Physician onboarding isn’t a formality for health systems. It needs to address new employees’ deep-seated concerns about how they will live their professional lives on a daily basis.
To wit: A report published by the Association for Advancing Physician and Provider Recruitment compiled data from two surveys—by Jackson Physician Search and LocumTenens.com—to identify onboarding activity and whether it contributed to the job satisfaction of physicians and other health professionals. Among physicians and other health professionals who had had a positive onboarding experience, 56% reported they were highly satisfied with their jobs, compared with just 19% of those who had had a negative onboarding experience.
Atlantic Health System, which employs some 1,600 physicians across New Jersey, has launched an onboarding program, the “Next Generation Work Group,” for its young-physician hires to help them transition to practice. The organization already had a formal onboarding that covered its history and some nuts and bolts of daily practice, but it needed something more informal and open-ended to address the social needs of physicians within three years of completing residency.
The onboarding’s quarterly meetings cover financial literacy, networking and other topics relevant to younger physicians.
“When you're a resident moving into your first job, having the support of established physicians and leadership is incredibly important,” said Jeanine Bulan, MD, associate chief medical officer for Atlantic Medical Group. “You want to know your questions will be answered. Sometimes, being able to talk to your peers is invaluable.”
Atlantic Health System is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Bulan and her colleague Peter F. Vitale, DO, a family physician with Atlantic Medical Group, helped create the Next Generation Work Group. In an interview with the AMA, they talked about what residents transitioning to practice ought to look for in an onboarding program. At the top of their list: Having a safe place to ask questions.
First, look for guidance
“There are two types of questions we encounter. One just has to do with the operationalization of things, or the business of health care. In other words: How do things run?” Dr. Bulan said.
Then there's the more elaborate part: How do I engage in day-to-day clinical practice?
“As a resident, you have the support of an attending, but in practice you become the final decision-maker in clinical care, and that can weigh heavily on people,” she said. “It takes time to transition to that. New residents come out and they need to know: Where do I ask clinical questions?”
Next, get the big stuff out of the way
“Every physician who's transitioning from residency to practice, regardless of their specialty, will wonder: What about billing?” Dr. Vitale said, noting that there needs to be good billing support.
But there are also contract issues that need attention. One of those is paid time off (PTO).
"You don't want to have to thumb through paperwork to find an answer to a simple question like how much PTO you get in a year or something like that,” Dr. Vitale said. “It's important to be able to ask that kind of question and have resources readily available.”
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Look internally too
Onboarding is a time for self-evaluation too, Dr. Vitale noted. So look for ways to shore up any weak clinical skills.
“Be confident in your training, but know what you don't know,” he said. “These are things that every medical graduate goes through and will struggle with to some extent between graduation from residency and transition to practice.”
Also ask about professional development resources, he said. “Identify your areas of weakness and where mentorship is a possibility.”
Search out ways to use your voice
One of Atlantic Health’s new physician hires noted during the onboarding that he really likes to hike. He thought he could add to the health system’s culture by organizing outings.
“I said: Why don't we go to the clinician engagement committee and see if you can organize hikes?” Dr. Bulan said. “We're coming up on our third hike within this year, and he gets about 30 people on a Saturday or Sunday morning with their families, their dogs, and he leads a hike on a structured trail.”
Another young physician said she would love to go into resident recruitment. She joined a recruitment committee and now speaks about her experience working for the medical group.
“What I like about this group” is its sensibility, Dr. Bulan said. The onboarding encourages hires to say, “I may not know how to get from point A to point B, but I know I like point B—that’s where I want to be,” and then ask, “How can you help me get me there?”
Comfort is key
“This is a safe space for people who are in the same position,” Dr. Vitale said of Atlantic Health’s onboarding program. “That allows for free-flowing conversation and for interests to flourish.”
The most important thing is that the process gives you a chance to explore what matters to you most professionally.
“I've been in medicine for a couple of decades, so I've seen ebbs and flows,” Dr. Bulan said. “We all learn from each other, and that's also a benefit to those of us who are more advanced in our careers. It's worthwhile on both ends.”
