Attracting and keeping a great NP/PA is an art form

In the tsunami of change resulting from sweeping healthcare reform in the United States, two integral, highly skilled medical roles have risen to the forefront of healthcare delivery: physician assistants (PAs) and nurse practitioners (NPs).
As a result, recruiting and maintaining talented PAs and NPs has become ultra competitive in the healthcare sector.

“Especially in primary care, PAs and NPs attract and manage a significant following of patients, especially in rural communities,” said Lisa P. Shock, MHS, PA-C, and CEO of Utilization Solutions in Healthcare, a specialty consulting firm based in the South that helps physician practices and hospitals statewide implement and improve the

A recent 2011 Physician Retention Survey by the American Group Medical Association (AGMA) shows the turnover rate for NPs and PAs is an unsettling 12.6 percent, more than twice the combined and adjusted physician turnover rate of 6 percent.
“With these statistics in mind, I summarize finding and keeping a great NP/PA with the 3-A approach – attract, advance and affirm,” said Shock.

To attract talent, properly wording the specifics of a job opening is vital. Instead of advertising a role in this manner – Family practice PA/NP wanted in XYZ, Fla. – consider this: Dynamic PA/NP wanted for charming, rural, underserved area in XYZ, Fla., suggested Shock.
“I’ve often said primary care was in my blood,” she said. “As a student, I was reprimanded on the cardiology service for worrying about a patient’s mammogram. Obviously, a PA or NP who’s passionate about your clinical needs is important. Highlighting the types of duties you need performed, as well as the type of patient population, is critical to the messaging. Interested providers will be responsible for healthcare delivery to an appreciative population that has limited resources. Also, Medicare and Medicaid credentialing are a must.”
Shock pointed out that suburban, rural and smaller practices all have the same complaint: they cannot recruit to their area because they cannot pay as much in salary as their competition.  

“However, often these groups are missing the mark as they often qualify for loan repayment within the state, or they might offer flexibility within a clinical work schedule that’s appreciated by the provider,” she said. “For example, if a PA/NP lives in town where they work, it might be agreeable that they can leave at 3 o’clock to pick up a child from school and then come back to wrap up the clinical day. Such flexibility isn’t easily achievable in a larger hospital or health system. Highlighting those ‘extras’ will be important as you list all the reasons why your office is a great place to work.”

Concerning advancement in the job, levels of clinical autonomy will be variable depending on the clinical experience of the PA/NP. New graduates will require additional supervision and training as their clinical judgment grows. Seasoned practitioners may be looking for ways to advance their knowledge and career direction.
“Often, creative thinking helps in promoting the experienced practitioner within the group,” noted Shock.
With the advent of Patient Centered Medical Home (PCMH) model and meaningful use attestation through quality assurance, a host of new avenues exist to explore for PA/NP leadership, she added.

“As practices explore the shift from volume of patients to value in patient population management, there are additional opportunities for PAs and NPs to take a central role in the incorporation of electronic technology through the Electronic Health Record (EHR) system,” she said. “Care delivery is changing, and PAs and NPs as team members can be a clinical ‘go to’ point person as changes are initiated.”
Regarding the final A – affirmation – that’s defined by Miriam-Webster as “clearly and strongly,” it’s a fact that PAs and NPs will leave a post if they believe their contributions in the decision-making process – patient care, work environment, technology – aren’t valued, said Shock.
“For example, if the physician doesn’t support the PA/NP care rendered to a patient publicly, or if they don’t advocate for the PA/NP within the medical community, these are flags of incomplete acceptance and lack of full incorporation into the team,” she explained. “Recognition is individual and personal to every PA/NP. Some may prefer a public acknowledgement at a staff meeting while others may greater appreciate a personal note or face meeting.  Supervisors and practice managers should have processes in place to assess communication styles and play to team strengths.”
Finally, it’s not always about the money when recruiting and maintaining PAs and NPs, said Shock.
“Often, individuals leave a position for reasons that aren’t financial,” she said. “Being mindful of the 3-As will foster improved communication and result in improved retention of your medical staff. Genuine acknowledgement of value and contribution goes a long way to foster loyalty to the practice and the group, and ultimately to the patients we serve.”


TAGS: Lisa Shock, Utilization Solutions in Healthcare, PA recruitment, NP recruitment.

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