‘Someone needs to own the retention strategy’ — keeping physicians on the job, or not

Just 39% of health care organizations have a formal, documented strategy for retaining physicians and advanced practice providers (APPs). Another 39% are doing retention work informally, without a written plan to guide or measure it.

That's according to the 2026 Physician & Advanced Practice Provider Retention Strategy Report from the Association for Advancing Physician and Provider Recruitment (AAPPR), published this year with Industry Insights and CHG Healthcare. The report surveyed 158 physician recruitment leaders and health care executives and builds on AAPPR's 2022 study of physician and provider turnover.

Carey Goryl, MSW, CAE, CPRP, is AAPPR's chief executive officer. The organization represents more than 2,700 in-house physician and provider recruitment professionals nationwide and supports the field through research, conferences, education and certification programs.

Goryl spoke with Medical Economics about the report's findings. She explained what separates a genuine retention strategy from a loose collection of retention activities, why unclear ownership emerged as the report's biggest finding, and what the data show about organizations with 200 or fewer physicians. This transcript has been edited for length and clarity.

How did this report come about?

Carey Goryl, MSW, CAE, CPRP: Physician retention is something that in our world we're always talking about, because if we're constantly backfilling positions, it puts added strain on the recruitment end of it. It's very cyclical. Years ago, we embraced the fact that onboarding, recruitment and retention are part of one cohesive continuum in the lane of workforce and physician staffing, so it's always been important to us.

We studied it a couple of years ago, and I went back and looked at our report from that time. Things have improved slightly since the last time we looked at physician retention strategies, and we wanted to look more broadly at what organizations are doing to address retention.

Is there a real difference between having retention activities in place and having an actual retention strategy?

Carey Goryl, MSW, CAE, CPRP: That is a really good point. Retention activities do not mean you have a strategy. A strategy is very intentional. The outcome has been clearly defined, and there are moments along the way that are measured to let you know if your strategy is working.

That's what we saw in the report: Depending on how many providers an organization has, how small or large it is, there's a continuum of maturity in retention strategy, even when not everyone has a formal one. We know organizations are attempting retention efforts. No matter where you fall on that maturity continuum, there's another step for you, whether that's formalizing it into a strategy, understanding what activities you're currently offering, or deciding what you're going to measure.

Most importantly, what we discovered is that someone has to own it. Someone needs to own the retention strategy. That was the big revealing factor: how few organizations have any clear ownership. You can't have a strategy if nobody owns it.

Among organizations with 200 or fewer physicians, 27% had a formal strategy and 51% had an informal or activity-based one. Can you explain that difference?

Carey Goryl, MSW, CAE, CPRP: In organizations with fewer providers, we saw that the person responsible for recruitment was probably also the one in charge of retention. We've also seen that in smaller organizations, historically, compensation has been the primary retention strategy. What we're seeing is that there are so many other activities and elements to a strategy beyond compensation. Physicians' compensation is great and certainly important, but it's not the only thing that keeps physicians.

Whether you're small or large, especially if you're small, hopefully there are fewer layers of bureaucracy and more nimbleness, more ability to act quickly. Having a stronger retention strategy program for a small organization could really be an excellent differentiator, to keep the physicians you have and make your organization a more attractive place to stay.

Can you talk about some of those retention activities apart from compensation?

Carey Goryl, MSW, CAE, CPRP: A lot of it centers on career development and career progression. Are there mentoring opportunities, whether internally or through outside connections? A lot of organizations are also looking at work-life balance, which has become something of a buzzword, so to the extent a team can offer flexible scheduling, that matters.

We didn't document this specifically, but it goes without saying: Good communication, a healthy work culture, and the ability to have healthy conflict that gets resolved are core elements of wanting to go to work every day. It's not just about who you serve, but who you work alongside. To the extent small groups can look at their workplace culture, define their values and live those values, that goes a long way too, along with competitive compensation, mentoring, support, and the technology and tools people need to do their best work. Create an organization like that, and you'll have good retention.

How would you describe the ideal role for physicians in retaining their colleagues, especially in a smaller practice?

Carey Goryl, MSW, CAE, CPRP: Clinical leadership has to be involved in retention. We saw that a retention strategy works best, and is more likely to be effective, when it's cross-functional, involving recruitment or HR, clinical leadership and executive leadership. But if it's cross-functional, it can't be unclear. There still needs to be a person championing the program and a person responsible for measuring its progress and sharing that with the larger team, to keep momentum moving forward.

If you're the one responsible for recruiting physicians, you're often the first to see turnover patterns. If you're constantly backfilling positions instead of spending time on harder-to-fill searches, it creates a vicious cycle. Clinical leadership throughout all of this is always important, because it's their physician workplace culture.