Blog Post

Clinician Onboarding: The On-Ramp to Engagement, Alignment, and Cost Savings

  • Clinical

by Lynette Kee, MA

Programmatic Advisor, Clinical Workforce Solutions

On a daily basis, we hear of the challenges clinicians face — lack of alignment and engagement with health system strategy and goals, well-being and burnout issues from the demands of professional duties, and the transition from fee-for-service to value-based payment with health information technology as the platform. These are just a few areas where we need to help clinicians achieve success while managing the demands of practice.

The research

Vizient researchers have been studying how the demands of practice in an increasingly complex and multi-requirement environment impact clinicians. We have found that while clinicians have received high-quality training to give patient care in their given area of focus, few are prepared for the other realities of modern medical practice. When clinicians join an organization, few understand its strategy and goals and how to impact either. This lack of understanding on how to impact organizational goals often leads to disenchantment and disengagement. So how best to improve this situation?

Our research shows the best time to equip clinicians to meet these challenges is at the beginning of the relationship between them and the organization. The first year of employment is a critical window! Physician turnover peaks in year two of employment, likely stemming from a poor start in year one. Providing education and inquiry on the skills for success in the organization and market leads to faster alignment and improved engagement.

Clinicians represent the “brand” of your organization. They are likely the reason patients choose your organization over your competitors. They are also the source of an often-hidden cost: turnover expense. Better alignment, engagement, and retention aren’t just qualitative issues — they lead to significant cost savings in an organization. As reported by our members and validated by literature, the average cost of turnover is $88,000 per nurse, $250,000 per advanced practice provider (APP), and between $500,000 and $1.5 million per physician. As your turnover ticks upward, there’s a large cumulative impact on your bottom line.

The current experience

Put yourself in the shoes of a newly hired clinician. What does the onboarding experience for the new clinician look like? Is the clinician given the time and attention necessary to assimilate into your organization, or do you provide the standard orientation (benefits, electronic medical records training, HIPAA compliance, etc.)? If you are depending on them to figure everything else out on their own, their response to the lack of assistance, support, and information may affect how they view your organization. This also will affect their perception of how much (or little) they are valued and may negatively impact team cohesion and patient care. Ultimately, this lack of support could also lead to turnover.

A worthwhile opportunity

From day one, most clinicians’ needs can easily be met through the establishment of a robust onboarding program. In addition to making sure they fully immerse themselves into your organization’s culture and network, properly onboarding clinicians also can have an extremely positive impact on your bottom line. As organizations grow in size and complexity, a consistent onboarding program also can be an important part of your culture journey, ensuring that all new clinicians understand your values, expectations, processes, and resources.

There is growing awareness that the old industry approach — the two-day orientation — is inadequate, but investing in a robust onboarding program is still a new concept for most organizations. It can be a heavy lift, requiring significant development work and curriculum maintenance if building from the ground up. Consider partnering with an organization that has established expertise and is ready to partner with you to quickly implement a program customized to your culture and needs. These types of programs improve provider engagement and retention, reduce turnover expense considerably, aid the organization’s culture journey, and improve overall quality of care.

If you want to positively impact clinicians and patients while also reducing expense, take some time to assess your current onboarding process. Investing in clinicians and showing them that you truly care about their experience from day one will have a lasting effect.

To learn more about how to establish a robust onboarding program for physicians and advanced practice providers, please visit Vizient Physician and APP Onboarding Program. To learn more about how to establish an effective Nurse Residency Program, please visit Vizient/AACN Nurse Residency Program.

About the author


As programmatic advisor for Clinical Workforce Solutions – Physician and APP Onboarding, Lynette Kee, MA, serves as a subject matter expert and primary point of contact for members who are partnering with Vizient to create a best-in-class onboarding and engagement experience for clinicians. She assists in ongoing program development, implementation, training and evaluation. Lynette has over 20 years experience in health care and has primarily focused on patient experience and workforce issues like clinician recruitment, onboarding, engagement and leadership development.