Building social connections among ways to improve physician retention

Key takeaways:

• Lifestyle demands and poor well-being are some of the reasons PCPs are leaving the field.
• Commensality programs, meet-and-greets for new hires and delegation strategies may help reduce turnover.

NEW ORLEANS — With a workforce shortage and increasing patient demands, it is important for clinical practice leaders in primary care to find ways to improve physician retention, according to speakers at the ACP Internal Medicine Meeting.

The field of primary care continues to face significant challenges. This year’s primary care scorecard from The Physician Foundation showed that the number of primary care practitioners per 100,000 people declined from 68.4 in 2012 to 67.2 in 2021. Of all physicians in training who specialized in primary care in 2021, just 15% were still practicing in the field 3 to 5 years after residency.

Ankita Sagar, MD, MPH, FACP, an associate professor of family medicine at Creighton University School of Medicine, said it was “not surprising” that some of the top factors for physicians leaving, apart from a desire for higher pay, were related to well-being, family needs and lifestyle demands.

“As [the] population ages, more of our physician workforce will become caregivers to elderly parents or other loved ones in their family,” she said.

The emotional and physical toll, demanding nature and intense workload of the position are also factors for physician departure.

However, multiple strategies centered around building social connections or reducing inefficiencies are proven to help reduce turnover, Elizabeth Cerceo, MD, FACP, FHM, an associate professor of medicine at Cooper Medical School of Rowan University, added.

Among these include commensality programs, “which have been around for a while,” she said. “They were started at Mayo Clinic, where you would pull together six to eight physicians [who] would meet for an hour over a meal. They would do this for 6 months.”

She said these physicians would be given a prompt, which they would the discuss for at least the first 20 minutes of the meal, if not the entire time.

This strategy “has been shown to have remarkable benefits in terms of burnout [and] retention,” Cerceo said. “This is something that you can do very soon.”

She also talked about the effectiveness of meet-and-greet programs for new hires. At her institution, employees who were there for less than a year had a virtual chocolate tasting with boxes of gourmet chocolate that were shipped to them.

“It was a mindful experience — it was fun — but then we would also have everyone introduce themselves and say a little bit about themselves,” she said. “It was a wonderful way to build community among people who might never otherwise be able to meet.”

Delegation can be another productive way to improve retention and quality of care, according to Cerceo.

For example, “inboxologists have been very beneficial,” Cerceo said. “There was a cluster randomized trial showing that when tasks were delegated to medical assistants, nurses, physician assistants … there was a big improvement in physician burnout. Just trying to manage our inboxes is one big thing that can be taken off our plate.”

She additionally highlighted two initiatives her institution started: “Get rid of stupid stuff” — where unnecessary bureaucracy and procedures were identified to help streamline processes — and a “What’s up doc” email, where physicians “can specifically reach out and bring up issues that they might be having” to those in the C-suite.

Through these strategies, “we can really try to prioritize and accelerate change,” Cerceo said.