Retention Isn’t Optional — Rethinking Physician Recruitment and Long-Term Success with AAPPR CEO Carey Goryl
Download MP3Well, hi, everyone. I'm Daniel Williams, senior editor at MGMA and host of the MGMA Podcast Network. I am so excited to talk with our guest today. That's Carey Goryl, CEO of the Association for Advancing Physician and Provider Recruitment. Good gracious, physician recruitment, retention, staffing.
Daniel Williams:It's what I hear all the time when I talk to our MGMA members. I'm so excited that we have Carrie on here. Carrie, welcome to the show.
Carey Goryl:Well, thanks for having me on. I know we've been talking. I've been looking forward to finally being on this show.
Daniel Williams:I know.
Carey Goryl:I love talking about physician recruitment and retention, so thanks. Thanks for having me.
Daniel Williams:You are very welcome. We were joking offline. How much time do we have? We were gonna talk all day, but now we have a hard stop, so we're gonna get right to it. For our listeners who may not know, tell us about AAPPR, what the organization does, anything else you might want to share about it.
Carey Goryl:Well, I think just sort of getting straight to it, our members, we're the professionals responsible for helping healthcare organizations recruit, namely physicians and advanced practice providers. We help them hire. We also work on onboarding, retention. I think a key distinction to make about members of AAPPR is that they're embedded. Right?
Carey Goryl:They're W two employees within the organization that they recruit for. So we're also the closest to the impact of turnover. Know, members often see when roles are the hardest to fill. They know how long it takes. They know what it means when we can't keep a provider in its role.
Carey Goryl:They're the ones that feel that day to day.
Daniel Williams:Okay. Where are y'all located? Where's your headquarters, and anything else you might want to share about the organization?
Carey Goryl:We're a national organization. We don't have a headquarters office. We have some staff that are distributed across the country. I can tell you our mailbox is in Michigan, but we definitely have a national and even broader mindset when it comes to our members. And and we're all located all across The United States.
Carey Goryl:Right? So over 2,700 individual in house recruiters.
Daniel Williams:Mhmm.
Carey Goryl:It's sort of hard to count how many organizations that represent. Everyone has condensed thousands. We recruit for thousands of facilities across the country.
Daniel Williams:That's fantastic. And then where are you what do you call home?
Carey Goryl:Annapolis, Maryland.
Daniel Williams:Oh my gosh.
Carey Goryl:I'm at the East Coast, Yeah. Right by the Naval Academy.
Daniel Williams:Okay. Do you have connections to the Naval Academy?
Carey Goryl:No. But I make them. So my family, we're a sponsor. So we sponsor midshipmen. Sort of give them a home away from home.
Carey Goryl:That's about, like, fifteen minutes from my house.
Daniel Williams:Fantastic. Oh,
Carey Goryl:I've so moved to Maryland twice. Okay. I'm originally a Detroit hometown girl, was where I grew up and went to college, but have lived here the other half of my life.
Daniel Williams:That's wonderful. All right. Let's go over some of the things. Your organization reached out to me. Y'all have some really good information, some survey data, some research that you've come across.
Daniel Williams:Talk to us about that. What is the recent research? What was the impetus for it, and what are you looking for in this particular analysis? Then we'll dig deeper into it after that.
Carey Goryl:Sure. So recently, AAPPR did some research on what strategies were health organizations employing when it came to retention.
Daniel Williams:Okay.
Carey Goryl:We do this sort of pulse check every couple of years. We did a couple of years ago, and not many organizations, very few had a retention strategy, and even not enough had meaningful activity when it came to effort being done in retention. So we wanted to take another pulse of what organizations were doing, and that's what we did. We partnered with CHG Healthcare to to develop our tool, put it out to health care organizations, and that's why I'm here today to talk about the new findings because we did see some improvement. And there it retention is a priority for more organizations.
Carey Goryl:And what we discovered is that there's this continuum of maturity when it comes to an organization's retention strategy. So I'm happy to talk about that.
Daniel Williams:I'm gonna have to pause and ask you that to define a continuum of what was that?
Carey Goryl:Yes. Like like a maturity continuum. Okay. Right? What
Daniel Williams:is that?
Carey Goryl:Well, I think I think there's a lot of great effort being done by individuals Okay. Departments, small and large organizations.
Daniel Williams:Okay.
Carey Goryl:Only about four in 10, about 40% of the health organizations we surveyed said they actually had a formal retention strategy. And there were even some, I think, asterisks on that, even that number alone.
Daniel Williams:Yeah.
Carey Goryl:There was probably another 40% that said, well, we have retention activities depending on the department, depending on the individual, depending on, I don't know, time and money and space. We're we're doing things that we think will help retain our providers. Okay.
