The Way Forward: Physician retention and turnover in critical access and rural hospitals

Physician retention programs remain a strategic initiative for healthcare organizations of all sizes. But rural facilities may feel the impact of turnover more acutely than larger ones, both in terms of patient care and financial cost. In our continuing series with Robert Budman MD MBA, former CMIO of Atlanta’s Piedmont Healthcare, we explore “The Way Forward” in offering strategic direction and help for critical access and rural hospitals.
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This article was first published on July 15, 2019, by Health Data Management. Reposted with permission.

Rural health facilities and critical access hospitals face the same inherent operating challenges as larger and urban organizations; the difference, however, is that the impact of each is heightened in more rural environments. Physician recruitment and retention are no different.

The loss of even one provider at a small facility can carry an enormous impact, both in terms of patient care and financial cost. In many cases, critical access facilities are the only nearby source of patient care, so when a provider leaves the organization, the result is limited access to healthcare services and a disruption to the community; it may also necessitate travel under duress. The financial impact can also be overwhelming. A recent article estimated the “staggering” cost of physician turnover to be as high as $400,000 per provider when you factor in the recruitment, onboarding, and training costs in addition to lost revenue opportunities.

There are ways forward. First, it’s helpful to learn why physicians may leave your organization. Rural communities are by definition more isolated; is that having an impact on dedication to remote entities? Are other incentives and amenities sufficient to positively affect providers’ quality of life? Consider how your organization might be able to effect change among these factors, including the intangible factors. One has to provide a mix of values and opportunities to succeed professionally and personally.

Second, we previously discussed the profound impact that administrative burden has on providers. Physicians tend to be increasingly busy in today’s healthcare environment, and that’s especially true in rural and critical access hospitals when the load can’t be shared across a large practice group the way it can in bigger organizations. Creating efficiency and enhancements in the daily workload and making more time for meaningful patient interactions deepens the providers’ connections to the community and may strengthen their attachment to that facility.

Various healthcare technologies and artificial intelligence (AI) can, as Deloitte has written, enhance the physician-patient experience, thus making it easier to integrate valuable data into the patient record. Improving outcomes, alleviating administrative burden, and automating routine and often mundane tasks make up the holy grail of modern digital healthcare. Together, all of these factors may help reduce burnout, which could lead to lower turnover rates, not to mention the impact on patient care in terms of quality, safety, outcomes, and reimbursement.

As the digital transformation marches on, we expect to see more and more opportunities for rural healthcare organizations to take advantage of advancements that lead to efficient and satisfied physicians, better patient experiences, improved provider retention, and organizational performance enhancements. That’s why it’s essential for organizations to rely on a consultative technology partner who can provide proven solutions that can help establish a technology roadmap that leads to a stronger and more stable future state.

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Robert Budman, MD

About Robert Budman, MD

Dr. Budman recently joined Nuance as a Chief Medical Information Offcer, primarily supporting the CAPD and CDI lines of business. Dr. Budman served as Chief Medical Information Officer at Piedmont Healthcare in Atlanta, GA from 2015 – 2019 where he rebuilt VT phophylaxis workfow in Epic, thus lowering Piedmont’s VTE rate to one the best in the nation. In addition, Dr. Budman was the executive champion to contract, build and lead physician training and support for Dragon Medical One and Dragon Medical Advisor. Dr. Budman is Board Certifed in Family Med and Informatics.