Leaders at Mid-Atlantic Permanente Medical Group could see the writing on the wall: There was a looming physician shortage.
While Mid-Atlantic Permanente Medical Group usually dealt with about a 4% turnover rate—low compared to the industry standard—their turnover rose to about 10% during the COVID-19 public health emergency. Doctors across the country were leaving medicine.
Richard McCarthy, MD, and his colleagues knew they needed a concerted focus on recruitment and retention.
Together, they solicited feedback, developed a robust internal referral process, encouraged a mindset for chiefs to always be in ‘recruiting mode’, created tools to ease physician logistical and administrative burdens, enhanced their on-boarding process and developed professional pathways to engage physicians from the beginning of their career through retirement.
The COVID-19 public health emergency “changed how many physicians viewed their practice and goals,” said Dr. McCarthy, executive medical director for Mid-Atlantic Permanente Medical Group. “It was an incredibly stressful time for all of us in medicine and a lot of physicians decided that clinical practice, or at least full-time clinical practice, was not where they wanted to devote their energies.”
Through their efforts, Mid-Atlantic Permanente Medical Group has brought in more than 250 new physicians since the start of 2023. The medical group 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.
“Physicians have to own their practices. They need to have the freedom to design and implement changes,” said Dr. McCarthy. “The front-line doctors are doing the most important work by seeing the patients. They see the problems and need the autonomy to pilot solutions and spread solutions that work.”
During an AMA Insight Network meeting, Dr. McCarthy highlighted how Mid-Atlantic Permanente Medical Group turned its staffing around by encouraging engagement through several efforts.
Among other benefits, members of the AMA Health System Program have access to the AMA Insight Network’s Quality, Safety and Equity community. This virtual forum provides an opportunity for like-minded leaders from across the country to hear more examples of how leading systems are finding innovative ways to address health care inequities in their communities.
Starting with requesting honest feedback
It all began with listening. Dr. McCarthy and his colleagues solicited detailed, honest feedback from physicians to get a sense of the “kind of ‘pebbles in their shoes’ in terms of their practice, and what steps could be taken to enhance recruiting efforts” he said.
From these conversations, they learned that there were major opportunities to make greater use of the networks of their own physicians.
“We asked our physicians and staff to share contact information for community doctors who would be interested in joining our practice. We celebrated those physicians and staff who provided referrals. In just one year, we increased the number of physicians recruited by internal referral by 25%,” said Dr. McCarthy.
The medical group also enlisted chiefs of service to maintain unofficial staffing pipelines with high-quality residency programs along the East Coast. “We also encourage our chiefs to build and maintain relationships with training programs and fellowships,” he added.
“Even if a department doesn’t have a current opening, we continue to develop a bench of physicians who are eager to join us,” said Dr. McCarthy. “That way, we are always ready when a position becomes available.”
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
Using data, technology and administrative staff to effectively to ease burdens
Mid-Atlantic Permanente Medical Group physicians have access to world class, cutting-edge technology. But fancy technical tools are no guarantee of patient or physician satisfaction. Physicians need tools that make their work easier, more streamlined, and less administrative.
“We have amazing staff at our regional office who help reduce the load that would normally fall to front-line physicians. For example, in the area of population health, our regional office staff are experts at effectively tracking and engaging patients who are due for cancer screenings—they keep patients from slipping through the cracks,” said Dr. McCarthy. “We focus on removing as much logistical and administrative burden from physicians as possible, with a simultaneous focus on enhancing patient care.”
This is all part of the medical group’s laser-like focus on what really matters for patients and physicians.
“We pay a lot of attention to patient satisfaction and physician satisfaction. We offer many of venues for physicians to give feedback, and for physicians to affect change within their practice,” said Dr. McCarthy.
Streamlining the onboarding process
Licensing and certification can be burdensome throughout all of health care. But in Mid-Atlantic Permanente Medical Group’s coverage area, it’s particularly laborious partly because the group covers Washington D.C., Maryland and Virginia. Practicing in the group requires a total of eight licenses, including the right paperwork from the U.S. Drug Enforcement Administration and licenses for the three jurisdictions in which the medical group operates.
“We hired a team that supports physician licensing and certification,” Dr. McCarthy said. “This made physician on-boarding much, much easier.”
The physician services team provides a concierge service to newly hired physicians, working directly to coordinate and facilitate obtaining the necessary licenses needed to practice at the Mid-Atlantic Permanente Medical Group. It is a weight lifted off of physicians’ shoulders during the time they are transitioning from practice or training to starting their career at the Mid-Atlantic Permanente Medical Group. This team is also responsible for license renewals.
Additionally, Mid-Atlantic Permanente Medical Group developed a mentorship program where new hires can build strong, supportive connections with their physician colleagues.
“Our mentorship program helps our newest physicians feel like a connected part of our community. Their mentors talk with them about all of the support available within our group,” said Dr. McCarthy. “The secret to successful practice ownership is making sure that your physicians are engaged and feel empowered to solve problems.
“Physicians usually do not have enough say in health care,” he added. “It's up to us to make the practice of being a physician rewarding and sustainable.”
Fostering career-spanning enrichment
Physicians and other health professionals also have access to various professional enrichment opportunities. For example, the Mid-Atlantic Permanente Research Institute supports research fellowships each year where physicians can perform clinical studies. For anyone who is interested in learning the business of health care, they can take advantage of Garfield Fellows program, where they can interact more closely with and learn from executive leadership.
Media training for physicians is also available for doctors who enjoy being in the news. Very importantly, physician and staff social outings and celebrations are frequent and well attended.
“We not only want to support our physicians, but we also want to celebrate them,” said Dr. McCarthy. “We want to care for them throughout their careers and afterward. We offer a generous defined benefit package, as well as post-retirement health care benefits and investment guidance. Our benefits are industry leading.”
After all this work, Dr. McCarthy is most proud their physician turnover rate is now at the group’s lowest in about 20 years. In the next 12 months, about 100 more physicians are slated to join Mid-Atlantic Permanente Medical Group.
