The Great Resignation: Why Physicians are Quitting and How Administrators can Mitigate the Impact on Care Delivery

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By Tony Stajduhar, President, Jackson Physician Search

Droves of physicians are nearing their breaking point. In a study conducted by Jackson Physician Search during Q4 2020 and prior to the widespread COVID vaccine rollout, 54% said COVID-19 had changed their employment plans. When asked which option they were most seriously considering, half of those said leaving their employer for another, 21% reported retiring earlier than planned, and 15% noted leaving the practice of medicine altogether. 

Now, nearly two years into the pandemic, more feel unheard, under-appreciated, and overwhelmed. The lure of leaving their jobs has become a reality that healthcare organizations are facing. In fact, a new survey conducted in June and July 2021 by Jackson Physician Search in partnership with Medical Group Management Association (MGMA) suggests that physicians are doubling down on their desire to make a change. Forty six percent – a significant increase from the earlier study – said they are considering leaving to work for a new healthcare employer, and a similar percentage report that they are thinking about early retirement. Getting ahead of physician turnover must be a significant part of every healthcare organization’s recovery plan.

There Are No Winners When Doctors Leave

The cost of physician turnover is devastating. Recruitment costs alone can reach a quarter of a million dollars per physician when you include sourcing, relocation, and sign-on bonus. With a 6-12+ month recruitment cycle, lost revenue stemming from a specialist vacancy can easily climb to $1 million. In the meantime, adequate patient access to care is at risk, and the remaining staff must shoulder the burden of the vacancy. It can lead to a continuous cycle of more hours, more stress, more frustration, more turnover. 

Administrators need to address burnout, engagement, and satisfaction to retain the doctors they have, while also formalizing a physician succession plan that looks out five years and includes an aggressive recruitment strategy.

Who Is to Blame for Increasing Physician Burnout?

A nationwide study on burnout released by Medscape in January of 2021 found that 42% of physicians are experiencing burnout. The report also showed that 21% of doctors said their burnout started with COVID-19, while 79% reported that it’s been building for years.  

In the new study, “Getting Ahead of Physician Turnover in Medical Practices,” it appears burnout has skyrocketed with 61% reporting they are currently experiencing it. When asked what’s causing it, 25% said it was due to COVID-19, similar to Medscape’s findings. 

However, the gap between physicians and administrators became ominous when each group was asked if burnout was caused by the employer or by the nature of being a physician. Sixty two percent of physicians blame their employer, but only 14% of administrators felt that way. Rather, 55% of administrators felt burnout stemmed from the demands of being a physician. 

These thoughts are echoed in one physician’s statement, “burnout stems from physicians operating in dysfunctional systems. The remedy is addressing flawed workflows and processes, reprieve and time for a life outside of work. Burnout is costly to organizations, yet physicians are treated as a disposable commodity.”

It should come as a surprise to no one that many physicians are also dissatisfied with the current employer. When asked to rate their satisfaction on a scale of zero to 10, the average level of physician satisfaction was 5.5. The proverbial writing is on the wall – administrators must help physicians recover from the extreme physical and emotional stress caused by the pandemic; else they will suffer long after it’s over. Physician retention may also nosedive, impacting a host of critical measures, such as quality, safety, productivity, and patient satisfaction.

A Strong Recovery Plan Leads with Two-way Communication 

The most recent survey shows that 88% of physicians said two-way communication with administration was the most important factor to keeping them satisfied in their current position. Following in importance are additional compensation, reduced administrative burdens, and additional time off.

While solutions won’t likely be obvious, here are some suggestions.

Listen more. Asking the right questions and encouraging physicians to speak freely is a good start. 

Provide freedom within a framework. A few engagement strategies should always be in play:

• Include physicians in the decision-making process across the spectrum of clinical care to organizational strategy.
• Develop and promote physician leaders; recruit effective physician leaders to serve in the c-suite.
• Competitive compensation is a baseline, but opportunities to achieve better work/life balance, recognition for their contributions, additional training, or leadership appointments may be just as influential. 

Express Gratitude. Recognition and appreciation for their work as well as frequent and transparent communication could be truly beneficial. 

Formal, Written Physician Succession Plans are a Rarity.

Recognizing threats and opportunities is where successful business decisions begin. Because Jackson Physician Search has seen a rapid and sustained increase in physician applications for new jobs, it’s somewhat surprising that only 16% of administrators report having a formal, written physician succession plan. Yet, they rate it’s importance an average of 7.5 on a scale of zero to 10. 

Administrators recognize the threat of physician turnover, but they have yet to address it with an actionable framework. With two out of every five physicians nearing retirement age, creating a long-term succession plan is obvious. But having an emergency succession plan that allows a practice to meet patient demand real-time has never been more critical. 

Successful Recruiting Starts with Succession Planning.

An effective succession plan not only addresses short- and long-term staffing needs, but it also must be aligned with the organization’s vision and mission. Along with determining key positions, developing a transition timeline, and documenting progress, developing an effective succession plan requires being mindful of the following:

1. Involve Shareholders. While practice leaders know the skills, education, qualities, and experience needed for each role, engaging the board of directors leads to increased buy-in and support.
2. Consider Employees. Especially for leadership roles, an internal physician could be on track to assume a role in the future. For those roles where there is no obvious successor, or for those that are in patient care roles, having a solid recruiting plan in place can minimize gaps.
3. Provide the Right Training and Mentorship. Internal candidates need to be prepared for the role to adapt quickly once the position is assumed. Onboarding new physicians and leaders is critical to learning the culture and feeling cemented within the team.

Organizations should follow their succession planning process with an assessment of where they excel and struggle in their physician recruitment process. When asked, administrators said they excel at interviewing candidates, assessing culture fit, and screening, while they struggle with marketing the position, creating effective job profile descriptions, and sourcing candidates. Effectively executing formal succession plans may require engaging a recruitment partner, a move that more are making as they see a rise in physician departures. 

About the Author

With more than 35 years of experience in healthcare strategy, Tony Stajduhar is the industry-recognized leader and innovator in the recruitment of physicians and advanced practice providers.  As President of Jackson Physician Search, he leads the most respected firm in the nation known for exceptional customer service, powered by proven recruitment strategy and search technology.

Jackson Physician Search is an established industry leader in physician recruitment and pioneered the recruitment methodologies standard in the industry today. The firm specializes in the permanent recruitment of physicians, physician leaders and advanced practice providers for hospitals, health systems, academic medical centers and medical groups across the United States. Headquartered in Alpharetta, Ga., the company is recognized for its track record of results built on client trust and transparency of processes and fees. Jackson Physician Search is part of the Jackson Healthcare® family of companies. For more information, visit www.jacksonphysiciansearch.com.