The COVID-19 pandemic put an enormous strain on the health care industry. Even without that additional burden, concern about how an aging population and a rise in chronic diseases are affecting turnover rates in health care has been the topic of conversation in hospital and clinical board rooms for several years. By investigating why workers are leaving the field, an administrator with an advanced degree in health care administration can find ways to mitigate the ongoing effect of the pandemic while finding and retaining the best health care workers — and keeping them engaged and satisfied.
The Extent of Turnover in Health Care and Its Effects
In the context of employment, the term “turnover” often means the number of employees who walk away from a company or organization. It can, however, also refer to job or position changes within an organization or industry. In the past few years, the medical and health care field has experienced both.
Turnover Statistics
As the COVID-19 pandemic initially overwhelmed hospital staff and facilities, researchers predicted a mass exodus of health care workers in general. While the predictions proved somewhat accurate, there were some unexpected results among the different professional positions.
Physician Turnover
In early 2022, researchers at Advisory Board were convinced that what they called a “great resignation” of doctors would upend the health care industry. It didn’t take long for them to revisit their research data and realize that physicians were not leaving the field any faster than the 6%–7% exit rate that had been the pattern for years.
Doctors have made significant changes, however, which have affected the normal rates of turnover in health care. A survey conducted by CHG Health revealed that between 2020 and 2022, 8% of the reporting physicians had retired, and 3% had left clinical work altogether — but a remarkable 43% had made a career move within the field. Several factors contributed to these moves, including increased compensation, work flexibility and location. However, the main reason most physicians made a move was work-life balance, which 35.2% of respondents reported as the No. 1 reason.
Other Health Care Professional Turnover
The turnover rate for professional workers other than physicians was decidedly a matter of leaving the field entirely. The 2022 NSI National Health Care Retention & RN Staffing Report provides the percentages of those who left each position in 2021. The figures outpace the numbers of every past survey the NSI has conducted.
- Registered nurses: 27.1%
- Certified nurse assistants: 35.5%
- Nurse practitioners: 15.3%
- Physician assistants: 10.7%
- Physical therapists: 13.6%
- Respiratory therapists: 25.3%
Turnover Effects
When health care professionals leave their current position or leave the medical field entirely, the fallout can be both financially costly and disruptive to medical services.
Training newly hired staff members in any position is expensive. For example, NSI estimates the costs involved in the turnover of a single RN to be anywhere from $28,000 to $52,000.
Due to the higher turnover rate of nurses, hospitals have employed traveling nurses at a cost that far exceeds staff RN salaries. On average, hospitals would save $3,084,000 per year by eliminating the need for traveling nurses, according to NSI.
Reduced staff in any area of health care service results in longer wait times to see a provider and less time available at the time of service.
In addition, when workers leave, the work remains and often becomes the responsibility of already overburdened colleagues. This increased workload can result in longer shifts. Those realities have caused higher rates of health care turnover, perpetuating a cycle that impacts patients, workers, families and communities.
The Link Between Turnover in Health Care and Employee Satisfaction
There are good reasons to choose a career in health care: consistent industry growth, a multitude of job opportunities, a fast-paced work environment and the satisfaction of making a difference in the community, to name a few. People from all backgrounds enter the field knowing that it’s both challenging and rewarding.
The reasons health care workers are leaving at record levels, however, are also varied. According to surveys conducted by CHG Healthcare in April 2021 and the Medical Group Management Association in March 2021, the prevailing reasons given by workers for turnover in health care include:
- Fallout from the COVID-19 pandemic. Workers are feeling the results of added hours, caseload, stress and anxiety caused by the pandemic. They’re also anticipating that the negative effects will continue due to the predictions of a resurgence of the virus, including burnout and concern about their own health and that of their families.
- Disconnect with administration. 70% of the administrators questioned believed they had an effective physician retention program in place, according to a survey conducted by Jackson Physician Search. Physicians disagreed: Only 17% reported knowing of a retention program at all. In the same report, 69% of the responding physicians described themselves as “actively disengaged,” while administrators were more optimistic, stating only 35% of physicians were disengaged. In addition, administrators were almost twice as likely to report the existence of a formal worker-recognition program as the physicians who felt increasingly unappreciated.
