Onboarding at your first physician job is often a lengthy process involving numerous departments and many activities over several months. But no matter how complex it may be, one element that should never be neglected is EHR support.
An AMA STEPS Forward® toolkit details some of the best practices employers should follow to pave the way for physician success, satisfaction and well-being. Its content can help job applicants determine whether prospective employers provide adequate onboarding.
"Let's say the physician transitioning to practice is staying at the same institution where they trained. They're not going to need as much EHR support as somebody joining a new organization with a different EHR,” said Sea Chen, MD, PhD.
“Regardless, the new hire needs to know there will be somebody there every step of the way to support them, including at the elbow in the first couple of days,” said Dr. Chen, who is physician director of practice sustainability at the AMA and co-wrote the onboarding toolkit with Jenn Balchunas, LPN, MHL, CPC.
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.
A real-world example
“EHR support will be essential to ensure a new physician or [nonphysician provider] can use the technology successfully and efficiently,” the toolkit says. Onboarding that is tailored to the physician’s learning style, technical aptitude and level of EHR experience “creates enthusiasm around learning and provides comfort to the new physician.”
The toolkit features a sample timeline for EHR onboarding from an academic health system in North Carolina, where an onboarding team begins providing EHR support once the physician has completed EHR training.
One vital element of the team is the onboarding teammate, who meets with the new physician and develops a preference list with labs, vaccines and referrals for the clinic location.
“This process reduces the stress of simultaneously trying to learn a new EHR and a new organization, and can help build relationships with patients during those first few weeks,” it says.
If you’re seeking your first physician job post-residency, get your cheat sheet now.
Dive deeper:
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What to look for and when
The toolkit also features a suggested EHR onboarding schedule with beneficial discussion items for several key points in time:
- Presession. One recommendation is to determine the physician’s documentation style preferences, such as problem-based or more freehand assessment/plan charting.
- Days 1–2 of seeing patients. This starts with offering at-the-elbow support, customizing common visit diagnoses, note templates, preference lists and speed buttons as much as possible in the EHR.
- Day 5. Now is the time to add in quality measures and sign the new hire up for physician compliance training.
- Days 14–30. Top-level items include focusing on quality measures and providing training on handling messages from clinical teammates, other clinicians and patients.
- Days 45–60. At this point, onboarding teams should continue working on EHR customization and efficiency.
The authors note that it is important to remember that an employer’s onboarding plan may differ significantly from these recommendations and others outlined in the toolkit.
“Every organization is unique and may have specific strengths or limitations in its onboarding program, especially when resources are thin,” the toolkit says. “This is especially true of small, independent practices.”
The key is to make sure the organization’s onboarding program has been well thought out. In particular, it should embrace the principles of open communication, physician support and adequate clinical ramp-up.
“If there is a priority area in onboarding for you in which the organization is particularly weak, it may help to discuss your concerns during the interview and negotiation process,” the toolkit says.
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 optimizing onboarding in an Aug. 26 AMA STEPS Forward Innovation Academy webinar featuring Dr. Chen and Balchunas. Register now.
