Retention Recommendations

• Create a schedule that is consistent and stable rather than constantly changing;
• Make sure the schedule is perceived as fair for all providers;
• Ensure that all providers get appropriate time off;
• Give providers enough flexibility to participate in other projects such as teaching, subspecialty clinics, administrative duties, or special projects; and
• Adhere to a schedule that promotes/accommodates a safe patient to provider ratio.

Salary and Bonuses

Money does matter in retention. As long as the pay you offer is perceived as fair, you have a good start. “In the end, you can only afford what your finances dictate,” says Dr. Simone. “Smaller hospitals may fall short on salary, so it’s important for them to recognize their strengths and sell them in order to compete.”

Your hospitalists may be attracted to participate in an incentive program that rewards them for hard work and productivity. “Incentives help change behavior, and people are stimulated when they have direct control over their own pay,” says Dr. Simone. “There are hospitalist programs with incentive plans, but many programs aren’t sure how to incentivize. You don’t want to reward doctors solely on the amount of work they do.”

For instance, a hospital-based program that rewards hospitalists on the basis of how many patients they admit is basically encouraging them to hospitalize every patient they see.

“I recommend finding a way to reward quality work and dedication, while not neglecting productivity,” says Dr. Simone. “In my opinion, the focus needs to be on increasing the program’s ability to standardize care following evidence-based protocols, encouraging participation in the value-added services that hospitalists are so good at, like participating in a rapid response team or a code blue team, acting as hospital leaders, educating hospital staff and residents, etc.”

Feeling Connected

Unlike many other physicians, hospitalists don’t get many opportunities to connect with patients or a community.

“In my opinion, a hospitalist’s professional job satisfaction and retention is influenced by the perception of feeling connected to the practice and providers, patients, colleagues, and the hospital,” says Dr. Simone. “There are various characteristics of an employment arrangement that may help an individual feel connected. When an employee feels connected, he/she will typically dedicate themselves to the mission of the company and perform at or above expectations.”

Create or revisit your group’s retention program today. By ensuring that the values and objectives of your practice are clearly stated, and catering to those values and objectives in scheduling and other management practices, you can begin to build your retention. TH

Jane Jerrard writes the “Career Development” column every month for The Hospitalist.