EP 58 500K question in academic medicine
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[00:00:00] This week on the Academic Medicine Strategy podcast, we are talking to you about the cost of losing faculty I wanna ask you a question. How much do you think it costs to lose a faculty member? It's not just the salary, it's the recruiting, it's the onboarding, it's the lost productivity, it's the disrupted programs, and the cultural impact. Most department chairs and deans I talk to have never actually done the math.
If you lose one faculty member, you're looking at somewhere between one and a half to two times their salary, maybe more, which is oftentimes a half a million to a million dollars in real cost, and some institutions report even higher. So that's the $500,000 question, and here's the more interesting part.
Many of you are spending money on retention strategies that are not working when there's a program solution that costs a fraction of that. By the end of this conversation, you are going to understand why the Faculty Excellence and Retention program isn't an expense, it's the cheapest insurance policy you can buy.
Now, the problem is you're [00:01:00] losing faculty. You don't need to tell me there's faculty walking out the door. In fact, if you look at the data, 46% of faculty leave within the first few years of their academic career, especially in the medical fields. Faculty careers are oftentimes reactive, and because of this, because they're not intentional, because our setup is really how to use your EMR and find your desk, not how to plan your career, Some of your best physicians are saying yes to the next opportunity that walks in the door because it came across their desk when they were feeling overwhelmed or tired or unsupported, and not because it was part of an intentional design that they planned.
So oftentimes we are saying yes to a lot of things. We say yes to the speaking engagement, we say yes to the new committee, we say yes to the clinic or the leadership opportunity, but somewhere along the way, we become exhausted and we don't see the career as we move forward. We don't see how we're going to get there because it hasn't been intentionally built, and the infrastructure that we need in our institutions and our departments hasn't been [00:02:00] provided in a way that it's easy to see.
And the cost of turnover is huge. And this turnover begets more turnover. It burns out the people who are left behind, and you're losing people who took years for you to develop, who know your systems, who your students trust, who your trainees trust, who your collaborating physicians trust.
And every time it happens, you're losing three, four, $500,000 just walking out the door. And I see this pattern in many of the institutions where I work. The problem is identical. It doesn't really matter where you are in the ranking system. Faculty don't leave because they don't love medicine. They leave because they're exhausted and they're reactive, and someone else's offer feels more clarifying, and that's where your $500,000 walks out the door.
So let's give you the breakdown. Now, when you look at the real cost of losing one faculty member, first is recruiting. You're advertising for the position, there's search committee time, there's travel for the candidate, there's lost productivity at all of those people involved in the [00:03:00] interviews, and you're looking at 50 to 150,000 just to get somebody in the door Second is onboarding.
The new person does not know your system. They can't find the emergency room. They don't know your culture. They don't have relationships with your students or your staff, and there are months where productivity is not as tight because they haven't actually figured out how to contribute at their optimal level yet.
The third is institutional knowledge. The person who just left knew how to navigate your system. They had mentoring relationships, they had collaborations with people in other specialties. They contribute to your research enterprise, and you can't just replace them in the drop of a hat. Now, the fourth is disruption.
While you are recruiting, your remaining faculty are picking up the slack, and productivity dips, and morale absolutely dips. And if you add it all up, two hundred thousand to five hundred thousand to your departure, and that's conservative. Some institutions I work with know that they're seeing turnover costs between six hundred thousand and a million.
And ask yourself, how many faculty have you lost in the last three [00:04:00] years? Multiply that by three to five hundred thousand dollars, and that's what you're losing. That's real money. That's a budget that could've gotten research or infrastructure or grown your department. And I understand how you got here.
I'm not telling you this doesn't make me feel bad too. I'm telling this because I understand exactly how this happens, as I've been the faculty member who walked out the door. I published, I built clinics, I became a chief medical officer. I did all that by saying yes to everything.
I was driven and ambitious. I wanted to prove myself, and I responded to every opportunity, and for a while, it looked like it was working. I was advancing. I was getting recognition, and I was exhausted, and I'd lost sight of what I actually wanted. In fact, I used to joke that I left my first position in order to escape the acuity of my clinic.
I was making decisions based on what was in front of me, not based on a plan that I had created. And then one day, I realized I'd become very successful living somebody else's vision of what my career should be, and I left. And that moment taught me [00:05:00] something critical. You can't stop faculty burnout with money or prestige or opportunity, but you can start working on an intentional plan which will help people to stay.
And quite honestly, at my next job, I had lots of opportunities to go to the next place, but I was intentional at building the career I wanted, and it made all the difference. Once I designed my career, everything changed. The stress went down, satisfaction went up, and I stayed happily. I built teams, I enjoyed the collaborations.