- Imbalance between workloads and compensation. Although choosing a career in health care may be driven by a sense of satisfaction, workers are discouraged by the increased workloads created by both the pandemic and higher staff turnover, and many have not seen sufficient rewards in either increased salary or benefits. Health care workers also report they’re struggling to find a work-life balance.
Other factors influencing over half of the health care workers surveyed by CHG Healthcare to either remain in the medical field or go elsewhere are job stability, workplace culture, professional autonomy, patient care, respect from colleagues and patients, and workplace safety.
Administrative changes or initiatives can’t resolve some of the factors contributing to the concern about the current turnover in health care, like the number of people who need care or an aging population with chronic diseases. But strong leaders, well prepared in both education and experience, can generate higher employee satisfaction rates with carefully designed worker-centered programs and communication.
Improving Employee Satisfaction to Reduce Turnover
Two of the most important issues facing health care administrators are patient outcomes and worker satisfaction. For better outcomes, Care Excellence recommends several steps that administrators can take, like budgeting for adequate tools and technology, setting high standards of care, making patient/staff communication accessible, and providing continuity of care from diagnosis to cure to proactive follow-up for chronic medical conditions. All of these contribute to positive patient outcomes.
Effective health care administrators can make changes to policies and procedures that will improve employee satisfaction and, in turn, lower health care worker turnover rates. Grant Thornton and Becker’s Hospital Review suggest several ways to recruit new talent, retain high-quality health care workers and find solutions to increasing turnover in health care:
- Conduct stay interviews and surveys to determine what matters to employees and what does not, why they stay where they are, and what would compel them to leave.
- Address some financial issues based on employee demographics. For example, offer financial coaching or loan relief to first-time employees, or make additional contributions to investment funds for those nearing retirement.
- For workers balancing work and home life, be creative with hours and schedules, offering flexible plans when possible.
- Cross-train personnel to provide scheduling options.
- Increase levels and areas of mental health assistance programs for employees.
- Reopen conversations about services provided to the community. Consider where funds may be used more efficiently or with a more significant impact.
- Ensure that compensation packages are competitive and that working conditions are safe and fair.
- Encourage workers to function as teams, and empower all members to be heard and contribute to patient care, medical practices and policies.
- Recognize strong work ethics and valuable contributions.
- Bring back the vision that health care is a calling, not a job.
- Listen.
Finally, when an employee does decide to leave, make the process smooth and friendly. Referrals and return employees make up about 15% of regular staff, so treating out-going employees well can pay off in the long run.
Addressing Health Care Turnover Through Leadership
Instituting new programs or employee perks won’t be the answer to all of the problems that health care and other industries currently face. But strong and well-prepared leaders at the executive and administrative levels can resolve many of the issues leading to a rise in health care turnover.
Become a leader in the health care industry by exploring the executive MHA. The difference you can make may be felt far and wide in an industry looking for top executives, prepared to improve health care and attract top-notch medical professionals to facilities both large and small. Find out how USC can help you shape the next stage of your career.
Recommended Readings
Health Care Administration: Lasting Impacts from COVID-19
Leadership Styles in Health Care: Approaches for Developing as an Executive Leader
Sources:
Advisory Board, “Staff Turnover: 4 Key Takeaways From Advisory Board’s Survey of 224 Hospitals”
BambooHR, What Is Employee Turnover?
Becker’s Hospital Review, “What Will Make Workers Want to Stay in Healthcare? Answers From 22 Execs”
Care Excellence, “5 Ways to Improve Patient Outcomes”
CHG Healthcare, “Survey: Healthcare Career Satisfaction Drops, Burnout Rises Amid COVID-19”
Grant Thornton, “The Evolving Healthcare Workforce: Caring for Our Caregivers”
Healthcare Finance, “Hospitals Pay High Turnover Costs Due to RNs Leaving the Profession”
Insider Intelligence, “The Aging US Population Is Creating Many Problems — Especially Regarding Elderly Healthcare Issues”
Jackson Physician Search, “Oh the Verge of a Physician Turnover Epidemic”
MGMA, “Measuring the Toll COVID-19 Took on the Physician Workforce”
Nursing Solutions, “2022 NSI National Health Care Retention & RN Staffing Report”