Three Steps to Recruit and Retain the Best ED Doctors

Medical professionals reviewing information in a corridor.
Step 1: Examine Your Recruitment and Retention Strategy
Step 2: Revise Your Recruiting Processes
Step 3: Factor Retention on the Front End

Part 2: Medical Directors

The Role of the Medical Director in Physician Retention

Recruiting outstanding, well-aligned physicians to your hospital’s Emergency Department is one thing; keeping them is another. As long as the number of opportunities across the U.S. outweighs the number of EM physicians, your EM team will continue to receive calls about other opportunities throughout their tenure. While you can’t prevent the calls, you can give your doctors enough reasons to stay so that leaving isn’t something they would seriously consider. As such, hospital administrators, along with the ED leadership team, must put as much priority on retaining top-tier talent as they do in recruiting them.

The tie between Medical Director leadership and physician retention.

Your ED Medical Director bears the greatest responsibility for the success of the Emergency Department, not only operationally and financially, but also regarding the quality of care and patient satisfaction. Because of the intense focus these areas demand, it’s possible for Medical Directors to lose sight of the linchpin that makes success in these areas possible: the physicians themselves.

For emergency medicine physicians to work safely and efficiently, and deliver excellent, patient-centered care, they must have a Medical Director who can lead effectively—someone who can combine broad vision with strong clinical, managerial, and interpersonal skills

Part 2: Medical Directors

Is your Medical Director up to the task?

  • Operationally, does your ED have reasonable throughput and wait times?
  • Does the Medical Director monitor operational and financial metrics, champion improvements, and motivate the team as a whole?
  • Does he/she help develop and implement protocols that support good patient care and a well-oiled practice environment?
  • Do complaints arise from patients, physicians, or the nursing staff?
  • Does he/she instill a sense of collaborative practice within the ED and extend it to other groups and specialists?

Ideally, you want an ED Medical Director who can create and maintain the kind of environment that is as beneficial for physicians as it is for patients.

Part 2: Medical Directors

Supporting your ED Medical Director

Before making a judgment call, consider the caliber of your support by asking these questions: • Are you providing your Medical Director with the tools and metrics they need to skillfully monitor and guide the day-to-day operations and performance of your ED and its physicians?

  • Are you giving them access to ED-specific leadership training?
  • What about ongoing education and training opportunities to advance their practice of medicine and ED management skills?
  • To whom are they accountable?
  • Who is guiding your ED Medical Director?

Regarding the last question, it should be someone with both clinical and management experience in emergency medicine who can mentor your Medical Director in the leadership of a cohesive EM Physician team and high-functioning Emergency Department.

Part 3: Hospital Leadership

Administrative Leadership’s Impact on ED Physician Retention

As recruiting and retaining ED physicians becomes increasingly competitive, it’s increasingly important that hospital leaders foster a healthy practice environment. When it comes to physician retention, practice environment is often cited as the most influential factor in a physician’s satisfaction at work.

An EM physician is like any other professional: If he likes where he’s going to work each day, he’ll be less inclined to look elsewhere.

New opportunities will come calling, many with bigger paychecks and grander promises. While you can’t prevent that, you can ensure your ED physicians are working in the kind of practice environment they wouldn’t risk giving up, regardless of the perks being offered. Aside from supporting the Medical Director, there are other factors you can impact to create a better practice environment—namely, ensuring adequate coverage, engaging and empowering the team, and keeping communication lines open.

Ensuring adequate coverage Engaging and empowering the ED team Keeping communication lines open
  • Does the current provider-patient ratio allow your EM physicians to spend adequate time with patients, or are both patients and doctors feeling excessively rushed?
  • Is the current nursing and secretarial or department support adequate for all shifts?
  • If adding another physician isn’t affordable, is it feasible to add a nurse practitioner, physician assistant, or a scribe to high-volume shifts?
  • Also, along with examining day-to-day operations and metrics, pull back and look at the big picture through a physician’s eyes as well.
  • Do your ED physicians feel valued?
  • Are they recognized for jobs well done as often as they receive suggestions for how to improve?
  • How are decisions made in the ED—by consensus or directive?
  • Are ED physicians granted a voice and an opportunity to share ideas and experience before you make decisions affecting them?
  • Is someone accountable for acknowledging or rewarding good physicians and working with or removing those who obstruct the harmony of the practice environment?
  • Are you checking in with ED physicians in person to gauge their satisfaction?
  • Do you have an objective, non-supervisor in place (such as a scheduler) who frequently communicates with physicians? Are you leveraging that person to help make you aware when physicians or the practice environment are struggling?




