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Provider Turnover: Reasons Differ Among Physicians, Advanced Practice Practitioners

Physicians are more likely to leave their organizations for retirement, while compensation is a bigger factor in turnover among advanced practice practitioners

Concerned  middle aged doctor

Turnover among physicians and advanced practice practitioners (APPs) is an expensive issue for health systems and medical practices. According to a report by Merritt Hawkins, physicians on average generate $2.4 million in annual revenue for their affiliated hospitals.

When physicians or APPs choose to leave their place of employment, it leaves a big revenue hole to fill. And, it can take many months to fill vacant positions.

The Association for Advancing Physician and Provider Recruit recently released a report detailing the rate or turnover among physicians and APPs, reasons they leave their jobs, and what types of retention strategies can mitigate the departures.

Rates of turnover

Turnover is higher among APPs than it is among physicians. The annual turnover rate among physicians is 3.8%; the rate among APPs is 4.7%.

The size of the organization plays a role, too. Smaller healthcare organizations with fewer than 300 providers have the highest rates of turnover. Mid-size organizations with 300 to 999 providers have the lowest turnover levels.

Reasons for turnover 

Here are the top reasons for turnover. Retirement tops the list for physicians, while compensation is a bigger contributor to APP turnover.

Among physicians

  1. Retirement
  2. New position (similar role) elsewhere
  3. Geography
  4. Burnout
  5. Compensation

Among APPs

  1. New position (similar role) elsewhere
  2. Compensation
  3. Geography
  4. Burnout
  5. Retirement

Financial retention strategies at the recruitment stage

To combat turnover, healthcare organizations typically use two tools: signing bonuses and retention bonuses. The use of these incentives differs between physicians and APPs as well as the size of the healthcare organization.

Signing bonuses

Across organizations of all sizes, 85% offer signing bonuses to physicians while 60% offer signing bonuses to APPs. The largest organizations with more than 1,000 providers offer signing bonuses most often.

Retention bonuses

Retention bonuses are used less often than signing bonuses, and typically kick in after three years on the job. Approximately 40% of employers offer retention bonuses to doctors. That number drops to just 20% among APPs.

The need for more retention programs

Despite the negative financial impact of physician and APP turnover, fewer than one in four health organizations report having any formal retention programs in place, outside of standard financial incentives.

According to the report, these retention strategies were deemed most impactful in reducing turnover:

  • Administrative support staff to reduce physician strain
  • Clinical supplemental teams to support call coverage
  • Technology superusers to help physicians
  • Physician mentoring
  • Offering physician leadership roles at all levels
  • Ability to transition to part-time or job share
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