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Journal of ASPR - Winter 2013 - One chance to get it right
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Onboarding and Retention

One chance to get it right

By Ashley B. Pace, Carolinas HealthCare System, Charlotte, NC

Ashley B. Pace“In general, when working with physicians, organizations have only one chance to ‘get it right,’ after which their credibility with physicians will be diminished,” according to the authors of A Guide to Physician Integration Models for Sustainable Success. That being said, we must proceed deliberately once a physician provides that coveted signed agreement. Developing and implementing a “comprehensive and proactive strategy for physician integration”1 has become paramount. As the healthcare industry dramatically changes, physicians (and recruiters!) may likely proceed with trepidation and hesitation. A physician’s decision to join a new organization will be very deliberate. Their primary focus will be on financial implications and how they are directly affected rather than on all of the requirements we impose upon them once we have their signed contract. This is where we should accept the call to greatness. We recruit exceptionally trained providers who provide excellent care. We should, therefore, provide them with an extraordinary experience and a seamless transition.

We onboard approximately 135 physicians annually at Carolinas HealthCare System (CHS). We have roughly 335 “best practice” steps required to integrate each physician. That’s 45,225 steps! Planning is imperative!

All on board

While many of us are well into the process of planning our 2013 goals, we should start the year off right by making integration a primary, system-wide focus. While creating your integration process, it is crucial to include administrators and physician leaders. Their “buy-in” and support will only make implementation of the new process easier. We should “empower physician leaders with the authority to drive change, recognizing their vital role in the value equation.” 1 While we may not all have a physician-lead organization, we can certainly empower them at the decision making level. At CHS, we gathered support by forming an Integration and Retention Task Force comprised of both administration and physician leadership. This has made the process much smoother.

Flexible standardization

In a recent JASPR article, Donna Ecclestone, associate director of physician integration at Duke Medicine, ASPR secretary, and vice president of OAR (ASPR chapter), said “Standardization is key in my world; however, meeting an individual’s specific needs for onboarding is just as important.”2

Knowing that every physician will present different needs, CHS has created a defined, yet flexible, process that improves the physician integration experience. Our replicable checklist serves as an onboarding template. As soon as we receive a verbal agreement, we partner with the physician’s hiring department to evaluate needs. We recognize the importance of relationship building between the physician and the department, so we want to empower the department to be involved. As a physician integration specialist with CHS, it is my role to be the primary point of contact for the physician, as well as to manage processes that should be completed at the departmental level. Ensuring a positive integration experience is the responsibility of the entire organization.

It’s in the details

As author/educator Charles R. Swindoll eloquently stated, “The difference between something good and something great is attention to detail.” While the “2 Cs” of contracts and credentialing play a major role in physician onboarding, don’t become so bogged down that you sidestep the details. Conquering the “little things” can catapult a physician’s experience from good to great. At CHS, we have honed in on the details in order to maximize our impact. For example, we host new teammate orientation every Monday. To us, every Monday matters. With this in mind, we commit to meeting our new physicians at orientation, providing lunch, and the opportunity to network with colleagues. We partner with all system support departments prior to a physician’s start date in order to have everything ready to go on day one. From lab coats, to badges, to log in information, to pens and a stapler—it all matters! We want our physicians to feel like they have been courted, as opposed to feeling like a commodity. Thus, we have had great success implementing a wide range of physician initiatives. We offer, among other amenities, a full-service concierge program, a spouse employment assistance program, a physician help line, new physician receptions twice a year, a physician-focused intranet portal, etc. We have made it a priority to pay attention to the details.

As the healthcare landscape continues to change, what is expected from us will shift. We should meet these changes head-on and plan for greatness…we will likely only get one chance! Start within your organization and lay the foundation for integration. Realize that a standard process is best but, as we all know, with physicians you have to be flexible. And ... don’t forget the small things!


  1. A Guide to Physician Integration Models for Sustainable Success. Health Research & Educational Trust and Kaufman, Hall & Associates, Inc., Chicago: September 2012. Accessed at
  2. Ecclestone, D. Onboarding and retention: Key areas of focus gleaned from 2012 ASPR Annual Conference, Journal of the Association of Staff Physician Recruiters. Fall 2012, page 27.
Journal of ASPR - Winter 2013

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