Case Study

7 minute read

How HIAE Used Mentorship to Retain Early-Tenure Physicians

Learn how one organization drives early success and retains new physicians with a mentorship program that helps them communicate effectively with patients.

Overview

The challenge

Newly graduated physicians were eager to work in the emergency department (ED) at HIAE (Hospital Israelita Albert Einstein). But many of them viewed the role as a short-term stepping-stone that would help them set up their own independent practices. As a result, few ED physicians went on to have careers within the HIAE system, with most leaving within five years. Poor retention was also tied to the limited “soft skill” development of early-tenure ED physicians, which hampered their ability to communicate effectively with patients and colleagues.

The organization

Hospital Israelita Albert Einstein is a multispecialty, private nonprofit hospital in São Paulo, Brazil, with Joint Commission International accreditation. It employs a workforce of 13,000 including over 1,300 physicians, of whom roughly 300 work within the emergency department (ED).

The approach

In 2017, HIAE developed a physician mentorship program for early-tenure physicians and piloted it within the ED before expanding it across the organization. The program supports new physicians within the first year of tenure and is based around monthly, one-hour meetings between mentor and mentee.

The result

The mentorship program has a 90-point Net Promoter Score from participants and has been rolled out to physicians across HIAE. Altogether, 152 physicians have passed through the mentorship program since 2017. Since the start of the program, turnover rates have fallen by 36% (from 25% to 16%). Similar mentorship programs are now being considered for non-physician clinical staff.


Approach

How HIAE structured its physician mentorshipprogram around a clearly defined set of goals

Hospital Israelita Albert Einstein’s physician mentorship program was designed to maximize the expertise of tenured mentors by focusing the program on career development and teaching “soft skills” like effective communication and teamwork best practices. Both mentors and mentees understand that this program was designed to facilitate meaningful discussion about personal growth, as opposed to discussing clinical skills or workplace logistics.

The four elements

The success of HIAE’s physician mentorship program came down to four main elements:

DNA Einstein Mindmap: HIAE’s online resource hub for physicians

HIAE created an online resource hub in the form of a learning map, a graphical organizer that provides a visual representation of how various concepts and resources are ‘mapped’ together. This learning map links to existing HIAE online resources, as well as webpages dedicated to the mentorship program. (For examples of how the learning map looks, see our supporting artifacts on p.13 of the PDF.) The goals of the learning map included:

  • To create a single, comprehensive repository of just-in-time resources related to employment questions and professional development resources.
  • To provide mentors with an easy, navigable resource they could easily refer mentees to without having to spend mentoring time on web searches.
  • To provide an online repository where mentors could log and submit session reports after each mentor-mentee discussion. The human resources department (HR) can track the number of reports and make sure the required 8 to 12 sessions are completed.

Mentees deeply appreciate the ease and accessibility of having all their online resources located in one place, especially given how many websites and portals most employees must navigate early in their career. But the most important use of the learning map is that it enables mentees to ‘self-service’ most knowledge-based questions about HIAE. As a result, mentor-mentee discussions can be focused on meaningful discussion about soft-skill development, career goals, and overall workplace engagement.

Examples of topics covered in the DNA Einstein Mindmap

  • HIAE organizational goals and strategic mission
  • Organizational compensation and benefits
  • Doctor career mapping, both in ED and overall system
  • Links to continuing professional education requirements
  • Learning and development offerings within HIAE
  • Resources to address clinical skill competencies and protocols
  • Resources to understand the patient experience at HIAE
  • Overview of the mentorship program guidelines and structure
  • Mentorship feedback portal for mentors to file session reports

For any organization attempting to create a physician mentorship program, a challenge is getting tenured physicians to find the time to act as mentors. At HIAE, the job descriptions of medical coordinators in the emergency department were changed to reflect the official expectation of providing mentorship and coaching to more junior colleagues. As a result, medical coordinators viewed participation in the mentorship program not as an additional, optional ask, but as a requisite part of their jobs.

Excerpt from HIAE Medical Coordinator Job Description (translated)

Job responsibilities

Responsibilities

  • “…that you will counsel and help train newer doctors…”
  • “…you will act as a resource and point of contact for new doctors.”

Secure physician buy-in by having executives set mentorship expectation

Prior to rollout of the mentorship program, the president/CEO of HIAE sent regular communications to senior physicians emphasizing the importance of the mentorship program. This reinforced the expectation that senior staff would actively participate as mentors. Additionally, at the end of the first round of the mentorship program, HIAE’s president/CEO recognized each mentor at a public ceremony. This form of recognition continues, with the CEO presiding over quarterly ceremonies for mentors and mentees. Former participants in the mentorship program may attend as well, helping to create a lasting community of program participants.

