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Becker’s Healthcare Podcast
Building a Physician Retention Roadmap with Scott Polenz of CHG Healthcare
00:19:59
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- [00:00]
A
Hello, everyone. This is Erica Spicer Mason with Becker's Healthcare. Thank you so much for tuning into the Becker's Healthcare podcast series today. So today we're going to talk about a roadmap for healthcare administrators that touches on physician alignment, engagement and retention. And joining me for today's discussion on this roadmap is Scott Pollins, a principal consultant at CHG Healthcare Advisory Services. Scott, great to have you on the podcast. Thank you so much for being here today.
- [00:29]
B
Yeah, thank you, Erica. I'm excited to talk about a topic I'm quite passionate about.
- [00:34]
A
Yeah, I'm excited to learn more about this roadmap and the role that you've played in developing it. And before we get to that, I wanted to talk a little bit about your background just to give our listeners a little bit of context here. I know you've held both rural CEO roles and system leadership positions, and now you consult nationally for healthcare. So how has your own journey shaped the way that you think about physician alignment, engagement and retention? And why are these areas so important to organizational success right now?
- [01:04]
B
Yeah. Thank you. Yeah, I've had a really cool career and have been a CEO and a CEO of hospitals in central, northern western Wisconsin and rural areas and then oversaw physician app recruitment and really retention. And that's really got focus. So back to your question. I think about it all the time as my career has evolved because I just feel very strongly that physician relations and how we treat our physicians is mission critical for all healthcare organizations. And if you think about taking care of your physicians, it improves patient care, it enhances innovation, it reduces burnout and turnover across your organization, it enhances efficiency and standardization of care and improves your healthcare organization performance, focuses on the quadruple aim, improves continuity of care and reduces recruitment costs and just really improves your overall culture. And if you think about physicians, many of them are in leadership roles, but most of them are not in leadership roles, but they're still the captain of the ship or the captain of the team in the or in the clinic, if they're in a primary care type of setting in the hospital. So they're the ones that are really running the show and they're the cornerstone and they really lead. If you think about pillars of excellence, quality and safety, service, patient experience, growth, finance, people, if you take care of your docs, you take care of all your pillars of of excellence. And what I worry about in the industry and what I've seen the last few years is it seems like we're moving to and have been moving to treating Physicians more like a commodity. And they're not commodities. We're all, you know, we seek healthcare. We're not commodities. These aren't widgets we're making. And so I'm just very passionate about committing to align and engage our physicians, then we can retain them. And from a financial standpoint, Erica, an engaged physician is 26% more productive than a disengaged physician physicians. So the numbers will demonstrate that physician alignment, engagement, and retention are really, really important. That's about that. 26% more productive is about a half a million dollars more in additional revenue annual for an organization.
- [03:13]
A
Yeah, Scott, I appreciate you tying some of these, you know, the benefits of effective physician alignment, engagement and retention, tying those to some of the key measures and areas that we know healthcare leaders are worried about right now. You know, you're talking about productivity, efficien, cost savings, and then, of course, the mission critical piece about streamlining and optimizing patient care too. I know that's really at the heart of why we want physicians to be happy and why we want them to be operating well in their roles so they can better serve patients. So, again, I really appreciate that overview, and I want to take a step back too, and talk a little bit about these words, alignment, engagement, and retention. I rattled them off very quickly in the beginning, but I know it's important to distinguish between each them, and oftentimes they're referred to as interchangeable terms. But I have a feeling that's probably not the case. So I'd like to know how you distinguish those three terms and how you address those in your physician retention roadmap. Would love to learn more there.
