Latest / Becker’s Healthcare Podcast / Building a Physician Retention Roadmap with Scott Polenz of CHG Healthcare

Transcript

Building a Physician Retention Roadmap with Scott Polenz of CHG Healthcare · Becker’s Healthcare Podcast

• 0:00
  Hello, everyone. This is Erica Spicer Mason with
• 0:02
  Becker's Healthcare. Thank you so much for tuning
• 0:04
  into the Becker's Healthcare podcast series today.
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  So today we're going to talk about a
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  roadmap for healthcare administrators
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  that touches on physician alignment, engagement,
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  and retention.
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  And joining me for today's discussion on this
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  roadmap is Scott Pollens,
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  a principal consultant at CHG Healthcare Advisory Services.
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  Scott, great to have you on the podcast.
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  Thank you so much for being here today.
• 0:29
  Yeah. Thank you, Erica. I'm I'm I'm excited
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  to to talk about a topic I'm quite
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  passionate about. Yeah. I'm excited to learn more
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  about this road map and and the role
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  that you've played in developing it. And before
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  we get to that, I wanted to talk
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  a little bit about your background just to
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  give our listeners a little bit of context
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  here.
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  I know you've held both rural CEO roles
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  and system leadership positions, and now you consult
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  nationally for health care. So how has your
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  own journey shaped the way that you think
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  about physician alignment, engagement, and retention, and why
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  are these areas so important to organizational success
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  right now? Yeah. Thank you. Yeah. I I've
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  had a really cool career and,
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  have been a CEO and a CEO of
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  hospitals in Central North and Western Wisconsin and
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  rural areas and then,
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  or saw physician in APP recruitment
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  and really retention, and that's really got focus.
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  So back to your question, I, I think
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  about it all the time as my career
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  has evolved because I just feel very strongly
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  that physician relations and how we treat our
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  physicians
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  is mission critical for all health care organizations.
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  And, you know, if you think about
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  take care of your physicians, it improves patient
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  care, it enhances innovation, it reduces burnout and
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  a turnover across your organization,
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  it enhances efficiency and standardization of care, it
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  improves your eight your health care organization
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  performance,
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  focuses on the quadruple aim, improves continuity of
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  care, and reduces recruitment costs, and just really
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  improves your overall culture. And if you think
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  about physicians,
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  many of them are in leadership roles, but
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  most of them are not in leadership roles
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  and but they're still the captain of the
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  ship or the captain of the team in
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  the OR,
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  in the clinic if they're in a a
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  primary care type of setting in the hospital.
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  So they're the ones that are really running
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  the show, and they're the cornerstone and they
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  really lead. If you think about pillars of
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  excellence,
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  from quality and safety, service, patient experience, growth,
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  finance, people. If you take care of your
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  docs, you take care of all your pillars
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  of of excellence. And and what I worry
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  about in the industry and what I've seen
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  the last few years is it seems like
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  we're moving to,
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  and have been moving to treating physicians more
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  like a commodity.
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  And they're not commodities. We're all you know,
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  we seek health care. We're not commodities.
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  These aren't widgets we're making. And,
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  so I'm just very passionate about committing to
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  align and engage our physicians then we can
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  retain them. And from a financial standpoint, Erica,
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  an engaged physician is 26%
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  more productive than a disengaged physician. So the
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  numbers will will demonstrate that
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  physician alignment, engagement, and and, retention are really,
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  really important. That's about that 26% more productive
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  is about a half million dollars more in
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  additional revenue annual for an organization.
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  Yeah. Scott, I appreciate you tying some of
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  these,
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  you know,
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  the the benefits of
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  effective physician alignment, engagement, and retention, tying those
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  to some of the key measures and
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  areas that we know health care leaders are
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  worried about right now. You know, you're talking
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  about productivity,
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  efficiency,
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  cost savings,
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  and then of course, you know, the mission
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  critical piece about
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  streamlining and optimizing patient care too. I know
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  that's really at the heart of why we
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  want physicians to be happy and why we
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  want them to be operating well in their
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  roles so they can better serve patients.
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  So again, I really appreciate that overview.
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  And I wanna take a step back too
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  and and talk a little bit about these
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  words, alignment,
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  engagement, and retention.
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  I rattled them off very quickly in the
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  beginning, but I know it's important to distinguish,
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  between each of them. And
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  oftentimes, they're referred to as interchangeable terms, but
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  I have a feeling that's probably not the
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  case. So I I'd like to know how
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  you distinguish those three terms
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  and how you address those,
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  in your physician retention road map. Would love
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  to learn more there. Yeah. Thank you, Erica.
