Introduction

Despite the perceived prestige of medical careers, healthcare providers in the United States are facing a shortage of caregiver nurses and doctors. In fact, in 2018 the American Association of Medical Colleges (AAMC) projected that by 2030 there will be a shortage of “between 42,600 and 121,300 clinicians by the end of the next decade.”

Not only are fewer students enrolling in medical studies because of the specter of student debt, but as newly minted physicians and caregiver nurses graduate, they have far more career options than previous generations. Physicians, for example, are choosing specialty fields at the expense of general practice, and nurses are in high demand not only in clinical roles, but in recruiting, teaching, and healthcare IT companies.

With fewer nurses and doctors graduating and entering the job market, the pressure is on for healthcare systems to not only attract the best new talent, but to retain top clinicians as they progress through their careers. But what does it take to create a workplace that physician and caregiver nurses want to stay in throughout their career?

Is Technology the Answer?

Typically, healthcare systems respond to this question by touting state of the art technology and facilities. While a fully digital environment or a brand-new operating suite may have initial appeal, Jeff Hargett, Senior Practice Director, at The Ritz-Carlton Leadership Center, shared with Future Healthcare Today that the latest tech and tools aren’t necessarily a sure-fire solution to retaining leading clinicians. “Even when organizations have the most advanced tech in the world, that doesn’t mean it’s being utilized correctly, or that it actually reduces the burdens that weigh heavily on clinicians and undermine engagement and satisfaction,” he shared. Take, for example, electronic medical records (EMR) that were supposed to simplify workflows but are now cited as being one of the leading causes of clinician burnout.

“Organizations spend their efforts on implementing technology and operationalizing healthcare to the most minute levels to the extent that those who would pursue the field find it detracts from their ability to practice medicine and be a caregiver,” Hargett noted.

What many healthcare systems overlook is how changing the working culture can positively impact clinicians and become a strategic tool in the effort to retain them. Culture, as Hargett explained, covers multiple aspects of a clinician’s working environment from how technology is deployed and used to how empowered clinicians feel in their workplace, or the interactions of administrators, clinical staff, and support staff. “From hierarchical structures that alienate younger generations of clinicians to the intrusion of insurance companies into the determination of care, culture – large and small – has a real impact on the loss of many talented nurses and doctors,” he explained.

A Prescription for Physician and Caregiver Nurse Satisfaction

To solve the challenge of clinician retention, healthcare systems need to embark on a journey of cultural transformation where they flatten the traditional hierarchies and focus on the clinician’s experience as a caregiver. This internal cultural shift from hierarchy to flat organizational structure and focus on clinician engagement will bring multiple benefits says Hargett. “This is a tremendous internal culture shift in which the organization is linking these things together and realizing that high levels of clinician satisfaction leads not only to the retention of highly qualified and well-trained staff, but also to better patient outcomes,” he explained.

Knowing how to go about a transformation of this scale and significance is as important as the journey itself. Hargett recommends that healthcare systems develop cross-functional teams that identify what culture is like today, what works and doesn’t work, imagine what the ideal culture would look like and then develop a pathway to get there.

To create a culture that will make clinicians want to stay and will make them thrive as providers, healthcare organizations should focus on:

• Breaking down hierarchies and fostering collaboration. Include clinicians in decisions about their environment, such as the use of technologies like EMRs, and develop mechanisms for feedback, developing change, and implementing action.
• Creating realistic goals and communicating them clearly. Something that sounds great on paper but cannot be delivered on will not help attract or retain the best medical talent.
• Aligning strategic initiatives to support cultural transformation and demonstrating that appropriate resources and funding are available to effect the transformation.

Conclusion

“Many organizations fear that in being aspirational, they will fail to meet the goal of cultural transformation, and as a result, they never set out to begin the journey,” Hargett said. But still, he encouraged healthcare systems to reach far but also to put a stake in the ground to mark where the next step begins.

Even if an organization is just at the beginning of its journey being able to share more than a vision, but a step-by-step plan demonstrates a commitment to change. “Not only will this help with clinician retention, it will also differentiate the organization and help it attract the next generation of leading caregivers,” he concluded.