- [04:16]
B
Yeah. Thank you, Erica. It was very intentional in thinking about this, and it really started a few years ago in a larger healthcare system I was working at. And we took an engagement survey and the results weren't very good at all. And my dyad partner and I had. I just kind of stepped back and said, you know, our engagement is low. Okay, we got to figure out how to better engage our physicians. But what we realized is that our physicians were engaged. They just weren't aligned with our mission and our vision and our executive leadership. And until we solve their alignment and focus on their alignment, we will not be able to get them engaged and ultimately retain them. So that's why we broke it out. And if you think about the roadmap that we've put together, it has four areas under alignment. So in the roadmap, we talk about culture, executive leadership, communications, and physician voice and leadership. And Then in the roadmap under engagement, which is really kind of that emotional connection and doctors feeling valued and all of us feeling valued, we talk about onboarding, how they're introduced to the organization, their work life balance and flexibility, their operational efficiency and just the whole social side and the socialization of with their colleagues and collegiality and also their families. And then we, we end with or then we focus on retention which is really that long term commitment supported by structure and our experience. And, and we focus in four different areas of professional their professional growth and development, their well being, their compensation and incentives obviously is important. And then just how do we recognize our physicians for doing the, the wonderful things that they do for our communities? And so it's just been really cool to have my, have my career with us, experience and passion about physician relations and chd, allowing me to kind of put a roadmap together to help our partner hcos that CHD Healthcare works with across the country. And within the roadmap we have like, you know, obviously definitions and background. We kind of try to challenge healthcare leaders across the country with strategic reflections and checkup questions. Questions. One question would be like on a scale of 1 to 10, 10 being the highest, what would your physicians rank their trust in? Executive leadership. And then we do for quite a bit some of the client work that we've done and some past experience, we go into a deeper dive within the roadmap. So it's been a really cool project.
- [06:44]
A
Yeah, it sounds like it Scott. Thank you. And I know when you just touched on the area of retention, you named a few important pillars underneath the that term. You talked about professional growth, well, being compensation, recognizing success. So it sounds like there's a lot that goes into the retention piece. So I'd love if you could share a little bit more with our listeners about the common struggles, barriers or challenges that you see organizations face when they're trying to develop a formal retention plan for physicians and apps.
- [07:14]
B
Yeah, it's because it's really hard work and it's very complex and it really takes to put a formal retention plan in place. It really takes a group of professional team that puts it together, puts it to paper and then operationalizes and lives it daily across the whole organization. And what I found fascinating is aappr, which is our, you know, our industry standard for the recruitment area. They actually said that less than 25 or right around 25% of healthcare organizations have a four formal retention plan in place for their physicians, which is, you know, that's quite low when you think about that and many will say healthcare organizations. In fact, the talk I gave yesterday at a national conference, people say we're doing a little bit of this, we're doing a little bit of that. And what I tell people recommend and consult with is the great organizations have a retention plan in place that will help them thrive in the future, but it's not easy work to do.
- [08:11]
A
Yeah, absolutely. It sounds like a lot of different areas that organizations have to pull from, whether it's finance, whether it's HR and mental health and well being. There's a lot that goes into that. So I'm sure it's no easy task. Again, appreciate you highlighting that and also tying that back to the roadmap that you've developed based on what you're seeing across hospitals and health systems. What would you say are the most significant forces that are reshaping the physician experience right now? And how do you think leaders should rethink their approach in response to some of those factors?
