Physician turnover: How mission statement gaps like “patient first” and rigid scheduling drive doctors away

Mission statements can read like promises, but physicians judge culture by what happens on a slammed clinic day. When leaders preach “patient first” while pushing volume targets, or talk about flexibility and team-based care without the staffing and schedules to match, the gap between rhetoric and reality can erode trust fast.

Scott Polenz, principal consultant of advisory services at CHG Healthcare, says those mixed messages are a common driver of physician turnover. He points to familiar slogans like “physician-led” that do not include doctors early in decisions and “we listen” surveys that never lead to follow-up or change as signals that the organization is not living what it claims.

Physicians Practice: Mission statements and day-to-day reality often diverge. What are common mission-versus-reality gaps that drive turnover?

Scott Polenz: One that always comes up is: “The patient first. The patient first.” But then a leader says, “You need to see 27 patients a day.” As the physician, how can you tell me to put the patient first if you want me to see 27 patients today?

Another one would be “physician-led.” What we recommend is more of a dyad model, partnering an administrative person like myself with a physician. Physicians want physician-to-physician communication. So if an organization says it’s physician-led, that means the physician should be at the table at step one of any change or decision.

Other cliches: “team-based care,” but you’re not going to give staff to do it. “Flexibility,” but scheduling is rigid. “We’ll give you flexibility,” but you can’t go see your kid play soccer at 3:30 without a bunch of people signing off.

And another one: “We listen.” You do a survey, but there’s no feedback, no follow-up, no change made, and you’ll never get a physician to fill out another survey again if nothing happens with it.