If you are a physician transitioning to practice, a lot rides on your first days and months on the job: your productivity, your patients’ outcomes, even your long-term well-being. Still, there is a lack of uniformity in employers’ onboarding processes, and not only because some practices are short on resources. Many employers are simply unfamiliar with the best practices around building a robust onboarding process that engages all key stakeholders to ensure new physicians feel supported as they ramp up their clinical work.
A recent AMA webinar lays out a seven-step process to optimize onboarding in health care, backed up by real-world insights. Its content can help residents and fellows entering the physician job market determine whether prospective health care employers provide adequate onboarding. The webinar now available on demand and eligible for CME credit.
Commitment is key
It is well known that low job satisfaction may lead to physician burnout and intent to leave an organization, said Sea Chen, MD, PhD, physician director of practice sustainability at the AMA. Prioritizing high job satisfaction from the get-go is therefore “not only for the physician and clinician well-being side of things, but also to decrease turnover and the costs that are associated with turnover and further recruitment.”
Dr. Chen was joined in his presentation by Jenn Balchunas, LPN, director of clinical growth at an academic health system in North Carolina.
They talked in depth about these seven steps that typify optimized physician onboarding processes.
Leadership has bought into it. “If you're a physician owner, you're also the leadership of that practice, and so you may need to make the case to yourself to allow for that onboarding time and resources, because I know it takes away from the busy clinic day,” Dr. Chen said.
Stakeholders span the organization. “We had our first meeting, and I immediately realized, OK, we're missing people,” Balchunas said, noting that it took several tries to get everyone they needed. “For us, it was recruitment, credentialing, HR, talent acquisition, somebody from finance, legal, operations.”
The employer uses a preorientation checklist. Small gestures such as sending the hire an email ahead of time with an outline of the first week and creating a welcome sign should not be overlooked, Balchunas said. “Those are things that go a long way to helping people feel welcome.”
The hire gets an orientation checklist. This helps in defining expectations. “Providing time for that physician or clinician to learn about scope of practice for our certified medical assistants, our licensed teammates—it’s incredibly important, and it really sets them up as a care team for success,” Balchunas said.
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Appropriate clinical ramp-up time is provided. Tossing new doctors straight into full clinic days can be a “very quick road to burnout for most physicians,” Dr. Chen said.
There is robust EHR support. “Our goal is to build them this really solid foundation,” Balchunas said, noting that the physician’s in-basket should look different on day 90 from how it did on day five. “We've learned that if we come back and we continue to give information in small pieces, they can build off of that.”
The employer offers access to peers, mentors and key stakeholders. “That is another piece that I think makes people feel very connected,” Balchunas said.
Dr. Chen noted that it is not necessarily a red flag if a prospective health care employer’s onboarding process does not cover all of these steps. But knowing the optimal process, based on the AMA’s toolkit, can help prompt a productive discussion to address your concerns as a new physician employee.
If you’re seeking your first physician job post-residency, get your cheat sheet now.
An AMA STEPS Forward® toolkit, “Onboarding Optimization: Pave the Way for New Physician Success and Satisfaction,” goes into further detail on these seven steps. Residents transitioning to practice or those already in practice who are considering a midcareer switch should consult a separate AMA STEPS Forward toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities.”
Both modules are enduring material and each is designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. Learn more about AMA accreditation.
Explore 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.