- [08:48]
B
Yeah, great question. You know, the biggest force is, as we all, we all know, there's a physician shortage. 86,000 by the year 2034. You know, you have, you have increased competition for physician time. You have non traditional employers now getting into this market and wanting to hire your physicians away from you. Engagement levels are a little bit better, but still struggle and just changing expectations. Flexibility and the need for flexibility. And what I wanted to just chat about briefly is a couple areas, is we did the study with our physicians because CHD employs thousands of physicians and we asked them what's important to you in your physician career. And the top five, you'd be surprised by this. The top five areas that they focused on or that they said were most important were better work, life balance, better workplace culture, more support from administration, executive leadership, opportunity for them to professionally grow and advance. Sometimes I think we think physicians just go and they just want to practice, but they want to do different things and grow and be in leadership or do research or do education and then increased autonomy. And then the next one is compensation. So compensation. Even though people may say this, it's not the most important area that physicians are focused on. And in fact, on the autonomy side, advisory board has this, this great kind of slide and discussion that they talk about and they really talk about three areas for autonomy for physicians. Physicians want to have clinical autonomy. They want to be able to make the decisions for their, that are best for their, for their patients. They don't want administrators like myself and, and others to tell them how to take care of their patients. They want to have schedule autonomy, they want to spend their days in a way that works for their patients and the family and also themselves. So again, it's kind of that work life balance, that flexibility allow them to grow their practice. And then the last one is strategic autonomy, where they want to help, they want help, and they want to be able to shape their future and their practice, wherever that would be. And I actually have quite a few doctor friends and we get together and, and get together monthly and talk coffee and have coffee. And this is what they talk about. They talk about their autonomy and their clinic and people telling them what they can and can't do. And they want to take care of their patients, they want to work hard, they want to get back to their communities. And so we, you know, we as organizations, we need to realize that physicians are humans, like all of us. They want that balance, that connection, that culture, that clarity. They want, they want to be recognized, obviously, autonomy. So we really need, as healthcare organizations oftentimes are kind of conservative. It's obviously changing now, but you know, 8 to 5, Monday through Friday, that's not what physicians are looking for. So we need to be more relationship based and really support the physician experience.
- [11:44]
A
Yeah, absolutely, Scott. So much of what you've touched on, those high priority areas for physicians, so many of them tie back to culture, you know, whether we're talking about work, life balance, work, actual workplace culture, support from leadership. And so I know leadership plays such a key role in the culture piece and in your roadmap, you even talk about the importance of trust, transparency, and also authentic communication. So I'm curious to know, what do physicians actually respond to and what leadership behaviors or structures most reliably can build trust. And I guess on the other side of the coin too, what behaviors erode it quickly?
- [12:23]
B
Yeah, no, this is such an important area. And, and I used to have a lot in my role, in my past role as of overseeing physician relations and recruitment and onboarding, I would have docs, I would get to know them really well and, and they would say, I don't trust it. But Scott, I don't trust administration. And I kind of challenge them and say, well, what do you mean by that? You can't just say that and not give some definition or give some feedback as to what you actually mean by that. And then I also studied Frances Fry, does what she calls a trust triangle. And she says there are a triangle of three areas that are important to trust. And you can do this in your relationship with your family, with Your boss with your co workers or the people that report to you. And she talks about how you have to be as a leader, you have to be authentic. People need to know the real you. You have to be empathetic to what's going on in their world and how their days are. And then you have to be logical in kind of your communications and your decision making. And if you're often one of those, you're not going to have the trust that you need. So, like, I can be a very authentic and very empathetic person, but if I just make these irrational decisions on a Monday morning and I don't talk about the why, there's not going to be trust. And so quite a few physicians, when I would ask them, they would just say, well, when somebody rounds an administrator rounds or executive leadership rounds, and I say, hey, X, Y or Z is not working well in my clinic. And they say, okay, I'll check into that. Then they never get back to me and there's no follow through. And the physician doesn't mind if the answer is no. They just want somebody to follow through and say, hey, I checked into this and we can do 1, 2, and 3, but we can't do 4, 5 and 6 and 7. So that's really important. And then I think the other side is, as I talked about, is just being authentic. And when we're communicating, it's not about a really good PowerPoint slide or a really well written memo. It's about telling patient stories. It's about the why. It's about how physicians were involved in the decision making and the communication, because physicians still want to be communicated by their colleagues, their physician colleagues, not necessarily administration. So great question.
- [14:24]
A
Yeah, thank you so much, Scott, for elaborating on that. And as we're winding down here, I want to make sure we also touch on infrastructure related to supporting all of these areas and recommendations in the roadmap. I know that in your roadmap, you close it by sharing this concept of essentially an office of physician and APP relations. So why is a structure like this gaining traction in health care right now? And what does it solve that traditional organizational models might miss most often?