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  It it,
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  was very intentional in in thinking about this,
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  and it it really started a few years
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  ago in a a larger health care system
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  I was working at.
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  And we took an engagement survey, and the
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  results weren't very good at all. And, my
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  diet partner and I had had just kinda
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  stepped back and said, you know, our engagement
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  is low. Okay. We gotta figure out how
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  to to better engage our physicians. But what
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  we realized is that our physicians were engaged.
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  They just weren't aligned
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  with our mission and our vision and and
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  our executive leadership. And until we solve their
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  alignment
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  and focus on their alignment, we will not
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  be able to get them engaged and ultimately
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  retain them. So that's why we we broke
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  it out. And,
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  if you think about the road map that
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  we've put together,
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  it has, four areas under alignment. So in
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  the road map, we talk about culture, executive
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  leadership, communications,
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  and physician voice and leadership. And then under
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  in the road map under engagement, which is
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  really kind of that emotional connection and and
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  and and doctors feeling valued and office feeling
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  valued,
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  we talk about onboarding,
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  you know, how they're introduced to the organization,
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  their work life balance and flexibility, their operational
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  efficiency, and and just the whole social side
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  and the socialization
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  of with their colleagues and collegiality and also
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  their families. And then we we end with,
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  or then we focus on retention,
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  which is really that long term commitment supported
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  by structure and our experience and and we
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  focus in four different areas of professional their
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  professional growth and development,
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  their well-being,
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  their compensation and incentives obviously is important, and
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  then just how do we recognize our physicians
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  for doing the the wonderful things that they
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  do for our communities. And so it's just
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  been really cool to have my have my
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  career with us experience and passion about physician
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  relations and CHG allowing me to kinda put
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  a road map together to, to help our
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  partner HCOs that CHD Health Care works with
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  across the country. And within the road map,
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  we have, like, you know, obviously, definitions and
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  background.
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  We we kinda I try to challenge, health
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  care leaders across the country with strategic reflections
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  and checkup questions. One question would be, like,
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  on a scale of one to ten, ten
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  being the highest, what would your physicians rank
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  their trust in executive leadership?
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  And then we do, for quite a bit
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  some of the client work that we've done
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  and some past experience, we go into a
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  deeper dive,
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  within within the road map. So it's really
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  it's been a really cool project.
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  Yeah. It sounds like it, Scott. Thank you.
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  And I know when you just touched on
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  the area of retention, you named a few
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  important pillars underneath that term. You talked about
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  professional growth, well-being, compensation,
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  recognizing success.
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  So it sounds like there's a lot that
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  goes into the retention piece. So I'd love
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  if you could share a little bit more
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  with our listeners about the common struggles, barriers,
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  or challenges that you see organizations face when
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  they're trying to develop a formal retention plan
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  for physicians and APPs.
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  Yeah. It's because it's really hard work, and
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  it's very complex. And it really takes
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  to put a formal retention plan in place,
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  it really takes a a group of team
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  a professional team that puts it together, puts
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  it to paper, and then operationalize
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  it and lives it daily across the whole
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  organization.
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  And, what I found fascinating is AAPPR, which
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  is our, you know, our industry
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  standard for the recruitment area. They actually,
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  said that less than 25 or right around
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  25% of health care organizations have a formal
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  retention
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  plan in place for their physicians, which is,
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  you know, that's quite low when you think
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  about that. And,
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  many will say health care organizations back to
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  talk I gave yesterday at a national conference,
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  people would say, yeah. We're doing a little
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  bit of this. We're doing a little bit
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  of that.
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  From what I tell people, recommend, and consult
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  with is the great organizations have a retention
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  plan in place that will help them thrive
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  in the future, but it's, it's not easy
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  work to do.
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  Yeah. Absolutely. It sounds like,
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  a lot of
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  different areas that organizations have to pull from,
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  whether it's finance, whether it's, HR and, you
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  know, mental health and well-being.
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  There's a lot that goes into that, so
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  I'm sure it's no easy task.
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  So again, appreciate you highlighting that and also,
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  you know, tying that back to the roadmap
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  that you've developed.
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  And so based on what you're you're seeing
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  across hospitals and health systems, what would you
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  say are the most significant forces that are
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  reshaping the physician experience right now? And how
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  do you think leaders should rethink their approach
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  in response to some of those factors?
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  Yeah. Great question. You know, the biggest forces
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  is we all we all know there's a
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  physician shortage,
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  86,000
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  by the year 2034.
