relationships. Practice and human capital management are generally not included in the pre-med degree plan and certainly is not part of the medical school curriculum. My 33 years of healthcare leadership experience has shown that the wizened physician practice veterans do not always take the time to coach the new recruits. In one rural group practice that has recruited 40 physicians over the past 10 years, more than 75 percent of the doctors who were recruited to the community at great expense have left the organization and the community, as the result of a strong non-compete provision in the employment contract.
Like executive and employee onboarding, a similar program tailored to the needs of your new physicians is an important strategy to maximize their community benefit and eliminate costly turnover.