Lastly, a major part in securing buy-in to the mentorship program was that the overall time commitment would be manageable. Mentors are expected to devote roughly one hour a month during work hours to meet with their mentee over the first 8 to 12 months of tenure. The ideal goal is to meet for roughly 10 to 12 sessions, with 8 being the bare minimum for completion. The range was set up deliberately to build flexibility into the scheduling of the sessions and recognize that mentee and mentor physicians have busy, unpredictable schedules.

New mentors go through two training sessions to help them build their mentorship skills. The sessions are run by HR colleagues and former physician mentors, under a model called “mentors training mentors.” The classes focus on:

  • Knowing how to navigate mentorship tools and resources
  • Understanding the mentor-mentee contractual agreement and being able to explain its various provisions to mentees
  • Developing a personal mentorship style that enables mentors to speak about their own personal growth and past experiences

The training sessions cover both mentorship/coaching theory and personal testimonials and tips from former mentors. The testimonial part of the training is effective at teaching mentors how to navigate conflict, provide affirmation to early-tenure physicians, and approach mentorship sessions with vulnerability.

Additionally, mentors fill out a Myers-Briggs Type Indicator (MBTI) test and develop a personal profile. The goal of this exercise is to better understand how personality interplays with professional development. It helps to equip mentors with the self-awareness needed to navigate their mentor-mentee relationships.

Overall, the training sessions are designed to prepare mentors for several goals:

  • Understand how to share personal experiences of career challenges and development in a mentorship setting
  • Ensure that the mentorship session represents a conversation between mentor and mentee, rather than a presentation by the mentor
  • Provide mentors with an understanding of the most common difficulties that early-tenure physicians report facing and how mentors can help address them

The first mentorship session is scheduled when a newly hired physician finishes clinical onboarding. During this session, both parties sign a mentorship contract. There are several important components of the contract:

  • Confidentiality clause
    Both parties agree that all discussions during mentorship sessions will be entirely confidential and may not be divulged. Mentors and mentees are not allowed to serve in the same workstream, and the confidentiality clause is designed to reinforce a safe learning environment that will not impact performance evaluation for mentees.
  • Acknowledgement of program schedule
    The mentee and mentor acknowledge the mentorship program schedule of one hour each month for 8 to 12 months and agree to prioritize these sessions.
  • Mentorship guidelines agreement
    This agreement asks mentees to acknowledge mentorship guidelines, including the recognition that the focus of mentorship is on professional development and not behavioral health support.
  • Results of values assessment
    Each mentee is presented with a self-assessment of 20 professional values and chooses the three that most define them. These values are then shared with the mentor during the first session as a way of creating a “common language” around professional development.

Results

HIAE’s physician mentorship program has produced strong results directly tied to the value early-tenure physicians received from their participation in mentorship.

  • Mentees give overwhelmingly positive feedback on program: The physician mentorship program has a Net Promoter Score (NPS) of 90, meaning that a net 90% of participants valued the program positively.
  • Boost in physician retention: In 2017, the turnover rate for early-tenure physicians was 25%. By 2019, this figure had been reduced to 16%.
  • Pipeline for physician leaders: Across the four years of the program, 23 mentees have been promoted into leadership positions across the HIAE health system.
  • Continuous interest in development of the program: Since 2017, 42 physicians at HIAE have participated as mentors within the program. Notably, 16 mentees have transitioned into the role of mentor.
  • Strong impact on patient outcomes: Since the start of the mentorship program, the patient Net Promoter Score reported in the emergency department has increased from 63 to 71.
The mentor-mentee relationship has developed over time into an invisible support network, especially during the pandemic. My mentees and I have all moved into different positions across the system, but even now we still routinely reach out to one another for support and advice. In effect, our mentorship has transformed into partnership.
Dr. Fernando Ramos de Mattos, mentor of first cohort, 2017
Hospital Israelita Albert Einstein
164
Total number of mentees who haveparticipated in the program since 2017

Supporting artifacts

SPONSORED BY

INTENDED AUDIENCE

AFTER YOU READ THIS

1. You'll understand why mentorship is important for retaining early-tenure physicians.

2. You'll learn how to develop a successful physician mentorship program.

3. You'll be able to decrease turnover rates in your organization.

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