Onboarding is the first and best shot at physician alignment

A physician’s first days in a new practice can decide whether they lean in or quietly start looking for the exits. For practice managers, that makes onboarding more than a checklist. It is the earliest, clearest signal of what the organization truly values, how it communicates, and whether it will support clinicians in doing their best work.

Scott Polenz says that is why onboarding is the highest-leverage place to start when the goal is physician alignment. He argues that practices should build a consistent onboarding experience that sets expectations early, explains the “why” behind decisions, and creates psychological safety so physicians feel comfortable raising concerns and offering ideas.

Physicians Practice: From a practice manager’s perspective, where’s the highest-leverage place to start to build alignment: onboarding, scheduling, workflows, compensation, expectations, communication?

Scott Polenz: Onboarding is extraordinarily important. That first experience matters, and onboarding is mission critical.

We work with a lot of organizations, and one of my first projects at my last organization was: We want a consistent onboarding experience across our whole system of care. We don’t want docs going into one part of the organization and getting a different experience than another.

So it’s onboarding, setting expectations early and saying, “Here’s what we want out of you. Here are your expectations. Here’s how we’re going to support you.” You start to build psychological safety so physicians can communicate with you.

And the “why” matters. Often, health care organizations make decisions and they don’t talk about the why. They don’t share stories. People resonate with stories. They don’t resonate with data points on a PowerPoint slide. So explain the why, and keep communicating throughout onboarding and moving forward.