In the latest episode of the MGMA Business Insights Podcast, host Daniel Williams, Senior Editor at MGMA, sits down with Tony Stajduhar, President, and Neal Waters, Regional Vice President of Recruiting, Jackson Physician Search, to discuss findings from their new report, From Contract to Connection: How Authentic Relationships Foster Early Career Physician Loyalty and Retention.

In this episode, Stajduhar and Waters unpacked the disconnect between administrative expectations and physician realities, revealing why many new physicians leave their first job within a few years. They discussed what practice leaders can do to keep new physicians engaged: Proactive relationship-building, culture development, and continuous communication — all key strategies for addressing recruitment and retention challenges in today’s competitive physician market.

Bridging the Expectation Gap Between Administrators and Physicians

When asked about what stood out most from the new research, Stajduhar noted a major disconnect in expectations between physicians and healthcare administrators.

“Physicians go into this first job coming out of their programs, and they typically stay in these jobs... three years or less,” Stajduhar explained. “Almost 60% of the physicians coming out of programs will be in their first position for three years or less."

He added, "The part that never ceases to amaze me is that on the administrative side, they believe the physicians... are with them for at least six years. So you wonder, how does that happen?”

This gap points to the need for clearer communication during recruitment and onboarding. For practice leaders, this means understanding new physicians' expectations and creating a plan to engage them early and consistently.

Spotting Red Flags Early

Waters explained that the warning signs of an at-risk physician often appear before a resignation letter hits the desk. “Yes, there definitely are [red flags],” he said. “But there are some that are specific to the individual — their personality, what their career aspirations are.”

Engagement is a key indicator of long-term fit. “Once they get into a position... [observe if they] are engaged with staff," Waters emphasized. "Does it seem like they’re making an effort outside of just their patient contact hours? Are they getting involved in the community?”

For medical practice leaders, these early signals offer opportunities for intervention. Observing patterns of disengagement — whether it’s social isolation, limited participation, or stress over compensation — can help leaders start constructive conversations before a physician starts looking elsewhere.

The Importance of Pre-boarding and Onboarding

A consistent theme throughout the conversation was the importance of engagement before a physician even starts their first day. Stajduhar described what can go wrong when practices treat a signed contract as the finish line.

“You go through this whole process... you finally say, ‘Oh gosh, we’ve got the one,’” he said. “There’s that sense of just like an exhale... and you just start losing track, and you forget about the people that you’ve just signed. You’re just assuming they’re ready to go.”

That lack of follow-up can open the door for competitors. “These doctors continue to get peppered with opportunities,” he added. “If they’re not being contacted by the people who’ve already signed with them, they start wondering, 'is everything okay? Should I be communicating'?”

Stajduhar recommended establishing consistent touchpoints — even small gestures like welcome notes, local newsletters, or assigning mentors — to keep future hires connected and excited about joining the team. 

“Communication is vital,” he said. Without communication, leaders run the risk of new physicians worrying that they've been forgotten. 

Culture and Connection Over Compensation

Compensation packages may help attract physicians, but culture is what keeps them. Stajduhar explained that while salary benchmarks are widely known, “the things that just kind of resonate [are] culture and the environment.”

He added, “There’s an old saying that people don’t leave positions, they leave bosses. That is from the top down, and it’s all about culture and what you build there.”

Stajduhar described the Jackson Physician Search culture as rooted in inclusivity and shared purpose. “You do that by making them feel that they are heard, that their voice matters,” he said. “People rarely leave really good cultures.”

Waters agreed, noting that successful organizations focus on relationships at every level. “How can we... make this person that we put so much effort into recruiting... feel as comfortable as possible that first day and ongoing?” he said. 

Simple efforts like peer introductions or early mentorship can have a lasting impact on loyalty.

Feedback and Mentorship: Building a Two-Way Dialogue

Creating structured opportunities for feedback helps physicians feel valued and supported. “One [approach] is that mentor and peer relationship,” Stajduhar said. “That meeting is set in stone — every second Tuesday of the month we’re going to meet, and we’re going to go over what’s been going on for the month.”

Beyond formal meetings, Stajduhar recommended peer programs for informal, day-to-day check-ins. “[A buddy] will say, ‘Hey, let’s grab a cup of coffee.’ Just somebody that you can talk to and really bounce things off of.”

These conversations not only provide emotional support but also give practice leaders valuable insight into potential issues before they escalate. As Stajduhar put it, “Let’s schedule 15 minutes at the end of the day... just have some intellectual honesty to say, 'help me understand what’s going on, and what can we do to make this better?'”

Creating a Culture That Lasts

When asked how practices can sustain engagement long term, Waters said it starts with relationships. “Some of the most successful organizations — from a cultural standpoint — have been ones where people really like to be around each other,” he said. “Encouraging those relationships and breaking it down to 'you’re not physician number 0021... you’re Dr. Smith. I know you’ve got three kids, and one of them plays soccer.'”

Stajduhar added that meaningful culture requires collaboration, not top-down directives. “If the key targets of building a program... are the physicians, it might be a good idea to actually ask them what they think,” he said. “Get them on part of your committee for retention, and they don’t have to be there for two years to be part of that.”

Both Stajduhar and Waters agreed that sustained engagement is an ongoing process of communication, listening, and connection — not just metrics and contracts. 

As Stajduhar put it, simply, “Keep trying. Don’t ever give up.”

Resources:

• Full Report: From Contract to Connection: How Authentic Relationships Foster Early Career Physician Loyalty and Retention
• Jackson Physician Search resources
• MGMA Insights podcasts