American Association for Physician Leadership

Retaining Healthcare Workers

Neil Baum, MD


Sept 5, 2024


Physician Leadership Journal


Volume 11, Issue 5, Pages 61-63


https://doi.org/10.55834/plj.3282640904


Abstract

How can employers do a better job hiring and keeping healthcare workers? It is no news that hiring healthcare workers is difficult. Labor shortages are widespread, millennials and Gen Xers are expecting higher starting wages, and after employers hire and train a new employee, the risk that they will leave for a better paying job is rising fast. The cost of turnover is high, but it has always been higher than many practices realize and it’s probably bad for your bottom line.




How can employers do a better job hiring and keeping young workers? To find out, we talked with workforce development professionals — people who help employers find workers and young adults find employers. We asked them what employers should do to promote good hires that last. These professionals see and appreciate both sides of the hiring process and were able to tell us what works and what fails in the hiring process for young workers. Our research focused on young workers filling the core production tasks in many types of jobs, including factories, healthcare, and administrative service firms. For all types of jobs our focus was on what employers can do to find and keep new entry-level employees.

To attract and keep their core production people, many practices are raising wages, some are switching to full-time benefited positions, and some are even offering signing bonuses. These are essential, but what we learned is that what is more important to get young workers to stick around are the social aspects of hiring, especially those having to do with developing mutual respect and trust. These especially are challenges for workers of color, who often expect to encounter discrimination.

This article discusses hiring and training practices that increase the speed at which new hires become productive team members and reduce the high dollar and emotional costs of turnover from failed hires.

1. Create career jobs.

We’re in an era of increased expectations for good jobs. A good job is not simply one that pays above the minimum wage. A job that promises a future and makes new hires feel valued are going to be successful in maintaining employees. Career jobs foster respectful relationships with the physicians and co-workers. Bad jobs communicate that the employer does not care whether employees stay or go.

2. Communicate opportunities for career progression.

New hires may have had multiple short-term, dead-end jobs before you hire them. If you want this new employee to be at the beginning of a long-term relationship, make that clear to the employee. If you do not make this clear, new employees may leave prematurely for a job they see themselves growing in.

3. Build positive relationships BEFORE hiring.

New employees need to be able to imagine themselves in your practice, doing their jobs, working with you and your staff. Mock interviews can communicate the practice’s value before the real interview. A tour of the practice and/or job shadowing one of the existing employees are effective in helping candidates see themselves in a role.

4. Ensure a positive first day reception.

Everyone gets nervous, but new hires are often particularly uncomfortable entering a new workplace. One of the biggest mistakes employers make is assuming that new workers are ready to work on the first day they join the practice and will figure things out. An extreme example is when new employees show up for work and everyone seems surprised to see them. From the employer’s point of view, this may indicate poor communication between the office manager and the physicians. From the new employee’s viewpoint, this is a sign that you do not care. First impressions are crucial to retention. Introductions to coworkers, supervisors, support staff, and the boss are vitally important.

5. Assign new hires a mentor.

Employees need to learn both job skills and the informal culture of the workplace. If you leave it to chance, some employees will figure things out, some may get lucky and be adopted by a more senior colleague, and others will struggle. One tendency is to think that the strugglers are lazy or dumb. More often, they simply have not been adequately mentored and need help figuring things out.

Mentors can provide information and integration into the social life of the workplace. Assigned mentors are particularly important for young workers of color who are often overlooked or ignored by older supervisors until they “prove” themselves.

Many firms have well-developed mentor systems for their managerial and professional workforces but leave onboarding of lower-level workers to chance. This is a mistake, especially because these people are often your core production workers.

6. Communicate and explain expectations clearly.

Every workplace has both formal and informal rules around expected behaviors. Many people discover these rules by keeping their head down and looking around. But some rules — like no use of cell phones on the job or the importance of calling in if you cannot get to work on time — may seem self-evident to supervisors but arbitrary or unreasonable to young workers. For example, cell phones are often young workers’ most expensive possession, a lifeline to their children or parents, and central to their identities and relationships for most young people.

Of course, checking one’s phone can be dangerous in some manufacturing settings, rude to customers in many service jobs, and irritating to supervisors in general. There is nothing wrong with a rule that makes sense, but it is the employer’s job to communicate not only the rules, but also why they make sense. Otherwise, you may sound like a coercive parent or teacher telling them to “just do it.” We all remember how ineffective that was when we were young.

7. Create a culture where young workers can ask questions.

Young workers are often hesitant to speak up and ask for help. They fear failure, and as a result, do not ask for help or explanations when they need it. Getting the hang of things happens sooner and more effectively when new employees believe asking questions is normal and that they will be treated with respect when they risk revealing ignorance.

In an atmosphere of disrespect and impatience, the tendency is to hide your need for help. Allow your young workers to ask questions and be clear that it is productive to do so.

8. Understand non-work lives.

Young workers typically live different lives from those of more established workers. This is particularly true when your emerging labor force are people of color or immigrants. Some have children. Many must commute on mass transportation. Some are in school or their children are. Successful supervisors understand that they must learn the reality of their young workers non-work lives. Children get sick, mass transit is often late and schedules sporadic, schools schedule exams or teacher work days, doctor appointment times are out of all of our control. Recognize that their lives may be far different from yours. Taking the time to understand can prevent mistaking complex lives for bad work habits.

9. Foster a climate of respect and dignity for everyone.

Sometimes supervisors and coworkers who are equal opportunity bullies are excused by managers despite being the source of toxic racist encounters and sexual harassment. Managers should never treat routine bad behavior as an excuse for racism and sexism. Tolerating disrespect in any form drags morale down, reduces productivity, and encourages turnover. Workplaces characterized by dignity and respect for all employees, regardless of race, citizenship, gender, or just plain newbie ignorance, are going to be much more successful in hiring and keeping young workers.

10. Create a racially equitable workplace.

Workers of color and immigrants have experienced discrimination in past jobs, schools, and public places, and are worried that they will experience it again in your workplace. A color-blind approach to race is an insult to immigrants and people of color’s lived experiences. Employers should pay attention to the basics, such as race and gender discrepancies in pay, shifts and hours, and job assignments. Additionally, building stable and respectful relationships among supervisors, coworkers, and new employees from all backgrounds is key to creating a racially equitable workplace.

Bottom Line

Think about a new hire’s first few weeks as a probationary period for both the employee and employer. Both are anxious to develop a long-term productive relationship. While employers are curious as to whether the employee will adapt to the rhythms and expectations of the workplace, new hires are gauging whether the workplace will be a respectful and encouraging place to build a career. Successful onboarding and reducing premature turnover require communicating that you value a long-term relationship and that your workplace is a welcoming and respectful one. If you have this attitude, the likelihood of retaining an employee increases significantly.

For over 45 years.

The American Association for Physician Leadership has helped physicians develop their leadership skills through education, career development, thought leadership and community building.

The American Association for Physician Leadership (AAPL) changed its name from the American College of Physician Executives (ACPE) in 2014. We may have changed our name, but we are the same organization that has been serving physician leaders since 1975.

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