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  You know, you have you have, increased competition
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  for physician time. You have nontraditional employers now
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  getting into this market and wanting to hire
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  your physicians away from you. Engagement levels are
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  a little bit better, but still struggle,
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  and just changing expectations, flexibility, and
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  and the need for flexibility. And what what
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  I wanted to just chat about briefly is
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  a couple areas is, what what we did
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  the study with our physicians because CHD employs
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  thousands of physicians, and we asked them,
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  you know, what's important to you and and,
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  and in in your in your your physician
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  career. And
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  the top five you'd be surprised by this.
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  The top five areas that they focused on
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  or that they said were most important were
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  better work life balance,
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  better workplace culture,
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  more support from administration, executive leadership,
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  opportunity for them to professionally grow and advance.
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  Sometimes I think we think physicians just go
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  and they just wanna practice, but they wanna
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  do different things and and grow and be
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  in leadership or do research or do education,
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  and then increased autonomy. And then the next
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  one is is compensation. So compensation, even though
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  people may say this, it's not the most
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  important,
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  area that physicians are focused on.
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  And in fact, on the autonomy side,
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  advisory board has this this great kind of
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  slide and and discussion that they talk about,
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  and they really talk about three areas for
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  autonomy for physicians. Physicians wanna have clinical autonomy.
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  They wanna be able to make the decisions
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  for their for that are best for their
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  for their patients. They don't want administrators like
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  myself and and others to tell them how
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  to take care of their patients. They wanna
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  have schedule autonomy.
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  They wanna spend their days in a way
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  that works for their patients and the family
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  and and and also themselves. So, again, that's
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  kind of that work life balance, that flexibility,
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  allow them to grow their practice. And then
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  the last one is strategic autonomy,
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  where they wanna help they want help and
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  they wanna be able to shape their their
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  future and and their, you know, their practice
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  wherever that would be. And I actually have
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  a a quite a few doctor friends, and
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  we get together and and and talk we
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  get together monthly and talk coffee and have
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  coffee.
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  And this is what they talk about. They
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  talk about their autonomy in their their clinic
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  and people telling them what they can and
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  can't do,
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  and they wanna take care of their patients.
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  They wanna work hard. They wanna get back
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  to the communities. And, so we, you know,
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  we as organizations,
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  we need to realize that physicians are humans
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  like all of us. They want that balance,
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  that connection, that culture, that clarity. They want
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  they wanna be recognized, obviously,
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  autonomy. So we really need, as health care
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  organizations, oftentimes are kinda conservative.
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  It's obviously changing now, but, you know, eight
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  to five, Monday through Friday, that's not what
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  physicians are looking for. So we need to
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  be more relationship based and and, and really
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  support the physician experience.
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  Yeah. Absolutely.
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  Scott, so much of what you've touched on,
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  those high priority areas for physicians,
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  so many of them tie back to culture,
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  you know, whether we're talking about work life
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  balance,
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  actual workplace culture, support from leadership. And so
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  I know leadership plays such a key role
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  in the culture piece. And in your roadmap,
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  you even talk about the importance
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  of trust, transparency,
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  and also authentic communication.
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  So I'm curious to know what do physicians
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  actually respond to, and what leadership behaviors or
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  structures
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  most reliably
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  can build trust? And I guess on the
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  other side of the coin too, what behaviors
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  erode it quickly?
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  Yeah. No. This
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  is such an important area. And
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  and, I used to have a lot in
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  my role, my past role as
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  of of overseeing physician relations and recruitment and
• 12:33
  onboarding. I would have docs. I would get
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  to know them really well, and and they
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  would say, I don't trust it, but, Scott,
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  I don't trust administration.
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  And I kinda challenged them and say, well,
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  what do you mean by that? It's you
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  you can't just say that and not give
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  some definition or give some feedback as to
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  what you actually mean by that. And then
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  I also studied
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  Frances Fry does what she calls a trust
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  triangle, and she says there are a triangle
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  of three areas that are important to trust.
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  And and you can do this in your
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  relationship with your family, with your boss, with,
• 13:02
  your coworkers, or the people that report to
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  you. And she talks about how you have
• 13:06
  to be as a leader, you have to
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  be authentic.
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  People need to know the real you. You
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  have to be empathetic to what's going on
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  in their world and how how their days
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  are. And then you have to be logical
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  in kinda your communications and your decision making.
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  And if you're often one of those, you're
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  not gonna have the trust that you need.
