AMGA links MD satisfaction to recruitment, retention

The interaction between physician satisfaction on one hand, and physician recruitment, retention and compensation on the other, can be measured by tracking a group’s internal satisfaction in confidential surveys, the American Medical Group Association says.

AMGA is in the third year of a physician satisfaction benchmarking program that it performs as a fee-based service for member groups that choose to participate. The Alexandria, Va.-based organization collects and compiles anonymous, voluntary responses on general satisfaction with the physician’s group, as well as with about a dozen components of satisfaction with the group, including compensation and relationships with colleagues and staff (see illustration, this page).

“Physician satisfaction is a major part of retention,” says Julie Sanderson, AMGA vice president for quality management and research. “It’s only recently that people even got interested in satisfaction. We used to assume that if physicians were making money, they were happy. Now we know that’s not true.”

AMGA advertises the service to its members as a recruitment tool, especially to candidates who have simultaneous offers from other groups. While all the potential employers may offer quality reputations, growing markets and similar financial offers, AMGA contends, only survey participant groups can present data that show most colleagues are satisfied with their workload, earnings and group quality of care. Having the data communicates to prospective recruits that the group cares about physician satisfaction and understands its complexity, the organization adds.

Because the AMGA survey is limited to its members, only medium-sized-to-large multispecialty groups participate. More than 50 groups participate, including several regionally prominent ones such as the Cleveland Clinic, Lovelace Health Systems (New Mexico), Park Nicollet (Minneapolis area) and the Fallon Clinic (Boston area).

Outside of AMGA, many physician compensation system revisions are instigated by physician dissatisfaction, occasionally measured by outside consultants, but usually simply felt and discussed by the physicians. The dissatisfaction sometimes is aimed at the group in general, and sometimes at the pay plan in particular.

Reports Target Sites, Specialties

Physicians rate their satisfaction on AMGA survey questions about various aspects of group operations on a one-to-five scale.

In addition to listing group-wide satisfaction levels and benchmarking them against norm and best-practice national response levels, AMGA reports results to participating groups by site and specialty provided that at least three providers in each site or specialty answer the survey. These results reflect answers to all survey questions.

The reports also present response levels by provider age group, gender and production guidelines.

In addition to using satisfaction measurements for recruitment and retention purposes, groups can use them to develop priority lists for management improvements based on what physicians see as problems in group operations. Mike Carrigan, M.D., medical director of 37-physician Premier Medical Group in Clarksville, Tenn., reports in the November/December issue of AMGA’s Group Practice Journal that his group went through a comprehensive physician satisfaction program that began with an in-house survey. Major operational changes the group made as a result were much-improved communications among physicians and staff, and a change in the compensation system from one based on individual production to one based on group, site and individual profitability, he writes. A follow-up satisfaction survey showed that the group’s physicians were much happier with communications and day-to-day operations, he notes.

The cost for a group to participate in the AMGA survey is on a sliding scale depending on the number of providers queried. For 25 or fewer providers, the cost is $1,100; for 500 to 1,000 providers, the cost is $5,000; and there are price gradations in between. Up to five custom questions can be added for an extra fee of $500.

Participation Depends on Use of Data

So far, the AMGA program has data on 3,500 to 4,000 physicians, Sanderson says. She expects participation to grow rapidly this spring because the survey form, which has been on paper, will be Web-enabled. This change will “increase the comfort level of the physician with the confidentiality” of the survey, because some worry that paper forms will be intercepted. Adding Web surveys to mail ones also will speed and simplify data collection and compilation, she notes. Reports will be sent to participating groups via the Web as well.

Participation rates by physicians in respondent groups vary from 60% to 93%, says Sanderson. The degree of participation depends on “how it’s presented to physicians,” she explains. If it’s to find out what parts of the operation physicians view as needing improvement, with some follow-up action likely, participation probably will be high, she says. But if it’s to weed out dissatisfied group members, participation probably will be on the low side, she predicts. In cohesive groups, physicians “see it as a real positive change agent rather than as something punitive,” she adds.

To learn more about the AMGA program, visit, click on services, then on quality management and research, then on provider satisfaction program. Contact Sanderson at (703) 838-0033, ext. 356.

COPYRIGHT 2003 Atlantic Information Services, Inc.

COPYRIGHT 2003 Gale Group

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