Practice Notes

Want to reduce APP turnover? Give them a voice in your medical group.

by Sarah Hostetter and Eliza Campbell

Frequent turnover is one of the biggest challenges medical group executives report with their advanced practice provider (APP) workforce. And this turnover is costly: A single APP vacancy costs practices $1,500 per day. In addition to productivity losses, investments to onboard and train APPs so that they can work top-of-license go wasted when APPs leave the group.

Just updated: Get the tools to make the most of your advanced practice providers

While several factors contribute to this problem, turnover often stems from APPs feeling as if they don't have representation in the medical group. According to Advisory Board survey data, the sixth-highest driver of APP engagement is, "My ideas and suggestions are valued by my organization." To stem the tide of turnover and become an employer of choice, medical groups must carve out leadership roles for APPs that make them feel engaged and heard.

Two ways to give APPs a voice

  1. Create a mechanism for APP self-governance: Providing a forum for APPs to come together is not only engaging for them, but also helps the medical group address APP-specific issues, such as scope-of-practice, that APPs are better suited to manage on their own. Start by creating a group-wide council that allows APPs from across the organization to come together and exchanges ideas. Many medical groups are taking APP governance a step further by appointing a single, dedicated APP leader to oversee the group's entire APP enterprise.

  2. Guarantee APPs a seat in group leadership: Not only does giving APPs representation in group-level governance have important signal value, but it also allows the medical group to surface their unique input on strategic issues. Involving APPs in quality or patient experience committees is a low-risk entry point for piloting APP leadership. However, medical groups who report the lowest turnover rates take these pilots to scale—giving APPs full representation and voting power in group decision-making bodies.

July 16 webconference: Elevate APPs to leadership roles to improve retention and ROI

Integrating APPs into group leadership structures that have been traditionally dominated by physicians
can feel like a large cultural shift. To dive deeper into this important topic, join our upcoming webconference on Tuesday, July 16, at 3 p.m. ET, "Elevate APPs to leadership roles to improve retention and ROI." We'll be sharing best practices for promoting APP leadership and hosting a Q&A with an APP leader from Advocate Aurora Health that you won't want to miss!

Additional questions on care team design?

We're continuing our research on team-based care across 2019—expanding the focus beyond APPs to uncover new approaches to innovative care team design. If you'd like to be included in this year's research, email Eliza Campbell at CampbelE@advisory.com to schedule a call or share your thoughts.

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Learn more: Get the full value from your APPs

A scalable APP model has four components. Each component plays a critical role in ensuring the harmonious use of APPs within your medical group.

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