Part 4: Work-Life Balance

The Truth About Emergency Department Burnout

Burnout is a problem for all physician specialties, but it’s particularly significant among emergency medicine physicians. Since hospital administrators ultimately bear the burden of ED stability, installing safeguards against burnout is vital.

A 2015 Medscape Physician Lifestyle Survey of 7,000 physicians revealed that:

  • 52% of EM physicians experience burnout.
  • EM physicians experience 3X the burnout as the average doctor.
  • 10% of EM physicians said they are so burnt out, they are considering leaving medicine.

Top 3 Burnout Causes (according to Medscape)

  1. Too many bureaucratic tasks
  2. Spending too many hours on the job
  3. Insufficient income


These factors affect physician well-being and lead to poor performance, lower patient satisfaction scores, increased errors, alcohol and drug abuse, and even thoughts of suicide. To retain the best EM providers, hospital administrators must make preventing burnout a priority. To do so, commit to providing strong ED leadership, appropriate staffing levels, a supportive practice environment, and perhaps most importantly: work-life balance

Three Keys to Healthy Work-Life Balance

1. Balance Work Schedules

While you cannot control who walks through the ED door or when, you can ensure your ED team is ready. A humane physician work schedule that allows for adequate balance with a doctor’s life outside the ED is a great starting point.

  • Ensure EM schedules don’t require flips from night to day and back again
  • Avoid lengthy and unsafe shifts
  • Monitor patient volume to ensure the ED is adequately staffed for swings in patient load
  • Ensure all physicians share responsibility for working nights, weekends, and holidays Striving for fair and equitable scheduling goes a long way in promoting a stable, team-centric practice environment.
2. Offer Value Beyond Income

Simply raising a physician’s rate isn’t a magic bullet. The reality is that raising ED physician pay above the market rate for your region may not be feasible for your hospital, or even fruitful. Long-term physician-hospital commitments tend to be more strongly fortified by those things money can’t buy:

  • Shared values
  • Capable leadership
  • A supportive practice environment
  • A collaborative ED team

That’s not to say money doesn’t matter. Signing bonuses and relocation reimbursements are often valuable draws for younger, less experienced physicians with minimal savings post-residency but face daunting school loans. For more established, experienced physicians, signing bonuses and relocation money may not be as important as what they want or need in a practice environment, culture, Medical Director leadership, or team.

3. Lighten the Load with Support Staff

The push to develop and deploy EMRs and the need for more detailed documentation has forced providers to spend extra time during and after patient visits capturing and entering data—impacting both time at the bedside and at home. A solution to help lighten the documentation load is the use of medical scribes or a speech-to-text EMR dictation resource. Scribes work as on-premise or virtual assistants—responsible for entering information into the medical record with the doctor’s oversight. Scribes can also look up details, such as: what’s in old records, nurse’s notes, medications the patient is taking, and things the doctor can’t readily recall. The scribe takes notes in real time as the doctor interacts with the patient and alerts the doctor to questions he or she may need to ask, such as social or family history. Scribes help boost provider satisfaction with:

  •  Increased efficiency and productivity
  • Better bedside manner
  • Improved surge volume management
  • Adequate shift coverage
  • Reduced wait times/LWOTs
  • Rural hospital assistance
  • Enhanced patient satisfaction

As the industry evolves speech-to-text EMR dictation tools are quickly becoming the resource of choice for provider documentation. This allows the provider to speak directly into the computer when documenting patient encounters. It is important for hospitals to support methods that improve provider efficiency, productivity, and documentation. Notes entered during the actual episode of care means fewer required entries at the end of the day for the physician.

The First Step Is to Take a Closer Look

Improving provider satisfaction can be a seemingly daunting task. Simply evaluating your existing recruitment and retention strategies and capabilities of hospital leadership will give you a healthy step in the right direction. With a proper understanding of your facility’s challenges, you can take small steps towards a more positive practice environment and ultimately, happier, more productive emergency medicine providers. Regardless of the steps you take, making a conscious effort to support your providers during work and protect their personal time outside of work will show you value your physicians and take the problem of provider morale seriously. This positive culture will not only benefit your physicians by reducing burnout, but also your Emergency Department’s overall care quality.

Learn how SCP can help improve provider satisfaction

Contact our team by emailing, call 800.893.9698, or visiting our contact page.