Daniel Williams:And then
Carey Goryl:there was the small, like, you know, 15 to 20% that, no. We don't have a strategy. Maybe we do some things. It's a little bit too immature. Mhmm.
Carey Goryl:But we wanna get there. Right? So so regardless of where an organization sort of fell on this continuum, there was there's the next step no matter where you are today.
Daniel Williams:I gotcha. Thanks for clarifying that. I was just about to bring up that four in 10 number that you mentioned. I've seen this across organizations. I've seen it across industries.
Daniel Williams:It's not relegated to just healthcare. To put it in a certain term, it's like we're so focused on the bright shiny thing that's out here that when you have these incredible people in the organization, there's not always that concerted it's not effort. It's not a matter of motivation as your research pointed out to me, but it's just there's a missing piece there. And what do you see as the missing piece that's really not connecting that dot where the effort is made to retain people?
Carey Goryl:There's a couple of dots Okay. Okay. In that process. And I think the most the most clearly sort of jaw dropping one was that very no organizations or very few organizations have defined who owns, who's accountable for retention. That's really the first missing piece.
Carey Goryl:I mean, you have all these different layers. It is cross functional. It does cross a multitude of you know, between executives, clinical leadership, HR, operations, recruitment, and yet no one has decided who's ultimately responsible, who's going to carry this plan through the finish line. That's the first piece, is clear accountability.
Daniel Williams:Okay. That puzzles me because I would think it would fall in the world of HR, but you're saying that's not necessarily the case here.
Carey Goryl:No. Fact, our respondents were telling us that HR was least involved, which we found very interesting. Now we were only talking about physician and provider recruitment. So this isn't a commentary on broader workforce within health care retention strategies. But for physician and provider recruitment, a lot of the activities tend to revolve I mean, the first and foremost one that every organization uses is compensation.
Carey Goryl:They're using compensation as a retention strategy, bonuses, these sorts of things. But it also comes down to are they offering mentorship programs is another retention activity. It's a little bit even in just how they look at scheduling and structure. Are they allowing for administrative type? The the things that physicians have said, all the things that say help reduce burnout, help give them workload work life balance, help them feel like they are a part of the organization and not just a widget within the organization.
Carey Goryl:All those things are your retention strategies. And so they just they all seem to live in disparate silos at the moment. And certainly, you know, key thing is we don't have any data. Right? We're not we're not actually looking at days to fill.
Carey Goryl:Not enough organizations are looking at days to fill from a recruitment standpoint. That's one metric. Cost to hire, that's a second metric. What is your retention rate first year, five year? What what is your retention rate?
Carey Goryl:And even starting with some of those basic metrics and then looking at the activities and are we actually improving retention? Are we needing to is all of our retention activity perhaps decreasing our days to fill because we've become a more attractive employer? Those things need to sort of be tied together in order for for this to work better in organizations.
Daniel Williams:Okay. In the statistics here, in the research, it said almost three quarters of the organizations who did not have a strategy currently on retention said they would like to have one. So what's keeping them from having one?
Carey Goryl:Like I said, you know, it's it's sort of the structure and lack of clear ownership. Right? Like so, again, again, start start there. But start like like like something listeners could do this week is just document what you think the organization is already doing. Sort of take an audit.
Carey Goryl:Document your activities. Look at maybe who is the official or even unofficial person in charge of those activities. Right? That is something you could do just to sort get your baseline of where you are at today if you don't have a strategy. Have communications.
Carey Goryl:Right? Bring in HR recruitment if you have a separate recruitment function or operations if that's one and of the same. Bring in your a clinical leader, and bring in executive leadership. And present. Like and so who is going to is there gonna be a team responsible, or is there gonna be a person responsible?
Carey Goryl:Start with some basic metrics. Right? If you've got that cross functional team, what are the metrics? How are do we have something in place already? Can we get something in place?
Carey Goryl:And then you're going to evaluate. Right? So like a year from now, then you're evaluating. Did we were we able to bring this together, create some target outcomes, measure it? Did we hit it?
Carey Goryl:What do we need to do moving forward?
Daniel Williams:Okay. I don't know if it's in this particular data, but perhaps it is. When a physician is not retained, if they're not able to keep them, is there a time frame when that usually happens? Is it within that first year, those first three years, five years? Is there a window, or is there any data on that?
Carey Goryl:You know, we we end up, it's more anecdotal.
Daniel Williams:Okay.
Carey Goryl:I think there if we're gonna find any data, it's more like in first year residents, first time residents Okay. That we sort of tend to track more broadly how how long do they stay. I I don't know the the source of the statistic, but anecdotally, it seems to be that residents say residents out of residency three years, and then and then there's turnover that that's pretty common. I've also heard from people who do onboarding. And when they when they evaluate even their own onboarding program and how well things were, I mean, you can decide within the first week.
