In May, Perceptyx published research on the state of the healthcare employee experience in 2022. To provide these evidence-based insights into how engagement levels have changed for healthcare employees, Perceptyx studied more than 3.25 million healthcare employees across more than 480 systems. Engagement, or one’s emotional attachment to their organization and what they are willing to do because of that emotional attachment, is measured with four components: pride, motivation, commitment, and advocacy.
In this article, we dig deeper into this Perceptyx data to illustrate how physicians — a critically important occupational category in any healthcare system — have been impacted by these trends. According to Statista, as of September 2021, there were just over one million active physicians in the United States, with the highest concentration of active physicians located in the largest U.S. states by population: California, Texas, New York, and Florida. Physicians are highly trained, often needing somewhere between 8 and 21 years of post-secondary education depending on their chosen specialty and subspecialty (assuming four years for undergraduate education, four years for medical school, and additional years of specialized training).
Staffing Challenges and Low Net Promoter Scores
In 2019, Pew Research reported that the US had 20,000 fewer doctors than required to meet U.S. healthcare needs, with the gap projected to rise to 124,000 by 2034 (including a shortage of 48,000 primary care physicians). Within a decade, 2 out of 5 physicians will be 65+ years old — and, if still in the workforce, will find themselves caring for a rapidly-aging population. A recent survey by Bain & Company found that over a quarter of U.S. physicians, advanced practice providers, and nurses are considering switching employers, with nearly 60% responding that their teams are not adequately staffed and physicians’ net promoter score dropping from 36 points in 2020 to 19 points today. One recent study from locumstory.com found that 55 percent of the 1,000 physicians surveyed had considered quitting or leaving the medical field in the past few years, while an article published in Mayo Clinic Proceedings: Innovation, Quality & Outcomes reported that 1 in 5 of the 2,914 physicians surveyed had thought about leaving their current practice in the next two years (a third survey from Elsevier Health reported that 1 in 3 physicians globally were contemplating departure from their practice within a 2-3 year period).
Given the time needed to train physicians as well as the current and future staffing challenges faced by healthcare systems, it is useful to step back and reflect on how these individuals are conceptualizing the current state of their workplace experience.
Physician Experience at a Glance
First, let’s consider general trends related to physician experience:
- Survey response rate averages: Physicians tend to respond at lower rates than other healthcare roles, and these rates vary by specialty. Emergency/ICU roles tend to have the lowest response rates (around 20%), while Radiology/Imaging roles tend to have the highest (75%). The overall response rate for physicians usually falls between 45% and 55%.
- Engagement average: Physicians usually score higher in engagement than other healthcare roles, especially in areas such as “sense of accomplishment.” Conversely, the lagging item is usually “recommend my workplace as a great place to work.”
- Areas that tend to perform better: Physicians generally report better outcomes related to “sense of respect,” “safe work environment,” and “quality of patient care.”
- Areas of improvement: Physicians generally report lower-than-average outcomes related to “decision-making/reporting” and “feeling supported.”
Our research here draws on 26,811 responses from physicians out of the larger Perceptyx healthcare benchmark database.
What’s Better for Physicians than Other Healthcare Employees
Compared to healthcare workers overall, physicians report higher scores in the following areas:
- Respect: Relative to healthcare workers overall, physicians report greater favorability in response to statements such as “People are treated with respect” and “People at our company trust and respect each other”.
- Safe Environment: Physicians report greater favorability in response to statements such as “Our company provides a safe work environment” and “This organization makes every effort to deliver safe, error-free care.”
- Access to resources: Physicians report greater favorability in response to statements such as “I am paid fairly for my contribution to the company,” “I have access to the information and equipment necessary for me to do my work,” “Rewards for performance are meaningful,” and “I get the tools and resources I need to provide the best care and service for our clients/patients.”
What’s Better for Physicians Compared to Last Year
As compared to physician responses in the 2021 benchmark database, physician experience has seen increases in the following areas:
- Change management: Physicians are reporting higher favorability to items such as “Senior management effectively leads through change,” “Change is handled effectively,” “Senior management communicates the reasons for business decisions),” and “Improvements were made as a result of the last survey.”
