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Retention Ideas


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Hi y'all,

I was hoping some of the PAs in leadership here could give me some ideas of retention packages your clinics/hospitals have. I am leading a group of PAs in a dept new to having PAs. Its a great QOL position and the PAs are happy and have supportive teams who utilize them to the top of their licenses, all have been here for 2-3 years. I am hoping to start to work with our executive director and medical director on retention plans for when the PAs start to reach 5, 7, 10 years. There is already a monetary productivity bonus in place. Of course we would all like increased bonuses (tiered) but I'd like to come to the table with alternatives. Looking for other ideas to keep our amazing group here for the long haul. 

Thanks in advance!

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From an HR perspective, you need to focus on retaining people in that crucial 1-5 year time frame. People who have been with the company greater than five years are likely already committed and don't need anything specific to keep them happy. You also only want to retain higher performers so your retention program should focus on that.

Some successful hospital systems have a "senior" PA that gets a higher pay grade and new title after 3-5 years of experience. They also have other criteria involved, for example some may require 3/5 of the following; precepting students, orienting new hires, CAQ, serving on hospital committee, participating in mentorship program, etc.

Other hospital systems also have defined leadership roles for PAs and some have academic/research positions available as well. All of those are alternative ways to retain your high performers who are always seeking out new challenges.

 

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1- work place environment - happy respected workers stay on board

2-appreciateion - simple 'thank you' goes a long way

3-pay for productivity - allows those that produce more to make more - not everyone should pay the same, those that make more produce more (this is just a fact of the industry we are in)

specific ideas

4-create a tiered structure ie PA I, PA II, PA III;  I= with license, II=  > 5 years, III = > 12 years in which there is responsibility and pay increases - these can be things to help the office,  PA III would be doing reviews on the PA 1 and 2 and office staff, also have some directional supervision in the office, PA I focus on learning - maybe articulation with local providers and doing CME for the staff - 

5-I think some type of bonus structure for individual productivity and practice productivity is essential - encourages teammates to work together not just poaching productivity.

6-doc's and admin have to be on board as well - they need to respect the PA's as professionals and at the same time realize that medicine is a team sport, and that gentle guidance is key in these cases.  The newer PA's should have more guidance, the more experienced less.  

7-I think overall information is key - having a more "open books" to the providers is welcomed - numbers and productivity can be the biggest motivator...

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Mostly agree with Ventana above. I am not a big fan of productivity based income. I think it encourages sloppy work and charting. I have worked at places that shamed staff into working harder by posting productivity #s. Not a fan. I do like his idea of a group productivity bonus and step scale for employees. Maybe also sabbatical after X years. When I worked at Kaiser we got a guaranteed raise every year, more PTO, etc and you could look at the scale and know at 5 years I will be here and have X weeks of vacation. That was kind of nice. 

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I agree with EMDPA and I did not want to imply a straight productivity structure

instead something that might give you a few extra grand at the end of the quarter that is just a nice little bonus for producing.  If you do not have a thumb on the pulse of productivity you tend to be become disconnected with the fact there is not a magic money making machine in the back room that can just keep printing more.....  High producers should make a little more then low producers (but not a lot) and then everyone should be doing chart review as well so obvious crap billing - like docementing and billing for a complete H&P on a simple ankle sprain does not occur.  (see story below) employees need to know and understand that productivity IS A PART of medicine, but not the major part.  But you have to be able to pay the bills to stay in business.

 

Also, I think making $$ the center point of retention is a horrible idea, just breeds greed.   

 

Funny story on productivity that proves it can be horrible.

Was the second most senior PA in a small ER - 2-3 providers at a time, I was always at the bottom of the productivity pile, consistently outproduced by newer PA's with far less experience and ability.  One day I watched one of the high producers stand in the door of the exam room, say "hi" have a 2 min conversation on why they were there and walk away.  Never touched the patient, never reviewed the chart.    I followed along and was amazed and mad when she documented a complete H&P including all major systems, stopping short of doing a gyn exam.  SHE NEVER STEPPED IN THE ROOM, NEVER TOUCHED THE PATIENT.

Admin thought this PA was great, and I was being compared to her.  No way I could ever win that one, gave my notice (8 weeks per contract)  they tried to replace me ASAP (in violation of the contract) and when I pointed this out to them - offering them to replace me immediately if they simply paid me my wages for 8 more weeks) they quickly put me back on the schedule.  Later learned the PA they replaced me with just lost a HUGE suit for discharging a floppy baby that died.  With in a few years the ER medical director was on suspension, the contract was cancelled, and most staff were gone.  

Point is there is toxic work places and making $$$ a major issue is the quickest way to destroy one.  Make it about quality of care with an awareness of productivity and practicing good medicine as a team. 

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8 hours ago, ventana said:

 

Point is there is toxic work places and making $$$ a major issue is the quickest way to destroy one.  Make it about quality of care with an awareness of productivity and practicing good medicine as a team. 

I used to work at a place where one of the PAs would u/s everything and bill huge $$$ for u/s guided xyz, like an easy abscess or a barely subq splinter that was visible with the naked eye. 

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