The changes that would keep more doctors from quitting

According to recent research, American clinicians are undergoing a mass exodus from the clinic. Poll results published by Morning Consult in October found that roughly 12% of healthcare workers have been laid off during the COVID-19 pandemic, and another 18% have quit their jobs.

That may only be a sign of what’s to come. The survey also found that, of those who kept their jobs during the pandemic, nearly a third are thinking about quitting. Of the 1,000 care providers surveyed, 79% said that the current national shortage of medical staff is affecting them and their place of work, and 19% are considering leaving the field of medicine entirely as a result.

But this exodus is not inevitable. The survey also quizzed physicians on what workplaces changes would keep them from quitting and found that a variety of preventable factors are driving the wave of resignations. Some 19% of respondents said they disapprove of how their employers have handled the pandemic, describing inadequate personal protective equipment, low pay, and a general sense of feeling disposable. Roughly half of doctors quit the clinic to seek a higher wage or a better professional opportunity. Others left due to burnout or a work schedule that’s too packed.

A physician retention survey commissioned by Jackson Physician Research showed that more than half of physicians were planning on making an employment change, based on a pool of 485 responses from healthcare professionals. Authors note that recruitment costs can reach as high as $250,000 per physician, which means that strategies for increasing retention rates are well worth considering. 

Based on the responses of several surveys and the findings of recent reviews and research, let's look at five action items that could help with physician retention.

1. Ensure physicians have confidence in COVID-19 safety measures

An article published in the Annals of Internal Medicine in November listed 10 measures that authors felt could improve retention rates. It’s perhaps not surprising that the first three items on the list are all related to COVID-19.

The first step should be to reduce the risk of contracting COVID-19 for healthcare workers, the study noted. Authors suggested that vaccination mandates and proper access to personal protective equipment (PPE) are the most important aspects of this, along with policies and practices to ensure universal masking and adequate ventilation in work areas. 

“Transparency about PPE supplies and contingency plans when there are shortages are particularly important to restore and maintain trust among clinicians who spent earlier COVID-19 waves without adequate PPE,” the authors wrote. 

The authors also emphasized that administrations should provide support in areas identified as “causing emotional stress or moral injury.” This ranges from training physicians in dealing with patients who have chosen not to be vaccinated, to being forthcoming about factors like staffing levels, hospital bed capacity, and medication availability. Many of these action items are aimed at rebuilding trust among clinicians who may be disillusioned after working through the pandemic.

2. Provide more compensation or more time off 

A review, published in BMJ in January, looked at 18 papers that focused on improving staff retention rates. Authors identified various factors linked with retention, including compensation. Specifically, they concluded that higher incomes correlate with better retention rates, while those who leave the clinic tend to have lower incomes. One of the papers revealed that income was “a major factor in decisions” to keep practicing medicine.

This is far from the first study to find that financial compensation drives employment choices. The aforementioned Jackson Physician Search poll found that respondents listed “additional compensation” as the most influential factor influencing retention, with “additional time off” coming in second place. 

3. Allow more autonomy over schedules

Among the retention-linked factors found by authors of the BMJ review, there are several related to schedules, including excessive workloads, working conditions, and "antisocial working patterns,” among others. Authors note that some of the studies they examined found that offering staff more autonomy over their schedule has the potential to improve these barriers.

The aforementioned AIM article lists several action items that relate to offering more schedule flexibility to clinicians. Authors posit that this is particularly important for clinicians who are parents or caregivers. They also recommend reducing administrative tasks that are not mission-critical to alleviate physicians of burdensome reporting requirements and time-consuming online training sessions. 

4. Address the causes of burnout

According to the Jackson Physician Search survey, during the pandemic, physician burnout rates climbed to 60%, according to one estimate. And yet the survey found that 28% of physicians work at an organization that doesn’t have a program in place to deal with burnout. 

The aforementioned AIM article listed a number of action items that relate to burnout, including urging organizations to offer free and confidential resources to support clinicians’ mental health. Authors also argue that credentialing and employment applications should remove unnecessary questions about mental health diagnoses, because they may deter care-seeking. 

Clinics should also implement suicide prevention strategies, including “wellness check-ins” for clinicians. Authors add that doctors should be actively encouraged to use their vacation time and professional development days to nurture a mentally healthy workplace. For more on this subject, click here. 

5. Take a multifaceted approach

The trick is not to focus on just one of the above suggestions, but to move forward with a strategy that recognizes the many needs of staff. Ultimately, the goal is to have a clinic full of happy and healthy doctors, who trust they’re working in a safe and supportive environment.