Key to physician retention: Adapt to generational differences

One of FiercePracticeManagement's most-read articles last week covered two recent surveys whose results indicate a rough road ahead for physician practices. In particular, the Merritt Hawkins "2011 Review of Physician Recruiting Incentives" and Accenture's survey revealed a rapid (perhaps more than we realized) shift of physicians out of their offices and into hospitals. At the same time, practices competing to recruit a limited number of doctors are faced with the challenge of determining, if at all, how they should change their compensation methodologies to adapt to the changing picture of U.S. healthcare.

For additional insight into what these trends mean for practices, I caught up with Jennie Campbell, chief operating officer of East Tennessee's Summit Medical Group, and former partner with healthcare accounting and consulting firm Pershing Yoakley & Associates. She put on both her executive and consultant hats when answering my questions.

FPM: According to the Merritt Hawkins survey, the majority of ‘real-world' physician compensation in the U.S. is still production-based, despite the recent emphasis on rewarding quality. Do you foresee quality bonuses taking on a larger role in compensation formulas in the near future?

Campbell: Third-party payment is definitely migrating toward more pay for quality and patient experience metrics, but in many parts of the country, reimbursement is still largely fee for service. Many organizations that employ physicians are also beginning to designate some portion of bonus based on quality and/or patient satisfaction, but the base compensation and majority of bonuses still mirror the fee-for-service compensation.

FPM: Is the culture of medicine ready to shift toward paying for quality?

Campbell: The migration is difficult, and it's important to align physician compensation with the actual revenue base. In physician-owned organizations that compensate partners on pure productivity--revenue minus actual and allocated expenses--the physicians' compensation is naturally based on the manner of third-party reimbursement.

FPM: Primary care physicians (PCP) have been in high demand for several years, with shortages expected to only get worse. At Summit, what have been some of your successful strategies for recruiting family physicians, internists, and other PCPs?

Campbell: As one of the largest independent primary care groups in the country, Summit is very in tune with what primary care physicians want and need, and those wants and needs are different for different generations of physicians. Work-life balance is most important to early- and late-career physicians. Having a hospitalist group and several after-hours urgent care centers allows our office-based physicians to minimize the burden of call and work regular weekday hours. In addition, our ability to offer job share and part-time options helps us retain late-career physicians for as long as they choose to work and allows those early career physicians who want to focus on family to do so.

FPM: For physicians who fall between those groups, what are some successful recruitment strategies?

Campbell: Mid-career physicians who may value income can work in a productivity-based model that enables them to earn more for working harder. In addition, we have had a number of physicians who have worked in our hospitalist program for a number of years and then transitioned to office-based practice as their family needs changed. The bottom line is the flexibility to meet the needs of all types of physicians at all career stages, and we work very hard to do that.

Editor's note: This interview has been edited and condensed.