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  So, like, I can be a very authentic
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  and very empathetic person, but if I just
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  make these irrational decisions on a Monday morning
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  and I don't talk about the why, there's
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  not gonna be trust. And so quite a
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  few physicians, when I would ask them, they
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  would just say, well, when somebody rounds, an
• 13:38
  administrator rounds or executive leadership rounds, and I
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  say, hey. X, y, or z is not
• 13:42
  working well in my clinic, and they say,
• 13:43
  okay. I'll check into that. Then they never
• 13:45
  get back to me, and there's no follow
• 13:46
  through. And the physician doesn't mind if the
• 13:49
  answer is no. They just want somebody to
• 13:51
  follow through and say, hey. I checked into
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  this, and we can do one, two, and
• 13:54
  three, but we can't do four, five, and
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  six, and seven.
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  So that's really important. And then I think
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  the other side is, as I talked about,
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  is just being authentic.
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  And when we're communicating, it's not about a
• 14:05
  really good PowerPoint slide or a really well
• 14:07
  written memo. It's about telling patient stories. It's
• 14:10
  about the why. It's about how physicians were
• 14:12
  involved in the decision making and the communication
• 14:15
  because physicians still want to be,
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  communicated by their colleagues, their physician colleagues, not
• 14:20
  necessarily administration.
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  So great question.
• 14:24
  Yeah. Thank you so much, Scott, for elaborating
• 14:26
  on that.
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  And as we're winding down here, I wanna
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  make sure we also touch on
• 14:31
  infrastructure related to supporting all of these areas
• 14:34
  and recommendations in the road map. I know
• 14:37
  that in your road map, you close it
• 14:39
  by,
• 14:40
  sharing this concept of essentially an office of
• 14:42
  physician and APP relations.
• 14:45
  So why is a structure like this gaining
• 14:48
  traction in health care right now, and what
• 14:50
  does it solve that traditional organizational models might
• 14:53
  miss most often?
• 14:55
  Yeah. It's it's real you know? So, yeah,
• 14:57
  it's I mean, it's easy to talk about
• 14:58
  all the thing, you know, that we just
• 15:00
  talked about, but but but how do you
• 15:01
  how do you operationalize them? How do you
• 15:03
  implement things? And I don't know how else
• 15:05
  to do it besides
• 15:06
  creating a a structure
• 15:09
  that really what I would recommend and what
• 15:11
  I was trying to do in my past
• 15:12
  career was almost like a one stop shop
• 15:15
  for physicians and APPs.
• 15:17
  And if you think about it from an
• 15:19
  employee standpoint, I can go to human resources
• 15:21
  for
• 15:22
  my salary, for my evaluation,
• 15:24
  for my benefits,
• 15:26
  you know, PTO, etcetera. But if you're a
• 15:28
  physician,
• 15:29
  you often because the structure is kinda all
• 15:30
  over the place, you have to go to
• 15:32
  this leader first for privileging, this leader for
• 15:35
  compensation, this leader for PTO. And and by
• 15:38
  the time you're you you don't know who
• 15:39
  to go to, so you just kinda, you
• 15:41
  know, you just kinda give up to a
• 15:42
  certain extent.
• 15:44
  So what we recommend is that you create
• 15:46
  an office of a physician and APP relations
• 15:49
  that you have many of these areas, credentialing
• 15:51
  compensation report directly reporting up to that area.
• 15:54
  Obviously, recruitment and onboarding.
• 15:56
  Then you have very strong,
• 15:58
  you know, dotted line type of relationships.
• 16:00
  But at the end of the day, this
• 16:01
  is the group of people and the and
• 16:03
  the structure and a diet. We would recommend
• 16:05
  a diet where a physician and administrator
• 16:07
  where docs can go to when they have
• 16:09
  questions about burnout, about work like balance, about
• 16:12
  compensation, about privileging, etcetera.
• 16:15
  And then, you know, just to think about,
• 16:17
  think about this. If you're recruiting a physician
• 16:19
  and
• 16:20
  and the physician says to you to the
• 16:22
  recruiter, to whomever, you know, what what sets
• 16:24
  you apart or what's what makes your organization
• 16:26
  different than the competition? And you say, we
• 16:29
  actually have a formal retention program in place,
• 16:31
  doctor Smith or doctor Jones, and we're gonna
• 16:33
  take care of you not only on day
• 16:34
  one in the first ninety days, but throughout
• 16:36
  your whole career, and here's how we're gonna
• 16:38
  do that.
