How to Train New-Hire Physicians on Practice Culture

Daniel Cassavar, MD, MBA, FACC, and Angela M. Brandt, EMBA

Physicians are increasingly gravitating to careers as employees rather than solo practitioners. When new providers and seasoned solo-practice physicians join large groups, cultural conflicts can arise—and can threaten retention. Since a revolving door for physicians creates career instability and imposes steep costs on employing groups, it pays to invest in cultural alignment from the outset to promote a stable, longstanding career for physicians within the organization.

Realizing that retention starts with putting down roots, ProMedica, a nonprofit health system in the Midwest, has invested heavily in physicians’ first year of employment—the organization now boasts a 98 percent retention rate. Multiple new programs are contributing to ProMedica’s success, and a profile of these cultural-alignment programs may help other organizations consider what could work in their environments.

Thorough Orientation

ProMedica has instituted a robust orientation process. Our previous half-day orientation has morphed into a three-day comprehensive overview of all aspects of our organization. Some of the topics covered include:

Day 1

  • ProMedica culture
  • Diversity
  • Provider leadership
  • Benefits and 401K

Day 2

  • Physician marketing
  • Documentation and coding
  • Error prevention

Day 3

  • Value-based care
  • Patient experience
  • Provider burnout
  • Connecting the dots and wrap-up

New hires have reacted positively to the orientation. As Kate Samberg, APRN, CN, one of our recent employees, said: “The first day of orientation was welcoming, and the level of responsibility and accountability to ProMedica's mission were clearly explained. A nice refresher on patient experience was enacted and beneficial. To be successful in any organization, it is important to feel a part of something bigger than you, a way of life, a goal to keep the experience better than the last time.”

Focus on the System and the Personal

All providers who join our physician group are enrolled in the provider academy during their first year of employment. New providers are required to attend a meeting once per quarter. Our seasoned providers are invited to participate. These meetings focus on topics that are imperative for new providers. We alternate topics between “system” information and “personal provider” information. For example:

  • Proper coding
  • Personal finance
  • Leadership development
  • Provider resilience

“The Academy helps providers voice queries and concerns in day-to-day patient care, stay up to date with new rules and regulations, and understand upcoming changes in the organization,” noted Abhijit Saste, MD, one of our new physicians who attended the year-long meetings.

Peers Facilitate Transformation

In addition to sharing our culture with new providers, we have also developed a Transformers Group to facilitate cultural transformation across our system. The Transformers Group comprises numerous physicians, advance practice providers, and administrative leaders. This energetic group works with our providers on patient access, network optimization, and leadership and engagement.

Recipe for Success

This combination of extensive orientation and timely first-year topics has allowed us to define new-hire physicians’ cultural expectations, and to demonstrate ongoing concern for the health and welfare of our providers.

Cultural alignment powers retention, which enables standardization and improved patient safety and outcomes.

Daniel Cassavar, MD, MBA, FACC, is the president and chief medical officer of ProMedica Physicians. He spoke on this subject at The Doctors Company’s 2018 Executive Advisory Board meeting.

Angela M. Brandt, EMBA, is chief operations officer of ProMedica Physicians Group.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.