Program Director’s Corner – February 2022
Will “The Great Resignation” affect fellows coming out of training?
Dragana Lovre, MD, Associate Program Director, Endocrinology, Metabolism, and Diabetes Fellowship, Tulane University Health Sciences Center
The Great Resignation, also known as the Extraordinary Exodus, is an economic trend in which employees voluntarily resign from their jobs en masse, beginning in early 2021, for reasons associated with the COVID-19 pandemic.
Most of us are well aware and concerned that healthcare workers, facing increased job stress and burnout, are going to continue resigning as the pandemic prolongs. As the time of the year approaches when the PDs and any attending that knows a graduating endocrinology fellow is asking: “have you signed your contract yet?”, it is our duty as PDs/APDs to bring the topic and trends of “The Great Resignation” to the attention of our fellows and help them make a plan for the next career move.
Here is the bad news:
“The Great Resignation” phenomenon may affect the graduating fellows mainly due to 2 reason as described in an article in Harvard Business Review (Sept 2021) titled “Who Is Driving the Great Resignation?” by Ian Cook (1).
The two key trends in this recent COVID-19 driven phenomenon are:
1. Resignation rates are highest among mid-career employees.
2. Resignations are highest in the tech and health care industries.
The article mentions that employees between 30 and 45 years old have had the greatest increase in resignation rates, with an average increase of more than 20% between 2020 and 2021. Furthermore, 3.6% more health care employees quit their jobs this year than in the previous year. Ian cook also explained how we’re also seeing higher resignations among women in the last 3 years and the 2020 spike was likely due to the pandemic. Women left their job to take care of their families. The opposite pattern took place for men.
Furthermore, according to a new study led by the American Medical Association and Mayo Foundation for Medical Education and Research (2), the health care industry is likely to see more staff turnover as workers experience burnout and resign. In the study by Sinsky et al., researchers surveyed 20,665 health care workers at 124 health systems between July 1, 2020, and Dec. 31, 2020, to examine the relationship between Covid-19-related stress and work intentions. Among the respondents, 44.84% were physicians, 21.41% were nurses and advanced practice providers, 11.83% were workers in other clinical roles, and 3.57% were administrators. Approximately 1 in 3 physicians, APPs, and nurses surveyed intend to reduce work hours. One in 5 physicians and 2 in 5 nurses intend to leave their practice altogether.
A new survey conducted in June and July 2021 by Jackson Physician Search in partnership with Medical Group Management Association (MGMA) (3) suggests that physician satisfaction with their current employer — reported at an average of 5.5 on a scale of 0 to 10 — is less about the impacts of the pandemic and more about disconnects that can be solved, at least in part, by better communication. Sixty eight percent of administrators and 61% of physicians confirm that physicians are experiencing burnout. Of those, 62% of physicians reported burnout as being caused by their current employer (versus being caused by the experience of being a physician), while only 14% of administrators recognized their role in physician burnout.
Now the good news:
Ian Cook, vice president of people analytics at Visier, explains that employers will have to take a data-driven approach to improve retention programs and plans and even developed tailored retention programs. Reducing burnout and improving a sense of feeling valued may allow health care organizations to better maintain their workforces post pandemic. Liking your place of work and feeling valued may help. Sinsky et al., found that “Feeling valued by one’s organization was protective of reducing hours (OR, 0.65; 95% CI, 0.59 to 0.72) and intending to leave (OR, 0.40; 95% CI, 0.36 to 0.45; all P<.01).” Additionally, most of the graduating endocrinology fellows are likely in the age group of that matches that of the greatest increase in resignation group mentioned above and most of the graduating endocrinology fellows are women which again would replace the women who left their job to take care of their families during the pandemic. Lastly, even if the field of endocrinology may not have issues with the number of physicians resigning, there is likely going to be an issue of lacking support staff which will affect the day-to-day practice of the future junior endocrinologists. One can hope that there will be programs to retain nurses and medical assistants too, especially since they are a crucial part of the team and require time to onboard and train.
Considering the information above, how do we implement this knowledge and resignation trends to advise our fellows and perhaps use for ourselves?
Here are several points to consider:
1. During the interviews, fellows should ask their potential future colleagues about how the resignation has affected the practice and what are the steps being taken to retain employees or hire new ones (physicians and support staff).
2. Similarly, during interviews, a question about raises and cuts should be approached.
3. Fellows should consider using their mentors’ network to help find a position they may have reliable information about.
4. Fellows may want to ask HR about the trends of hiring and resignation at the place they are considering for employment.
5. Fellows with student loans should be advised on researching employer that would qualify for Public Service Loan Forgiveness (non-profit and VA) and Education Debt Reduction Program (VA only)
6. Once hired, endocrinologists should communicated clearly and frequently with staff and administration to ensure reasonable work flow and job satisfaction in order to continue to improve employee retention.
7. Fellows should be encouraged to join national committees as well as groups on social media that connect them to other endocrinologists to stay up-to-date on national trends in our field and more importantly to advocate for positive changes.
a. https://hbr.org/2021/09/who-is-driving-the-great-resignation
b. Christine A. Sinsky, Roger L. Brown, Martin J. Stillman, Mark Linzer. COVID-Related Stress and Work Intentions in a Sample of US Health Care Workers, Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Volume 5, Issue 6, 2021, Pages 1165-1173, ISSN 2542-4548,https://doi.org/10.1016/j.mayocpiqo.2021.08.007. (https://www.sciencedirect.com/science/article/pii/S2542454821001260)
c. https://www.prnewswire.com/news-releases/does-the-great-resignation-have-an-outsized-impact-on-the-business-of-healthcare-301407263.html
Dr. Dragana Lovre is a member of the APDEM Newsletter Committee.