Create New Value Propositions to Retain Your Advanced Practitioners

Consideration for the retention of advanced practitioners (physician assistant or nurse practitioner) has become a hot topic for most emergency medicine groups in the country.  As the reimbursement landscape changes and payments are generally thought to decrease, staffing and retention for advanced practitioners has become a difficult challenge.  Advanced practitioners are becoming a heavily relied upon part of an emergency medicine practice and the employment market is more competitive for these individuals.  Smaller democratic groups may not have access to capital to compete with large organizations on financial compensation for retention.  How then can small groups position themselves to be successful?

Motivation to stay at a practice has been a focus for Vituity for years.  Like many other industries, we found that compensation is not the primary reason people leave their jobs.  So then what is the “magic sauce”?  When Vituity looked at successful practices and their retention techniques a few concepts arose.  Below are some examples:

• Ownership: Democratic groups have the flexibility to incorporate advance practitioners into the practice that larger organizations may not have.  Many of these techniques do not involve an actual “ownership” stake in the group.   Vituity promotes a financial transparency model in which advance practitioners have the same access to site financials as the partners do.   This allows the whole team to understand the successes and challenges that the site faces.  Another is creating lead positions for advanced practitioners that meet with leadership and have input on-site practices and hiring decisions. 
• Family: Changing the narrative from employee to a member of the family is a challenging one. It requires a change in culture, a 360 approach to feedback, and commitment to building relationships.  This is a long-term strategy but is crucial for retention.  A quote of a physician assistant in our practice sums it up, “We operate like a big caring family…the fact that the organization cares so deeply about its team members is the ‘why’”.    “Everything else seems to grow from that, like benefits, operation, and work-life balance”.  Seeking regular feedback sessions to discuss an advanced practitioner’s concerns for work-life balance, financial health, benefits, and operational challenge at the site only helps build a sense of belonging and commitment.

People want to feel valued and that their work makes a difference.  If your practice has an employee-employer mentality you risk losing valuable members of your team.  Financial compensation is not always the answer.  Position yourself for success by creating a sense of ownership and commitment to a culture of family.  Seek feedback to ensure that their voice is heard and hold leaders accountable.  Because in the end, the “magic sauce” isn’t a pay raise, it’s an investment in people.

Sergio Hernandez, MD
Newsletter Editor, Democratic Group Practice Section