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PHYSICIAN RETENTION

PHYSICIAN RETENTION. Retention.

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PHYSICIAN RETENTION

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  1. PHYSICIAN RETENTION

  2. Retention • All in all, there is a lot more governments can do to support retention efforts. For instance, agreements between government and the medical professional could include incentives to keep older physicians in the workforce longer. Current efforts are mostly aimed at increasing physician supply and recruitment. But for most communities, their best chance of having a doctor tomorrow is to keep the one they have today. (Physician Retirement in Canada: What is known and what needs to be done. Pong, Lemire & Tepper, 2007)

  3. Retention Plan • Who has a concrete retention plan? • Formal with objectives • Clear vision with definitions • Why a retention plan? Improved physician retention has proven to decrease turnover while increasing morale and efficiency, which can significantly improve the quality and continuity of patient care.

  4. Predicting who will leave? Who are the most vulnerable groups? • Early careerists “47% of all physicians leaving did so within the first three years and 60% who left did so within the first five years.” (American Medical Group Association (AMGA) and Cejka Search, Physician Retention Survey, 2006) • Late careerists “Although there is a lot of talk about possible shortages of physicians in Canada, not much has been done to date to encourage older physicians to remain in practice.” (Pong, Lemire, Tepper, 2007)

  5. Early Careerists:Primary Reasons for Voluntary Separations • Practice Issues-44% • Compensation-27% • Location-25% • Spouse-4% What do your exit surveys say?

  6. Late Careerists: Are they really getting older? By the year 2009, 44.8% of all physicians in the province will be over 55 years of age, 30.1% will be over 60, and 18.2% will be over 65. (College of Physicians and Surgeons of Ontario, 2006)

  7. Late Careerists • When do physicians retire?  What is our assumption? • Do you have an idea of when your physicians 'plan' to retire? • How many have retired before the age of 55?  65? • For most of the data available it is inconsistent in showing how to differentiate between retirement, death, part-time practice, departure from the medical workforce for other reasons. • Retirement behaviours vs. retirement intentions • Changes in the way older physicians practice • What is semi retirement? • Full retirement vs. change in practice • Narrowing scope, Decreased workload

  8. Late Careerist Impact on Rural (Pong, Lemire & Tepper, 2007)

  9. Late Careerists • Increased Retirement • Reduction in Workload • Scope of Practice changes • So what can we do? • Retain more older physicians • Older physicians who continue to practice remain clinically competent

  10. Late Careerists • Retain the late careerist by: • Creating alternative practice opportunities It appears that many older physicians still want to make a contribution. Strategies should be developed to accommodate those who still wish to work. Possibilities other than full time clinical practice need to be made available in order to keep older physicians in the medical workforce and make the best use of their experience and expertise. Retirement should be seen as just one aspect in a continuum of changes in medical practice as old age sets in. But prior to full retirement, many other changes may have occurred, which may also have implications for medical care delivery and physician workforce planning. (Pong, Lemire & Tepper, 2007)

  11. Late Careerists • Retain the late careerist through: • Mentorship programs • Initiatives on mentorship currently through provincial funds • UofT programs on Mentorship Ontario has started a Late Career Initiative for front line nurses older than 55, where 20% of their time is protected for mentorship, administration, and teaching with a view to reducing the physical demands of nursing while providing new opportunities for skills acquisition. It would be interesting to see if similar approaches would be effective in the retention of older physicians. (Pong, Lemire & Tepper, 2007)

  12. Physician Engagement New buzz word, what does it mean

  13. Engagement = Recruitment

  14. If Recruitment is like the Engagement……. • Is Retention like the Marriage???? • And now the work begins….

  15. What can I do for Retention? • Some time? • Barely any money?

  16. 3 Strategies for Retention • The Recruiter : Are we the problem? • Do we need to change • The CME challenge • How to run a weekly program with a little time and no funds! • The Mentor

  17. The Recruiter: Are we the problem? • Could it be that the physician recruiter is a problem in retention initiatives? • How many people here are considered or hold the position of Medical Recruiter? • How many people hold the position of Medical Affairs officer? Medical staff developer? Medical Affairs Director? Director of Physician Development? Medical Staff Practice Liaison

  18. What is in a name? • Are we always seen as just recruiters? • If our title only involves recruitment, how do we expect to make retention a priority. • How do you connect with physicians that are vulnerable or +5 years in your community? What are your responsibilities to those physicians? How do they see your role with them? • Do we see a shift in physician recruiters moving towards the role of Medical Affairs Officer/Director? Medical Liaison? • Changing the name of your position: a cost effective measure making physician management all inclusive to recruit, maintain & retain. • A clear message to all about your priorities

  19. CME • Introducing a CME program with a little time and no money • Providing 40+ sessions per year • 30 hours administrative time per year • Topics, Sponsorship, Location, Time, Advertisement, Meals • Communication & Relationships

  20. Mentorship program • Who has a mentorship program? • Why? • To assist the new physician and his/her family in integrating in to the culture of the practice, the hospital and the community; • To assist the physician in starting a successful practice; and to reduce the risk of turnover. • Examples of the most effective retention efforts include • selecting the right mentor • implementing more intensive and longer mentoring program

  21. Mentorship program • Utilization of late career physicians, and other physicians with an interest in mentoring (recommended by Pong, Lemire & Tepper, 2007) • Program assists both vulnerable groups – late careerist and early careerists • Look at the success of recruitment in our rural streams • Influence of a formal mentor for 2 years

  22. Quality of Work Life • 46% of physicians are in the advanced stages of burnout (CMA, 2003) • Collaboration and Team work now part of the model • Little Leadership training • Quality Workplace Initiatives but in a Doctor’s office??

  23. Quality Worklife Quality Healthcare Collaborative • National resource • Measuring engagement and Quality Worklife www.cchsa-ccass.ca 613.738.3800 x242 • “Worklife Pulse Tool” • “Within our Grasp”

  24. Sculpters???

  25. Ten Evidence-Based Practices for Successful Physician RetentionBy Hannah King, MPH; Carrie Speckart, MA Physician Work Environment: Summer 2002/Vol. 6, No. 3 • Realistic job preview and behavioural interviewing • Essential startup resources and administrative processes planned and in place • Practical, timely, comprehensive orientation programs delivered in multiple ways • Physician enculturation, socialization and fostering feelings of belonging, great place to work initiatives • Mentoring program • Perceived control over the practice environment • Accurate, effective and timely feedback • Recognition, rewards, opportunities for advancement/career development • Open and trustworthy communication; belief that management listens and acts on suggestions • Reduction of stress in the workplace

  26. A little time and a few dollars… • A start to retention in your community • Early and Late Careerists and the Engagement in your community • What is in a name? Who you are working with? Are you by definition leaving the most important folks out of your program. • Cost effective CME offered in your community • Mentorship program • Quality Work Life measurement

  27. Retention Radar • Challenge: Putting retention on the radar Michelle Hunter, MSc Rural Ontario Medical Program 459 Hume St. Collingwood, ON L9Y 1W9 705-445-7667 www.romponline.com mhunter@romponline.com

  28. Michelle Hunter Rural Ontario Medical Program 459 Hume St. Collingwood, ON L9Y 1W9 705-445-7667 www.romponline.com mhunter@romponline.com

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