IHS Retention Briefs | Volume 3 — Issue 7
August 2016
Photo of Employees

Retaining valued clinicians is the No. 1 way to ensure your community’s continuity of care.

Prepare to Welcome a New Provider

Preparing your community for a new provider and supporting your new hire’s transition can have a profound and positive effect on retention over the long haul. Despite measures to improve health care in rural areas, there is still a major shortage of rural providers. Retaining valued clinicians is the No. 1 way to ensure your community’s access to and continuity of care. Research has shown that practitioners are more likely to stay in rural health when they have a rural background themselves1. But it’s important to help those without rural experience adjust to small town life, too. Providing resources such as a community mentor/liaison can help.

Sources: 1 American Academy of Family Physicians, Keeping Physicians in Rural Practice. 2014.

Seven Ways to Offer Support for Your New Provider

Here’s a list of ideas to help you prepare your facility and the community:

1. Send a letter of introduction to community leaders and businesses.
2. Host an open house to introduce the new provider.
3. Provide access to information about available housing.
4. Introduce the new hire’s spouse to prospective employers and ask other employees’ spouses to welcome him or her to the area.
5. Provide peer introductions — host a lunchtime meet-and-greet or after-work gathering of professionals.
6. Form a welcoming committee to introduce the new provider and family to area recreational activities.
7. Arrange for a designated community liaison or mentor to help with questions about retail locations, utility setup, enrolling children in school, etc.
Transitioning a New Hire

Transitioning to a new area is tough enough; transitioning to a new culture and way of life can be especially challenging for clinicians moving to American Indian/Alaska Native communities. Many facilities find that introducing new providers to those in the community who are willing to be mentors leads to a firmer grasp of local customs and social etiquette. Seek out volunteers to introduce new hires to Tribal and community leaders and to invite and encourage them to participate in local social events and customary observances.

Communicate about Benefits

Make sure your new provider is aware of all of the benefits available through IHS. It’s important to let a new hire know about opportunities for health profession education loan repayment, whether through the IHS Loan Repayment Program (LRP), the National Health Service Corps LRP or assistance through the state or a Tribe. The LRP not only creates a sense of loyalty to your facility, it also reduces the financial stress that could lead a provider to look for a higher paying position.

Be transparent about other benefits as well. This might include flexible schedules, on-site daycare or an employee referral program. Ensure early on that your staff is aware of all that your facility and an Indian health career have to offer.

Set the Right Expectations

The most critical step you can take during the recruitment process is to give the potential hire a clear understanding of his or her role and what community life is like. Let the employee know what type of support staff are available and set realistic expectations for on-call hours and referral networks. Be transparent about services, housing and educational opportunities.

Integrate the New Hire into the Community

Once a provider is hired, facilitate an introduction to local school administrators, business owners and social and sports groups. Make sure he or she has the information needed to efficiently and happily live, learn, shop and play.

A great way to help a new hire get to know the patient population is to arrange a ride-along with a public health nurse or clinician who is familiar with the community lifestyle, culture and health disparities. New providers may be surprised to learn that some patients don’t have refrigeration for certain medications or may not have running water in their homes. This knowledge will be helpful in determining treatment options, medication regimens and other specifics that lead to positive patient outcomes.

Stay Connected

IHS defines a good retention outcome as a provider remaining with a facility for three years or longer — ideally, much longer! Keeping this in mind, your retention program should continue throughout the employee’s tenure, providing continued encouragement, measurable and achievable benchmarks and support strategies that lead to an invested and loyal employee.

While the primary goal is to retain providers at the site of original hire, this may not always be possible; secondary and tertiary goals are to retain the clinician within the Indian health system or within the public health service.

Some suggestions:

  • Encourage continuing education and professional networking.
  • Check in quarterly with the clinician and his or her family to identify areas of concern. Move forward on issues that can be addressed and make a note of those that may affect future recruitment and retention.
  • Arrange quarterly social activities for staff outside of the facility.
  • If a clinician must leave, introduce him or her to a recruiter to find a position at another suitable Indian health site or within the public health system.
AThis graphic shows heath disparities between urban and rural areas: 25 percent of US residents live in rural areas, but only 10 percent of physicians practice in rural areas. Urban areas have 134 physicians per 100,000 residents, while rural areas have only 40. And 2,157 federally designated Health Professional Shortage Areas are in rural or frontier locations, compared to 910 in urban areas.
The policy of the IHS is to provide absolute preference to qualified Indian applicants and employees who are suitable for federal employment in filling vacancies within the IHS. IHS is an equal opportunity employer.

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