It's not me, it's you.

Ahhh ... you thought it was going to be the old “it’s not you, it’s me” breakup saying, didn't you?  Well, when it comes to recruiting, it tends to be the other way around for many organizations hiring medical providers.  Turnover is an important topic that medical practices discuss, but often changes to curb attrition don’t happen until it’s too late. Of course, this issue isn't solely tied to medical providers, but is particularly important in this sphere - the main reason being that there are limited number of providers out there and they all have other options.  "What’s the turnover like at this practice?" is a question that I hear over and over again as a physician recruiter. And the candidates don’t want to hear about the excuses or extenuating circumstances; they just want the turnover numbers and make their own impressions from there. Which is understandable ... regardless of the reason, if a practice is turning over 50% of its providers every year, it's probably not somewhere that a physician can find a long-term fit and they know that.  When physician candidates hear of high turnover numbers, it immediately sends up a red flag. And the medical provider network is a small one; they'll ask questions of their peers and colleagues and if they hear of negative experiences (regardless of whether or not they're relevant to the candidate specifically), they will walk away.  

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Whenever a practice loses a provider, no matter the reason, I strongly recommend conducting an exit interview with the departing staff member. Whenever possible, you should have this interview conducted by the individual most likely to elicit an honest response ... all too often a provider will focus on leaving on "good terms" and won't be truthful about their reasons for resigning. If you have the option to have a member of human resources or a manager that didn't work so directly with the provider conduct the interview, you should strive for that pairing. And then make sure to USE the information collected in the interview!! Don't become defensive or offended by negative feedback; this provider is leaving and there's nothing you can do about it. But if you can have an unemotional response to the feedback and strain out any exaggerated information, you will be left with data that can help you prevent other providers from walking out the door.

To illustrate this, I'd like to share a story that is outside of the healthcare field, but nonetheless relevant. A friend of mine was an attorney at a large firm and left his position to take another.  He left because of inappropriate internal conduct and conversation, unfair decisions, and a horrible gossip problem that led to tumultuous "office politics". His supervisor asked the important questions during the exit interview and covered everything as expected.  "What could have changed to make you stay?", the supervisor asked.  My friend was honest and gave his candid feedback, knowing it would likely be difficult for his supervisor to hear - but he felt it was important for the firm to know. Instead of taking the feedback in the spirit in which it was given or saving it to reflect on and discuss later, his supervisor immediately said, "I don’t see that or agree with you, so it must just be a bad culture fit for you."  This supervisor essentially threw out every concern and piece of feedback and, in short, said "it’s you - not us". Because this supervisor, and others in the firm, refused to accept the problems with their culture, four more attorneys have followed in my friend's footsteps. And all five of them - and who knows how many others - have shared their stories with colleagues, clients, etc. ... and the firm continues to lose staff members and clients steadily, while finding increasing difficulty in securing quality candidates for even initial interviews.

With the provider recruitment market becoming more and more difficult every day, hiring managers can’t afford to just look the other way when a medical provider points out issues with the practice.  As practice leaders, you have to check your ego at the door and WANT to make changes - look into the proverbial mirror and ask, "What’s wrong here?".  Most people say they can handle constructive criticism, but then are in denial about what constructive criticism is; instead of taking negative feedback to heart, they make excuses such as "that doctor is just a Negative Nancy" or "they're just making a fuss because they don't want to follow the rules". As practice leaders, we need to stop thinking that way and look at it as a positive - your providers are telling you what you can do to make your environment better, increase retention, and grow your business. Sure, you sometimes have to take things with a grain of salt, but you make a huge mistake when you throw all the feedback out the window and refuse to believe that it might actually be you ... not them.  

Try to pull on the attitude you have towards your patients. When you get calls from patients complaining about your service, are you going to tell them "it’s not us, it’s you"?  I would hardly think so ... instead, I imagine that you are going to try to see how you can make things better.  So do the same within your practice!  A happy staff makes for a better patient experience and leads to greater levels of success for your business.  

Now, let’s start saying "it’s not you, it’s me" and mean it!