I had mentors and sponsors, and I was a mentor and a sponsor, and I loved all of those pieces And that's when I realized you shouldn't have to rely on luck to keep your faculty. Now, the solution I found to be most effective in the groups I'm working with is our Faculty Excellence and Retention Initiative.
It is intentional faculty development through executive coaching and implementation across the department. It is creating a common language so that everybody knows what they're looking for and what they're doing, and they can identify their niche so they know the promotion criteria, so they have a clinical plan and a research plan and a [00:06:00] promotion plan.
And it includes some one-on-one coaching with someone who's lived the academic journey. We have a team of coaches who have published and built programs and gotten grants and navigated the exact choices your faculty are making. And it's not another administrative burden. It's not a training program.
It's not a lecture series, although there are some workshops that are included. But the goal there is to give everybody some common language and some common skills. And it's not intended to take a lot away from work, but we do spend a lot of time helping people figure out how to get their time back and to get their work back on track and to be more intentional so they're spending their time on the things that they care about.
And in that coaching relationship, we ask the questions that matter to them, that are individualized and personalized, whether at the beginning of their career or they're towards the end of their career, or they're looking for their next leadership position, hopefully internally. Now, we ask, "What do you want your career to look like?
Well, how do you get there? What are you doing right now that you're saying yes to, and what are you saying no to, whether it's intentionally or [00:07:00] unintentionally?" We've helped people
So they're spending their time on the places they care about, that they're aligning their time with their mission, and we help them get a plan that helps design the career that they love and want to continue. We help faculty get clarity so they can say yes to the things that matter and no to the things that don't without the guilt that so often comes with it, and the outcome is a faculty member who is intentional, clear, and much happier, someone who's no longer feeling burnt out every day or that they have dread or that their career is looming.
And here's the thing that faculty members do when they are happy: they stay. Now, the math. Let's talk about the investment. When we talk about a career program like this, it is about 100th of the cost of losing a faculty member, and that's not a lot of money for a year of support for a faculty member who you know is going to actually be happier, be able to be more productive, who's actually gonna get better patient satisfaction scores, and in fact, may even be seeing more patients, which happens in a lot [00:08:00] of the studies.
Now, I want you to think about the fact that 200 to 500,000 is lost in a blink of an eye, and it seems that so many of the faculty I talk to say they wish they had known that there was a program like this when they were struggling. Everybody knows that they were gonna leave, at least that's what they thought.
They thought they'd sent signals, they told everybody, but it's amazing how often people were surprised by the fact that they wanted to go. I'm gonna tell you it happened to me when I left my first job. And if you look at what our opportunities are We just need to get one faculty member feeling like they're intentional, and that creates momentum for the rest.
And then the second faculty member sees that their colleague's designing their career intentionally, they're getting clarity, they're happy, and they want the same. And then one becomes two, and two becomes three, and suddenly you have changed the culture of your entire department. And they start coaching each other, which is the coolest and most amazing part, because they've created a shared language and a shared intention.
So it sounds like, you know, when we talk to people about the cost of [00:09:00] coaching, that that's a lot of money, but you have to put it in context. Compared to them being able to get one grant, or do one more clinic, or honestly stay one more month, if they can get promoted more quickly and it all just starts to tumble and makes it so you have a culture where people are telling their friends, "This is a place you should come to work."
It's not just a place where you retain people, it's a place where excellent people wanna come. And so it's one of the best budget decisions you can ever make. But the ROI doesn't stop at retention. When faculty get intention instead of reaction, they show up differently. They mentor better, they're more engaged, they make more thoughtful decisions about what they take on, and that ripples through your culture.
One intentional faculty member influences the next, and pretty soon you have a culture where people are designing their careers instead of just responding. Your research productivity goes up. It's shown in studies. Your teaching quality improves 'cause faculty who are present are less burnt out, and your retention rate improves, like we said.
But that means you are not constantly rebuilding teams, and all of that is an ROI that goes [00:10:00] beyond the spreadsheet. But let's talk financially. Here's what it means. It means you're not paying for the disruption of constant turnover. If you're already paying the cost of faculty burnout and turnover,
the reactivity is losing faculty and paying that two to five or $1 million figure per departure, rebuilding constantly and dealing with those culture disruptions that really demoralize the rest of the team.
Proactively is investing in your faculty with the FERI program, retaining faculty, building intentional culture, and preventing that huge outlay of money walking out the door, and the math is simple. The question is, which approach makes the most sense for your budget and your institution? If you're interested in exploring more about the Faculty Excellence and Retention Initiative program, please reach out and talk to us, 'cause we would love to present it to you.
Or go to our website at amedsg.com and check out department coaching. In the meantime, if this is useful for you or anyone else, please pass it along, and I look forward to talking to you next week.
