The Executive Suite: Intentional onboarding for physicians: A comprehensive approach for medical practices

One of the biggest takeaways from new research is that a formal onboarding process that lasts three months or more has the potential to increase job satisfaction and improve physician retention. The newly released Physician and Clinician Onboarding Research Report from the Association for Advancing Physician and Provider Recruitment (AAPPR), Jackson Physician Search, and LocumTenens.com provides a road map for physician practices that want to ensure that both permanent hires and locum tenens providers integrate seamlessly into your culture as well as your workplace.

It’s useful to distinguish between orientation, which is short-term and paperwork-based, and onboarding, which is a longer-term effort designed to create a relationship between new providers and your organization. When you think about onboarding, consider that it’s a strategic process that can impact a clinician's satisfaction, productivity, and, ultimately, patient care outcomes. From understanding the nuances of facility operations and technology to the seemingly simple task of where to park, clinicians say that onboarding can set the tone for the entire relationship.

Before Day 1: Set the stage for success

The preparation for a new clinician’s first day begins long before they step through the door. A structured process ensures everything is in place, from privileging and payor enrollment to the finer details that make a clinician feel welcome and ready to start. According to the Physician and Clinician Onboarding Research Report, 85% of surveyed clinicians noted that detailed instructions and timely credentialing were pivotal in ensuring a smooth transition. This early groundwork is not just about ticking off a checklist; it’s about setting a positive tone for the clinician’s experience.

Key steps to take before the clinician’s first day include:

1. Communicating with existing staff: Informing your current team about the new clinician’s start date ensures everyone is prepared to welcome and support them.

2. Ordering essentials: Where appropriate, have business cards, white coats, prescription pads, laptops, and other necessary tools ready for the clinician’s arrival. These details convey that the practice is organized and values the clinician’s time.

3. Workspace preparation: A well-prepared workspace makes a positive first impression. Ensure the clinician’s office or workstation is fully equipped and ready for use.

4. Addressing logistics: Clear instructions on parking, dress code, and other logistical details help reduce first-day stress.

5. Travel arrangements for locum tenens providers: For locum tenens providers, arranging travel and accommodations ahead of time demonstrates consideration and professionalism.

6. Community orientation for permanent providers: While it is likely part of your recruitment, permanent hires very much want a strong orientation to the community – they rated this as a “must have” in the recent survey.

On Day 1: Making a strong first impression

The first day is often overwhelming for clinicians as they are introduced to a myriad of new information. Therefore, meeting their high expectations for organization and clarity is essential. Our recent survey with AAPPR indicated that over 75% of clinicians expect a thorough orientation that covers job expectations, facility systems, and protocols. A well-structured first day can set the tone for the clinician’s entire tenure with your practice.

To achieve this, consider including the following in your first-day orientation:

1. Introduction to key personnel: Provide the clinician with the contact information of key staff members who will be their primary points of contact.

2. EHR/IT training: Comprehensive training on the electronic health records system and other technology they will use is crucial – 63% of those surveyed said that technology adoption was the biggest challenge in starting a new position.

3. Review of facility workflows and policies: Ensure the clinician understands the practice’s workflows, policies, and protocols. This will help them integrate quickly into the practice’s operations.

4. Assigning a clinical buddy: Pair the new clinician with a more experienced colleague who can offer ongoing support and answer questions as they arise.

5. Allowing breaks: Orientations can be overwhelming, so schedule regular breaks to help the clinician absorb the information being presented.

6. Hands-on training and retention checks: Incorporate practical, hands-on training sessions, followed by retention checks to ensure the clinician is comfortable with the new systems and processes.

Beyond Day 1: Long-term integration

While the first day is important, ongoing support is crucial for ensuring a clinician’s long-term success and satisfaction within your practice, regardless of whether they are a permanent hire or a locum tenens provider who will only be with you for weeks or months. During the first week, clinicians particularly value introductions to team members and gaining a clear understanding of their roles within the practice. For younger clinicians, ongoing support and social integration are especially important.

Here’s how you can support clinicians beyond their first day:

1. Team introductions: Facilitate introductions to all onsite clinicians and staff. Building these relationships early on can help the new clinician feel more at ease in their new environment.

2. Social events: Organize informal social events to encourage team bonding. These events can help the clinician feel like a valued member of the team.

3. End-of-week check-in: Schedule a check-in at the end of the first week to address any concerns or questions the clinician may have. This shows that the practice is invested in their well-being.

4. Gradual increase in patient volume: Allow the clinician to gradually take on a full patient load, giving them time to adjust to the practice’s operations.

5. Dedicated time for learning: Especially for your permanent team, ensure the clinician has dedicated time to familiarize themselves with the facilities, processes, and any additional training they may need.

6. Discussing future growth opportunities: Engage in conversations about the clinician’s future within the practice, including opportunities for professional growth and involvement in practice development.

Generational and gender differences in preferences:

Adapting to specific protocols and procedures consistently ranks as the most challenging aspect of starting a new position, with older clinicians particularly finding this adjustment difficult. Younger physicians showed a preference for ongoing support, such as social interactions and dedicated time for learning more about the facilities and processes.

While male physicians were generally more satisfied with their onboarding experience, female physicians and younger providers emphasized the importance of having opportunities to ask questions and receive clear pre-start information prior to their first day.

The long-term benefits of a formal onboarding process

Implementing a formal onboarding process is not just about getting a new clinician up to speed; it’s about setting them up for long-term success within your practice. A well-organized onboarding program allows clinicians to focus on what they do best—caring for patients—while reducing the stress and uncertainty often accompanying a new job. By investing in a thorough and intentional onboarding process, you not only improve clinician satisfaction for permanent hires but also enhance the overall efficiency and reputation of your practice and improve the likelihood that a locum tenens provider will be open to returning if and when you need them.