Carey Goryl:I mean, the first week of onboarding can really make or break how a provider feels. And honestly, it probably is pretty telling how organized are they, how transparent, How how what sort of supportive structures do they have in place? Am I getting information? Is anyone listening to me? I mean, all those things happen in the first week.
Carey Goryl:Honestly, they're happening in the recruitment process. Are people getting back to me? How's communication? Is it responsive enough in a way that seems reasonable? You're getting evaluated all throughout the way.
Carey Goryl:So, maybe compensation is what seals the deal, but it really is that onboarding, that first three to six months, what that experience is like that determines likely whether a physician is going to be sticking around for a while.
Daniel Williams:Is there one step? Is there one thing our listeners can do in that window, that first week, that first three to six months, so they are just hitting it out of the park. Maybe the physician leaves for different reasons, but not because they didn't follow this little ingredient within the recipe of success.
Carey Goryl:I'm gonna go back to have clear ownership of who's running your onboarding program. And, hey, we're not I mean, AAP pair, we do a lot of research around onboarding programs, and you can come back to our website. We've got reports, activities. We have recommended best practices. Shoot.
Carey Goryl:I can have a two day course on how to set up a physician onboarding program that is great. But plan now for the physicians and the providers that you're going to hire. That is just it's not about orientation. I mean, are those elements involved of where to park and how to get your name badge and how to log in and where to go. Treat people like you would anybody else.
Carey Goryl:Don't don't hyper automate. Don't keep it so transactionable transactional because there's so much to process and things going on. To the extent that you can humanize and recognize that a person has just radically changed their life, and that first week is with you and your organization and your team, and recognize how important that those first days are, I think even if you don't have all the structure in place, you remember that.
Daniel Williams:Right.
Carey Goryl:I think that will be a good stunt.
Daniel Williams:I love that. I'm gonna let everybody know we are gonna have a direct link to that report in our episode show notes. We're also gonna create an article based on this conversation. We'll bring that information in there as well so people can click right on it. I can give it.
Daniel Williams:It's aappr.org/research, but a lot of people are driving as they're listening to this. Everybody listening, we will put that hyperlink in there. All you have to do is click on it once. So in the re remaining couple of minutes, I wanna switch gears because I want our audience to know you, Carrie. You told me something right before we went live.
Daniel Williams:You have a passion. You clearly are passionate about recruitment and retention of physicians, but you have an outside passion as well. Tell us about that. What is it?
Carey Goryl:Okay. So my outside passion is everything dancing. Ballroom dance, line dance, Latin dance, smooth dances. I pretty much can't get enough of it. Tonight tonight is ballroom dance.
Carey Goryl:After work, I've got a couple of hours of ballroom dance ahead of me. Mhmm.
Daniel Williams:Yeah. That is so cool. And you were telling me offline you do between six to ten hours of dancing a week. Is that correct? That is remarkable.
Carey Goryl:Trying to get the brain and the feet and the musicality and the grace and style that I'm going for, it takes a lot of practice. I decided a couple of years ago I mean, dance has always been an interest of me since I was younger. But I don't know. Right? When you become an adult and you do adult things like families and work, dance is hard to sort of fit in other than playing the music loud while you're cleaning or doing some chore around the house or at the occasional party.
Carey Goryl:I really wanted it to be a part of my life, and so I made it my sport. And once I could wrap my brain that dancing wasn't some frivolous thing that you do sort of once or twice a year, and it became my sport. It's how I exercise. It's how I learn and practice in my brain. Right?
Carey Goryl:It's constantly humbling. What looks maybe should be really easy and how to be really difficult. I love that. It keeps me balanced and brings me a lot of joy.
Daniel Williams:That is so cool. I love when people who are guests on here share their passions outside of work, because we know in healthcare, people work really hard, and it's so important to find some balance outside of it where we can let off some steam, have some exercise, anything else that just brings us joy. It's clear when you talk about dance that it brings you a lot of joy.
Carey Goryl:I'll just say this. It is perfect for introverts. Right? It is the best. There's so much community.
Carey Goryl:It's so friendly. Like, no matter where I travel across the country, I always find the local dance community. But it's also one of things I am introverted, and I like my downtime. It's one of those where you don't have to do a lot of talking.
Daniel Williams:That's so cool.
Carey Goryl:So you get to be around people and have fun, and you just get to dance. I love it. It's nothing like networking.
Daniel Williams:All right. Well, Carey Goryl, I am gonna let you get back to dancing. So CEO of AA PPR, thank you for joining us and sharing this new research with our audience today.
Carey Goryl:Thanks, Daniel. Thanks for having me.
Daniel Williams:Alright, everyone. This research is a appr.org backslash research. It will be in the episode show notes. It will be on our social post, and it will be in an article that we're gonna post on mgma.com. So until then, keep on dancing and keep on listening to the MGMA Insights Podcast.
