Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Reduce Clinician Turnover

Employers must cultivate a nurturing culture that supports the emotional and physical needs of their employees.


When patients lose the clinician with whom they have an established relationship, they may suffer a relapse in their physical and/or mental illness. To retain valued healthcare professionals, employers must create a work culture that supports their needs.

Provider turnover has been a challenge for organizations for many years. Estimates are that in any organization there’s a seven to 30 percent turnover, ambulatory care being on the lower end and hospital-based providers the upper. Burnout has most likely exacerbated the situation during the pandemic.


The increased access through online portals and other asynchronous means has been helpful to patients, especially as care was driven more remotely. But the increased access, much of which is not reimbursable, has increased time spent working for providers. This comes at a time when providers themselves have been experiencing their own personal challenges managing their families and worrying about their own and family’s safety.


When we add other factors that contribute to turnover, like the practice’s bureaucracy, perceived under-compensation, lack of consistent mentorship, changes in stage of life or family needs, or a desire for new geography, we can see that the outlook remains challenging. Further, providers toward the end of their career may choose early retirement, and younger providers have different expectations of work-life balance that often leads to even greater functional shortages.


There’s a cost of this turnover to all stakeholders. Providers changing jobs often have gaps in employment and income, significant logistic challenges revising professional information to insurers, societies, colleagues, and patients. Likely the greatest toll is emotional loss due to changes in precious relationships.


Organizations suffer challenges in recruitment and managing long-term shortages to access for patients. The estimated costs, including recruitment, onboarding and lost revenue, for every provider that changes jobs is more than $600,000.  Further, patients may leave the organization rather than wait for the practice to replace their provider.


Patients may suffer the greatest loss in provider turnover. The loss in continuity of the provider who knew them and their family the greatest is priceless. Logistic challenges in re-establishing care, shortages of providers, and exhausted and overworked practices could result in relapses or exacerbations in illness, including those that are physical, mental, and emotional.


What can be done to mitigate this crisis?

Organizations can:

1. Focus on cultivating a nurturing culture that supports the emotional and physical needs of their employees.

2. Develop more team-based care models.

3. Restructure payor contracts to reduce incentives to see more patients and increase incentives to take better care of patients.

4. Develop recruitment tactics that foster transparency and ability to meet mutual expectations.


Providers can:

1. Scrutinize their contracts to understand how the incentives align with their personal goals.

2. Choose organizations whose culture and expectations are congruent to their own.

3. Seek business diversity in their positions, choosing to expand expertise in finance, quality, or management.

4. Seek intrinsic joy through teaching and sharing knowledge through academic alliances.

5. Regularly practice their own wellness and/or artistic pursuits.




This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.