Onboarding: Smoothing Cultural Differences

Posted on June 6, 2013 by VITAL WorkLife

An effective onboarding program is critical to supporting and building upon retention efforts. New physicians often bring expectations or “baggage,” based upon their past experiences—which may or may not have come up during the interviewing and hiring process. This can be compounded by different cultural norms based upon training, country of origin and regional differences, and other factors.

For example, a physician who did his or her residency in a large east coast metropolitan hospital and is now in a clinical setting in a Midwest suburban community is probably going to have a more difficult adjustment. Similarly, physicians who are used to the autonomy of a group practice may struggle within the context of a large health system.

Don’t leave culture subject to interpretation—make sure the new physician understands what your culture is, how it plays out in day-to-day operations, and how it ties into their performance expectations. Don’t leave organizational expectations to chance—make sure they are explicit at all levels, e.g., behavior and performance, and put them into writing.

One thing that is often missing when organizations hire a new physician is identifying who is accountable for the physician’s success. The easy answer is that it’s whoever the physician reports to. However, in today’s healthcare environment, there may be a matrix, or multiple reporting relationships. And, even if there is just one reporting relationship, there may be multiple stakeholders.

Thus, it’s critical that expectations and accountabilities be defined and aligned from the beginning—within the organization, and between the organizational stakeholders and the physician. For many of these organizational stakeholders, these will be new skills, and helping them with training and tools will be important in creating and maintaining a more solid, effective onboarding program.

Supporting the New Physician

Supporting the new physician in multiple ways is important to not only help them fit into their new job and culture, but make them feel valued. Assigning a coach or mentor to each new physician is ideal. This can be someone who is part of the organization, but could also be an external resource who can support the organization’s cultural aims, as well.

Frequent pulse checks—with the new physician and their co-workers—is also important. If there are issues, they can be caught early and appropriate interventions can occur. Make sure this is a two-way dialog. This also signals to the physician that the organization wants them to be successful in their new position, and reinforces that many in the organization have a stake in this.

Also, don’t forget the physician’s family and personal life. Even if things are going well at work, if the family is having a hard time fitting into the community, or if the physician’s work/life balance is poor—a critical factor for younger physicians, especially—this can negatively impact retention. Again, coaches, mentors and your employee assistance program can be important resources to help in this area.

Having a formal program in place not only helps ensure that all bases are covered, but signals to the new physician that ensuring their cultural fit and success is a priority to the organization.

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