- Learning culture: Physicians are reporting higher favorability to items such as “Staff are treated fairly when they make mistakes” and “Mistakes have led to positive changes.”
In terms of why these areas might be higher-scoring than other healthcare roles or improved from previous physician benchmarks, two possibilities warrant consideration:
- Increased communication, transparency, and visibility of efforts by hospital administration to manage change during the pandemic.
- Prioritization of well-being and prevention of burnout during the pandemic, along with the provision of more resources and support to meet these challenges.
What’s Worse for Physicians than Other Healthcare Employees
Compared to healthcare workers overall, physicians report worse scores in the following areas:
- Reporting: Relative to healthcare workers overall, physicians report lower favorability in response to statements such as “We are informed about errors that happen in the unit,” “Mistakes are being reported,” and “We are given feedback about changes put into place based on event reports.”
- Information exchanges in other settings: Relative to healthcare workers overall, physicians report lower favorability in response to the quality of information exchanged with imaging centers and outside laboratories, other hospitals, and other medical offices and outside physicians.
- Organization: Relative to healthcare workers overall, physicians report lower favorability in response to statements such as “Following up when we do not receive a report we are expecting from an outside provider,” “This office is more disorganized than it should be,” and “Shift changes among RNs are not problematic for patients in this hospital.”
What’s Worse for Physicians Compared to Last Year
As compared to physician responses in the 2021 benchmark database, physician experience has seen decreases in the following areas:
- Confidence in the future of the company has declined by 15 points.
- Communication: Physicians are reporting lower favorability to “My ideas and suggestions are valued by my manager.”
- Safety: Physicians are reporting lower favorability to “This organization makes every effort to deliver safe, error-free care to patients.”
- Resources and support: Physicians are reporting lower favorability to items such as “I get the tools and resources I need to provide the best care and service for our clients/patients” and “I have access to the information and equipment necessary for me to do my work.”
In terms of why these areas might be lower-scoring than other healthcare roles during 2022 or decreased from last year’s physician benchmarks, two possibilities warrant consideration:
- There is less overall safety reporting and more overall mistakes being made due to intense strain on healthcare workforce capacity over the previous two years.
- As reported in this AMA article about “medicine’s great resignation” and elsewhere, physicians are becoming increasingly disillusioned with their professions.
Actions to Take to Improve the Physician Experience
With this data in mind, healthcare systems can confront challenges related to physician burnout, attrition, and retention. Not all of these challenges are new, but they have been exacerbated by the pandemic. Several data-driven actions spring to mind, though this is by no means an exhaustive list:
- Improve communication and feedback loops across the continuum of care, especially as related to patient safety. This means ensuring that a trusting relationship exists among hospital administration, nurses, and healthcare workers in other roles and departments.
- Focus on ease of practice to reduce stress, improve work/life balance, and enhance well-being. Work to ensure efficient processing across all hospital systems, as physician experience is greatly impaired by inefficiency related to “throughput,” sometimes also called the “patient lifecycle” (i.e., the period that begins when a patient makes an appointment and ends with discharge).
- Create and support more avenues for the development of the physician workforce, such as conferences, continuing education courses, and speaking/writing opportunities.
- Continue to ensure physician involvement in administrative decisions, where applicable, and create and hold space for physician opinions to be heard. Physicians want to understand the “what” and “why” behind healthcare organization decisions, not just the “how.”
An Urgent Call to Action
Efforts to improve physician staffing, well-being, and safety must continue as healthcare organizations listen to the voices of physicians and shift focus to a bright future ahead. Now more than ever, healthcare organizations need to elevate the voices of physicians, collaboratively trailblazing a path forward that reinvigorates them about their calling and provides the supportive environment needed to succeed. By listening to and then acting on physician feedback, healthcare organizations can create a physician experience that will attract, engage, and retain the star talent needed to achieve business success.
Perceptyx helps healthcare organizations create listening programs that will facilitate the best practices in physician experience and engagement. From crowdsourcing insights to developing always-on listening models, we provide organizations with crucial resources for limiting physician turnover and attrition. To learn more, schedule a demo today.