Becker's Spine Review

22 22 HEALTHCARE NEWS The cost of physician turnover By Laura Dyrda P hysician turnover rates are increasing as more clinicians experience burnout and decide to retire early, leave the field or refresh their practice setting. The Association for Advancing Physician and Provider Recruitment's report on physician and provider retention and turnover in 2022 showed around 76 percent of physician exits in organizations with the most and least providers were due to retirement. Physicians finding a new role elsewhere was also a top response. If caught unaware, physician turnover can hit the health system's finances hard. Here are seven points: 1. Losing a physician means hospitals won't receive the revenue associated with those cases until the physician is replaced. Physicians also typically have a ramp-up period for to build a patient base. On average, physicians generate $2.4 million for affiliated hospitals each year, according to Merritt Hawkins. The highest revenue generating physicians being interventional cardiologists who generate $3.48 million per year and then orthopedic surgeons who generate $3.29 million per year. 2. Interview expenses could be $30,000 per candidate, with the interview process relevant to recruiting costs being around $250 for human resources per hour plus lost productivity during the interview, according to a report from the New England Journal of Medicine authored by Tony Stajduhar, president of Jackson Physician Search. 3. Revenue lost from the vacancy of a physician depends on the specialty; a family medicine physician that generates $1.5 million revenue for the hospital could mean a loss of $130,000 per month until the vacancy is filled, Mr. Stajduhar noted. 4. On average, it takes 4.3 months to fill an open family medicine role, and five to 10 months to fill a specialist role, NEJM reported. In that time, hospitals could lose $559,000 on the open family medicine spot and much more for medical specialists. 5. Newly hired physicians receive a myriad of financial perks. More than 90 percent of hospitals offer an average of $10,000 to $15,000 for physician relocation as needed, according to the Association for Advancing Physician and Provider Recruitment. Forty-one percent of organizations surveyed offered $75,000 to $99,000 in physician student loan repayment. 6. Ninety-one percent of organizations offered signing bonuses to new physicians, typically $20,000 to $30,000, according to the American Association for Advancing Physician and Provider Recruitment. Physician signing bonuses jumped 21 percent from 2022 to 2023 to $37,473, according to a report from AMN Healthcare. The signing bonus for the most requested specialties was much higher; family medicine physicians had an average signing bonus of $45,918 and a high of $250,000. 7. Hospitals will sometimes pay for medical malpractice insurance for physicians, which varies by state and specialty. Overall, medical malpractice premiums increased 30 percent from 2020 to 2022, according to the American Medical Association. n Leadership has its own retention problem By Alexis Kayser A mid staffing shortages and dipping engagement levels, workforce retention is top-of-mind for many healthcare leaders. But oentimes, the problem extends beyond frontline employees and into management — even C-suites. In the first 11 days of September, Becker's recorded 11 executive exits from hospitals and health systems. e trend keeps pace with CEO turnover rates tracked monthly by executive coaching firm Challenger, Gray & Christmas; 100 hospital CEOs le their roles between January and August, a 56 percent increase from the same time period in 2022. ere are several reasons why an executive might pass off the reins, especially in today's challenging market. System combinations and reorganizations can spur job cuts (and tensions); many leaders who postponed retirements during COVID-19 are announcing them now. Some are choosing to leave healthcare entirely, opting for a less tumultuous industry. John Couris, CEO of Tampa General Hospital, noted the trend in an August interview with Becker's. "It breaks my heart to see the turnover in the CEO ranks," Mr. Couris said. "It really does, because for the first time in my career, I have seen and I'm hearing CEOs say, 'It's not worth it. I'm out. ere's a better way to earn a living. I'll go to venture capital. I'll go to private equity.'" But instability up top can trickle down, weakening the organization as a whole, according to Mr. Couris, who recently decided to extend his contract with Tampa General another decade. He agreed that, to some extent, his loyalty to the organization is setting an example. "I'd submit to you that you need consistency and longevity to manage through the [industry's] turbulence," he said. "It creates a calmness and a sense of security in the organization that allows people to innovate and drive toward the organizational imperatives." If consistency drives calmness, steady middle management is imperative to reduce workplace angst. A recent analysis from

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