In the transition to practice, a health care employer’s onboarding is crucial to new physician hires’ integration into the organization and can play a key role in their job satisfaction and productivity, as well as their patients’ care outcomes. Many health care organizations recognize this and work hard to make physicians feel valued from the day they sign their contract.
A new AMA STEPS Forward® toolkit details some of the best practices employers should follow to pave the way for physician success, satisfaction and well-being.
“Onboarding is extremely useful for residents and fellows to ease into practicing on their own,” said Sea Chen, MD, PhD. He is physician director of practice sustainability at the AMA and oversaw the development of the onboarding toolkit.
“If it's well structured and well thought out, it will give you time and space to get set up for success,” Dr. Chen said. “If you just get thrown into the fire without adequate onboarding, then you know you're starting off on the wrong foot.”
The AMA Transitioning to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance, and other essential tips about starting in practice.
Don’t be afraid to ask
While the toolkit is designed for health care employers, its content can help applicants determine whether prospective employers provide adequate onboarding.
“You want to get a sense of whether the institution emphasizes physician well-being as a component of hiring,” Dr. Chen said, adding that it is totally appropriate to ask about onboarding during the interview process.
“If you ask about it and the employer is dismissive, that should be a red flag,” he said. “On the other hand, if they say, ‘No, we don't have that, but that's a great idea, let's talk about it,’ then you’ll know they have your well-being top of mind and you can work within their resource limitations to get where you want to be.”
If you’re seeking your first physician job post-residency, get your cheat sheet now.
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Look for signs of commitment
According to the toolkit, these are some things that physician job applicants or new hires should expect in an optimal onboarding process.
They are ready for you on day one. The employer should have lots of practical things in place before you start onboarding. These include a computer and workstation materials, access to clinical and office spaces, and a schedule in the EHR.
They work through an orientation checklist with you. This provides a gradual education on your day-to-day work. It should include the scope of practice for clinical teammates, the steps taken in rooming patients and medication refill protocols.
They provide adequate clinical ramp-up time. This includes allowing time for learning the EHR, getting at-the-elbow support and building relationships with patients and the care team. The toolkit features a sample three-phase plan that rolls out over 24 weeks.
They provide robust EHR support. Since each new hire will have their own level of comfort with and technical aptitude for a new EHR, this should be personalized. It may run up to 60 days.
They offer peer connection, mentorship and access to key stakeholders. The employer should set up weekly meetings with the medical director to go over clinical best practices and how to place referrals for internal resources; weekly meetings with the practice manager, clinical coordinator or floor lead to build relationships; and ad-hoc meetings with the compliance or coding team, a compensation team member and a clinical quality coach.
“You should get a feeling from the organization that they have thought things through, regardless of their resourcing and limitations,” Dr. Chen said. “It really speaks to an organization’s culture if they say: We want our physicians to be happy and successful.”
For residents transitioning to practice or those already in practice who are considering a midcareer switch, a separate AMA STEPS Forward toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities,” will help you identify available practice settings and understand how they may impact your experience, clarify your priorities, and tailor your search for a fulfilling career in a positive and supportive environment.
Learn more about the AMA Young Physicians Section, which gives voice to and advocates on issues that affect physicians under 40 or within the first eight years of professional practice after their training as residents and fellows.