• 16:39
  And I just I were passionate about this
• 16:41
  because I one time I had a doc
• 16:42
  I really respected. We recruited him for a
• 16:45
  long time and his family. And after about
• 16:48
  three years, he came up and saw him
• 16:49
  in the hall, and he goes, you know,
• 16:50
  Scott, you guys did a great job at
• 16:51
  recruiting and onboarding me, but you forgot about
• 16:53
  me. And and I don't hear from anybody
• 16:56
  anymore. And that's not how I want my
• 16:57
  crew to evolve. And that was just kind
• 16:59
  of a gut check and kind of the
• 17:01
  the passion about bringing this all together.
• 17:04
  Oh, absolutely.
• 17:05
  A great example, Scott. And it sounds to
• 17:08
  me like
• 17:09
  this office of physician and APP relations, it
• 17:12
  might look different at one organization compared to
• 17:14
  another, but it sounds like the most important
• 17:16
  piece is that there are those
• 17:18
  those resources dedicated
• 17:19
  to these efforts. Do I have that right?
• 17:22
  Yes. Exactly. The, you know, the the physician
• 17:24
  experience.
• 17:25
  When you're a physician, this is the group
• 17:27
  of people that are gonna take care of
• 17:29
  you and and make sure you have a
• 17:31
  great career.
• 17:32
  Yeah. Fantastic.
• 17:33
  And, Scott, I know we've covered a lot
• 17:35
  of ground in this conversation, and,
• 17:37
  I I'm sure that once listeners are able
• 17:39
  to see the roadmap, they'll they'll have even
• 17:41
  more questions that will come up. But I
• 17:43
  thought it might be helpful to end our
• 17:45
  conversation,
• 17:46
  talking about next steps. So considering everything that
• 17:49
  we've talked about, if a health system wants
• 17:51
  to really improve retention in the next twelve
• 17:54
  to twenty four months, is there a best
• 17:56
  place they can start or a next step
• 17:58
  that you'd advise?
• 17:59
  Yeah. Yeah. Yeah. I think a couple areas,
• 18:02
  like, three or four areas is is, first
• 18:04
  of all, have a very standardized and structured
• 18:07
  and consistent onboarding program when you bring them
• 18:09
  into the organization and their family.
• 18:11
  Put a formal retention plan in place. Don't
• 18:14
  just say that, well, we do a few
• 18:15
  of these things, and and we're doing pretty
• 18:17
  well right now. Put the actual plan in
• 18:19
  place.
• 18:20
  Get executive leadership visible and authentic. We talked
• 18:23
  about this quite a bit. Executive leadership, our
• 18:26
  doc docs wanna know them. They wanna touch
• 18:28
  them, and they wanna shake their hands. They
• 18:30
  wanna know who they are and how they
• 18:31
  make their decisions,
• 18:33
  and then create the like, we just talked
• 18:35
  about, create the office of physician and AP
• 18:37
  relations and and start down that don't start
• 18:40
  down that journey.
• 18:41
  Fantastic.
• 18:42
  Scott, I I wanna thank you so much
• 18:44
  for making time for Becker's today and sharing
• 18:46
  everything that you've shared about the road map
• 18:48
  and and what's ahead.
• 18:49
  Is there anything that we didn't touch on
• 18:51
  or any final thoughts that you wanted to
• 18:53
  leave listeners with?
• 18:54
  I don't no. I don't think so. I
• 18:56
  think I've kinda talked a lot, and obviously
• 18:58
  very passionate about that. More than willing to
• 19:00
  you know, if people wanna reach out and
• 19:02
  have a further conversation about anything we talked
• 19:04
  about or the road map or or the
• 19:06
  office of physician APP relations, more than happy
• 19:09
  more more than happy to do that. I
• 19:10
  would just emphasize
• 19:12
  strongly that
• 19:14
  physician relations and recruitment and retention and onboarding
• 19:17
  and alignment
• 19:18
  should be in your strategic plan as a
• 19:20
  as a significant
• 19:22
  initiative each and every year because they are
• 19:24
  the cornerstone of all health care organizations.
• 19:28
  Great note to end on, Scott. Thank you
• 19:30
  again for your time and your insights today.
• 19:33
  And as Scott mentioned,
• 19:35
  we will be sure to include his information
• 19:36
  in this description for the episode so that
• 19:38
  if you'd like to reach out or,
• 19:41
  see a copy of the roadmap, that will
• 19:43
  be available to you. And of course, we
• 19:45
  also wanna thank our podcast sponsor, CHG Healthcare.
• 19:49
  Listeners, be sure to tune into more podcasts
• 19:51
  from Becker's Healthcare by visiting our podcast page
• 19:53
  at beckershospitalreview.com.