Gender, age factors in physician retention

Turnover among male physicians rises, while more female physicians are staying with their group practices.

By Myrle Croasdale — Posted April 2, 2007

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Women physicians appear to be less likely to leave their employment than men, according to an initial look at survey results from Cejka Search and the American Medical Group Assn. Along with gender, age may also play a role in who is more likely to stay put, as the physician work force undergoes a significant demographic shift.

Turnover among female physicians fell almost 1 percentage point to 6.6% in 2006 from 7.5% in 2005, while turnover among male physicians rose roughly 1 percentage point to 6.8% in 2006 from 5.9% in 2005. The average rate of physician turnover increased slightly to 6.7% in 2006 from 6.4% in 2005. Survey results were based on data on 17,000 physicians employed by 92 medical groups.

The AMGA represents large physician groups.

"One of the things we think is happening is that more women are going into medicine and are in their first practice years, and they remain where they are," said Mary Barber, vice president of marketing with Cejka Search, a St. Louis-based physician search firm.

In contrast, the male physician population is generally older, and retirement contributes to a higher turnover rate, Barber said. This generational difference does not entirely negate the gender difference in retention, she said. Women entering practice for the first time also may be having children or raising young families and may be less prone than men to change their work situations.

At the same time, both genders appear more interested in part-time work. The proportion of physicians who were reported working part-time increased to 20% in 2006 from 13% in 2005. Medical group leaders said flexible work hours or part-time options were among the top three retention incentives.

Donald W. Fisher, PhD, AMGA's president and chief executive officer, said these changes are evidence of a major demographic shift.

"The current physician work force is still dominated by male physicians age 42 and older, but this is changing," Dr. Fisher said. "Women comprise half of the new medical school graduates, for the first time in history. These trends will influence the way that medical groups recruit and retain physicians throughout their career cycles."

In 2006, female physicians accounted for 35% of physicians employed in the responding groups, compared with 28% in the previous survey. In 2006, 49% of U.S. medical graduates were women and 51% were men, according to the Assn. of American Medical Colleges.

Carol Westfall, president of Cejka Search, said retention efforts should begin at the start of the recruitment process.

"For example, practices can tailor each interview to better match the generation and gender of a specific candidate," Westfall said. "Today's physician work force responds well to a diversified interview team with a mix of experienced and newer physicians, including interviewees with similar professional and personal interests."

Interview techniques specifically designed to assess cultural fit can also help a practice make a hiring decision with long-term retention in mind, Westfall said.

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Why physicians leave

Cultural fit and family needs are the top driving forces behind physician turnover, according to a survey from Cejka Search and the American Medical Group Assn. released in March. Data were collected from 92 AMGA member organizations representing 17,000 physician employees. Respondents were asked for the most common reasons physicians gave for choosing to leave, and they could pick more than one response.

Poor cultural fit with practice 51%
Relocation closer to family 42%
Higher compensation 32%
Spouse's job required a move 22%
Relocation to find better community fit 20%
Incompatible work schedule/excessive call 17%

Sources: Cejka Search, AMGA

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