- [14:56]
B
Yeah, it's really, you know, so, yeah, I mean, it's easy to talk about all the things, you know, that we just talked about, but. But how do you, how do you operationalize them? How do you implement things? And I don't know how else to do it besides creating a structure that really what I would recommend and what I was trying to do in My past career was almost like a one stop shop for physicians and apps. And if you think about it from an employee standpoint, I can go to human resources for my salary, for my evaluation, for my benefits, you know, pto, et cetera. But if you're a physician, you often, because the structure is kind of all over the place, you have to go to this leader first for privileging, this leader for compensation, this leader for pto. And by the time you don't know who to go to, so you just kind of, you know, you just kind of give up to a certain extent. So what we recommend is that you create an office of a physician, App relations, that you have many of these areas, credentialing, compensation, report directly reporting up to that area, obviously recruitment and onboarding. Then you have very strong, you know, dotted line type of relationships. But at the end of the day, this is the group of people and the structure and a diet. We would recommend a dyad where a physician and administrator where docs can go to when they have questions about burnout, about work life balance, about compensation, about privileging, et cetera. And then, you know, just to think about, think about this. If you're recruiting a physician and the physician says to you, to the recruiter, to whomever, you know what, what sets you apart or what makes your organization different than the competition. And you say, we actually have a formal retention program in place, Dr. Sm, Dr. Jones, and we're going to take care of you not only on day one, in the first 90 days, but throughout your whole career. And here's how we're going to do that. And I just, I'm passionate about this because one time I had a doc I really respected. We recruited him for a long time and his family. And after about three years he came up to me, I saw him in the hallway and he goes, you know Scott, you guys did a great job of recruiting and onboarding me, but you forgot about me and, and I don't hear from anybody anymore. And that's not how I want my crew to evolve. And that was just kind of a gut check and kind of that, the passion about bringing this all together.
- [17:04]
A
Oh, absolutely. A great example, Scott. And it sounds to me like this office of physician and app relations, it might look different at one organization compared to another, but it sounds like the most important piece is that there are those, those resources dedicated to these efforts. Do I have that right?
- [17:22]
B
Yes, exactly. The, you know, the, the physician experience. When you're a physician, this is the group of people that are going to take care of you and. And make sure you have a great career.
- [17:32]
A
Yeah. Fantastic. And Scott, I know we've covered a lot of ground in this conversation, and I'm sure that once listeners are able to see the roadmap, they'll have even more questions that will come up. But I thought it might be helpful to end our conversation talking about next steps. So considering everything that we've talked about, if a health system wants to really improve retention in the next 12 to 24 months, is there a best place they can start or a next step that you'd advise?
- [18:00]
B
Yeah, yeah, I think a couple areas, like three or four areas is. First of all, have a very standardized and structured and consistent onboarding program when you bring them into the organization and their family. Put a formal retention plan in place. Don't just say that. Well, we do a few of these things and we're doing pretty well right now. Put the actual plan in place. Get executive leadership, visible and authentic. We talked about this quite a bit. Executive leadership. Our docs want to know them. They want to touch them and they want to shake their hands. They want to know who they are and how they make their decisions and then create that, like we just talked about. Create the Office of Physician AP Relations and start down that. Don't start down that journey.
- [18:42]
A
Fantastic. Scott, I want to thank you so much for making time for Beckers today and sharing everything that you've shared about the roadmap and. And what's ahead. Is there anything that we didn't touch on or any final thoughts that you wanted to leave listeners with?
- [18:55]
B
No, I don't think so. I think I've kind of talked a lot and obviously very passionate about that. More than willing to, you know, if people want to reach out and have a further conversation about anything we talked about or the roadmap or the Office of Physician App Relations. More than happy, more than happy to do that. I would just emphasize strongly that physician relations and recruitment and retention and onboarding and alignment should be in your strategic plan as a significant initiative each and every year because they are the cornerstone of all healthcare organizations.
- [19:28]
A
Great note to end on, Scott. Thank you again for your time and your insights today. And as Scott mentioned, we will be sure to include his information in this description for the episode so that if you'd like to reach out or see a copy of the roadmap, that will be available to you. And of course, we also want to thank our podcast sponsor, CHG Healthcare listeners, be sure to tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.