Why Are They Leaving, and What Can We Do to Extend Their Tenure?

It’s called “quick quitting” and it is trending among younger workers. According to Forbes Advisor, the average turnover in the United States is 3.8%, and the average tenure of an employee is 4.1 years. When we look specifically at early-career employees, that tenure goes down to 2.8 years. My company recently partnered with the Medical Group Management Association (MGMA) on a survey of early-career physicians, and the research revealed that new doctors are spending a lot less time in their first jobs than previous generations. As employers and recruiters, we are wondering what we can do.

As the physician shortage continues to reverberate through the healthcare industry, the competition for hiring residents is increasing. Many healthcare organizations are upping the ante with big signing bonuses, repayment of medical school loans, and salary guarantees. It turns out that more money is attractive to new doctors, but in the long run, it might not be what they need to stay in the position. Retention rates are declining, and given the expense of recruiting, hiring, training, and onboarding young employees, it’s clear that leaders need to prioritize retention programs to keep new hires in their jobs longer.

Our research is the topic of a new Early-Career Physician Recruiting Playbook, which confirms that compensation is what drives first-job decisions. While it was not surprising to learn that compensation is why physicians accept a first job, it was surprising to learn that the reason they most often cite for leaving is the “practice ownership/governance model.”

According to Forbes Advisor, employees who leave within the first year do so because of a lack of career development opportunities, job characteristics they don’t like, and poor work-life balance. For new physicians, how an organization is run impacts how content they will be with their jobs, and so it’s especially important for them to learn: what will day-to-day life be like in their organization? Will they have autonomy, balanced with learning? Will they have a voice in decisions that affect their patients, or them personally?

Because we place hundreds of physicians each year, we have some insight into why this might be happening more frequently today. In some cases, it is generational — younger generations have different expectations. The pandemic has also shifted mindsets; many times we find that people are looking to expand the sense of purpose they find in work.

Aligning Expectations with Reality Starts Early

We have a saying in our business, “retention begins at recruitment.” Our best opportunity to make a long-term hire is to have that goal when we start the hiring process and structure everything from our job description to onsite visits accordingly. When early-career physicians say that they are leaving a job because the reality didn’t align with their expectations, we know that means there was not a cultural fit, that it’s likely there was a misalignment in terms of values, and/or that the young physician realized that their longer-term goals were not going to be met in the job, however great the compensation seemed initially.

We can guard against quick quitting by committing to transparency in recruiting. Lay out the typical career track during the interview, including how earnings might grow over time. Be upfront about the potential for leadership or ownership/partnership, and what that path looks like. And most importantly, look for a cultural fit — give candidates access to your work environment, their potential peers and mentors, and the overall community in which they will be working. Then ensure that their expectations align with the realities of the day-to-day of the job.

How to Retain Early-Career Professionals

• Create a Strong Onboarding Process: Ideally, you have an onboarding process that starts well in advance of day one on the job. Communicating key information over a scheduled timeline minimizes uncertainty in those first weeks on the job and gives confidence for the long term.

• Communication Is Key: The doctors we surveyed told us that they want the chance to have a dialogue with leaders. Clear communication between employees and their peers and supervisors is critical to giving new hires a sense that they are well-informed and that their voices will be heard.

• Be Upfront About Compensation and Career Track: Today’s recruits prioritize compensation — that’s nothing new — and they’re thinking long term, too. Ideally, you offer compensation that is market-competitive, and you demonstrate how your hires can grow their careers with you. Communicating both of these commitments before, during, and after your hire will reinforce to early-career recruits that you understand their expectations and are working to meet them.

• Prioritize Balance for Better Retention: Younger generations place increased value on work-life balance. If we hope to retain them, we have to commit to flexible schedules, paid time off, and when possible, hybrid work options. Administrative burdens and workloads must also be manageable. We’ve heard from newly trained physicians that they want to enjoy the work they are doing without high levels of stress and burnout, and they are not alone. As employers, we must commit to a staffing plan that provides support for all employees as a part of our retention planning.

As our lives are more mobile, times have changed, and employees are unlikely to commit to us for their entire careers. However, we can do our part to create an environment where early-career professionals want to stay long enough for us to recoup our investment in recruiting them. Along with formal onboarding, two-way communication, and a commitment to work-life balance, ongoing employee retention should evolve as the work changes and as employees grow in their careers.

By addressing the issues that matter most to younger generations, we can become employers of choice where professionals want to build their future.