ST. LOUIS – As the economy perks up, it appears that physician turnover rates rise with it.

For the first time since 2008, physician turnover has increased, reminding medical groups of the delicate balance between physician supply and demand. According to the 6th annual Physician Retention Survey from Cejka Search and the American Medical Group Association, in 2010 total turnover was 6.1 percent, compared to 5.9 percent in 2009, and appears to track with reports of modest improvement in the U.S. economy.

The survey was distributed to 383 medical organizations with AMGA medical group membership, of which 62 organizations (representing 17,624 physicians) responded.

Officials say the increase is consistent with anecdotal reports and findings in the 2008 survey that the worsening economy and plummeting home sales caused physicians to delay retirement and relocation – key drivers of recruitment and activity.

Growth in the Gross Domestic Product and the leveling out of previous steep declines in home sales may partially explain the uptick in turnover in 2010.

Looking ahead, the majority of respondents in the 2010 survey said they believe physician retirement will increase (27 percent) or continue at the current rate (65 percent). This could alert medical groups to prepare for greater turnover in 2011 as improvements in the marketplace make it more conducive for physicians to retire or relocate.

[See related story: New factors affect physician recruitment, retention]

"Although shortages still persist in today's physician workforce, we have seen exponential growth in the size of medical groups, many of which are taking the lead in developing new care models that will increase patient access and keep physician satisfaction and retention high," said Donald W. Fisher, the AMGA's president and chief executive officer. "Medical groups are actively addressing the needs of physicians throughout their careers, providing mentoring and leadership opportunities and flexible work options."

"Medical groups can prepare for increased turnover by identifying key demographics in which turnover rates are the highest and find ways to address the cause of turnover at its source," said Lori Schutte, president of Cejka Search. "In the past five years, we have seen turnover rates consistently trending higher for young, full-time female physicians and pre-retirement male physicians. Offering flexible work options can be effective in retaining a strong physician workforce and investing in the retention of physicians at all stages of their careers will pay long-term dividends for medical groups."

The composition of the respondent group reflects changes in the healthcare industry as groups consolidate, more physicians choose employed opportunities and women pursue careers in medicine. The average size of the groups responding to the survey has nearly doubled in the last six years, from an average of 146 physicians to 284 physicians. Female physicians comprised 34 percent of physicians represented in the 2010 survey, compared with 28 percent in 2005.

According to the survey:

• Incentives for staying on – 51 percent of respondents said they don't encourage physicians to delay their retirement, while 49 percent do in some circumstances. Of those who try to keep physicians in practice, they most frequently incent them with flexible hours (90.6 percent), no call (62.5 percent) and/or reduced call (65.6 percent).
• Part Time Practice Continues to Grow – Since 2005, the part-time workforce has grown by 62 percent. This trend tracks with the change in profile of today's medical workforce, in which the two fastest growing segments are female physicians entering the practice and male physicians approaching retirement. In the survey, 13 percent of male physicians practiced part-time and 36 percent of females practiced part-time, compared to 7 percent and 29 percent, respectively, in 2005.
• Mentoring Makes a Difference in Reducing Turnover – The majority of medical groups (73.8 percent) believe mentoring reduces turnover, but just more than half (56.1 percent) assign a mentor to newly hired physicians. For those who do assign a mentor, a formalized program makes a difference. The turnover rate was 1 percent lower (5.3 percent) for groups that have written goals and guidelines compared with those who do not assign a mentor (6.3 percent).
• Medical Groups Are Hiring Physicians – The consensus from the medical groups responding to the survey indicates that the hiring of physicians and advanced practice providers will accelerate through 2011. The majority of medical groups (83 percent) will hire more or significantly more primary care physicians, indicating that an already competitive physician market may become more so. Nearly as many said they will be hiring more or significantly more specialists (79 percent) and advanced practitioners (78 percent).