“Healthcare turnover is not just a staffing challenge; it’s a mirror reflecting the systemic pressures and unprecedented demands placed on our healthcare professionals,” says Brian White, CRO, Co-founder at DoorSpace.

The Startling Reality of New Hire Retention

The issue of turnover is further compounded when examining the retention rates of newly hired healthcare professionals. The same report indicates that a staggering 39.8% of all new hires leave their positions within a year. This high rate of attrition among new employees suggests significant challenges in the onboarding, integration, and satisfaction of healthcare workers in their new roles. The implications of such turnover are far-reaching, affecting not just the morale of the remaining staff but also the financial health of healthcare institutions, which must continually invest in recruiting, hiring, and training new employees.

The Brief Tenure of Healthcare Employees

Further exacerbating the turnover crisis is the finding that 58.7% of employees who left their positions had spent less than two years in their role. This short tenure indicates a deep-seated issue within the healthcare employment ecosystem, where professionals feel compelled to leave their positions prematurely, often due to burnout, lack of support, or better opportunities elsewhere. The brevity of employment spells trouble for healthcare organizations, leading to a cycle of perpetual recruitment and loss of institutional knowledge and experience, which are critical for delivering high-quality care.

Analyzing the Underlying Causes

The high turnover rates in healthcare are symptomatic of deeper, systemic problems within the industry. Factors such as emotional and physical burnout, inadequate staffing levels, lack of professional development opportunities, and unsatisfactory compensation and benefits have all been cited as contributing factors. Additionally, the COVID-19 pandemic has intensified these challenges, placing unprecedented stress on healthcare workers and further accelerating turnover rates.

The Impact on Healthcare Delivery

The consequences of high turnover in healthcare are manifold. Patients may experience decreased quality of care due to the constant changing of healthcare providers, which can lead to a lack of continuity in patient care and erode patient-provider trust. For healthcare organizations, the financial strain of addressing turnover, through both direct costs like recruitment and training and indirect costs such as decreased productivity and morale, can be substantial. The remaining staff often face increased workloads and pressure, potentially leading to further dissatisfaction and turnover.

“The unending cycle of staff turnover will inevitably send ripples throughout the healthcare sector, impacting patient care in numerous and complex ways. Our healthcare system needs an overhaul and needs to revolutionize their methods, amplify support for our healthcare workers, and pave the way for a future of stronger, more patient-focused care. We must address turnover head-on, ensuring our healthcare system thrives in the future,” says White.

The words of Brian White highlight a critical path forward that necessitates an overhaul of current practices and a revolutionary approach to supporting healthcare workers. It is imperative that healthcare organizations, policymakers, and the community at large come together to forge strategies that prioritize the well-being and retention of healthcare professionals. By doing so, we can pave the way for a more robust, efficient, and patient-focused healthcare system. This endeavor is not just about preventing the loss of valuable staff but about reinforcing the foundation of patient care and ensuring the long-term sustainability of the healthcare sector.

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Pain management is an incredibly important field; and Jordan Sudberg has been one of the field’s most pre-eminent specialists. Dr. Sudberg is the CEO and Medical Director of Spine & Sports Rehabilitation. He served as a research scientist at Harvard’s Massachusetts General Hospital in the tissue engineering department. Sudberg also served as a research scientist at Columbia University in the Department of Cardiology in the Exercise physiology lab, studying the effects of cardiovascular exercise.

During his extensive training, Dr. Sudberg developed a deep interest in Regenerative Medicine Techniques. He is certified and trained in ultrasound guided injections as well as in viscosupplementation. He is certified and trained in Nerve Conduction Studies at Columbia University Presbyterian Hospital in Nerve Conduction Studies. His specific areas of interest pertain to elite fitness, regenerative medicine and peak performance.

Sudberg and other medical professionals recognize the importance of members of the public receiving truthful information during public health crises. The COVID-19 pandemic has sadly accentuated the importance of combatting misinformation about matters of public health, in a way that has never happened before.

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One such savvy marketer plying his skills for the benefit of others is Arra G. Yerganian, Chief Marketing and Branding Officer at Sutter Health. I met Arra through The CMO Club (he won the Officers award) and not only was he kind enough to share his thoughts with me below, he even agreed to rerecord our podcast episode after the sound quality proved deficient (stay tuned for my “9 Ways to Screw Up a Podcast” post!). More importantly, Arra is leading a massive transformation in how Sutter Health not only markets itself but also how it delivers patient care.

Drew: Tell me about Sutter Health.

Arra: Sutter Health is a remarkable organization. We are an integrated team of clinical and non-clinical pioneers who are deeply rooted in our not for profit mission. And we really work together to change how you and I experience healthcare. In fact, through an independent study in the last few months, Truven Health Analytics (which is part of IBM) recently recognized Sutter as one of the highest performers (top five) amongst healthcare system in America. This study looked at things like saving more lives, having fewer complications, spending less per patient on episode of care, etc. This is truly an organization that’s unprecedented. We’re about $11 billion in revenue supported by 55,000 employees. I call them ‘members of our tribe’ and nearly 7,000 providers. These are people who develop the product and care every day that makes a difference in people’s lives.

Drew: Wow. So what does your role as CMO encompass?

Arra: Well, it’s a multitasking role for sure. I feel like I’m steering a big ship and I think for me it’s really about walking the brand promise. It’s about how we tell powerful stories and how we translate that into something that the consumer can really relate to. I often talk about this relationship that we have with the people we serve, not the “patient” and you need to understand the distinction. As healthcare’s going through the transformation in America, it’s not about putting the patient first. It’s about putting the person first. During every stage of being a patient you’re still a person. So it’s about leaning in. It’s about helping them understand you know them intellectually and emotionally and about the support and access we can provide. How we change the conversation around them and I think that’s our secret weapon for the healthcare system in Northern California.

Drew: Interesting. How does marketing fit into this vision?

Arra: For me, it’s about operationalizing the brand. It’s helping my fellow leaders understand that investing in marketing is an important endeavor, not just an expense. It’s changing the way the organization thinks about the brand. We’re helping the organization see that marketing can really add value. In fact, we can contribute to creative growth within this organization. I tell people we don’t necessarily need one more person to care for; we just need to take great care of the ones we have now. I call this the “love the ones you’re with” approach and it is a big differentiator for us since so many healthcare companies are just trying to acquire as many customers as they can.

Drew: How big is Sutter Health?

Arra: We are one of the largest healthcare systems in America and we’re really just in the Northern California footprint today. We service a geography of 12.5 million people and each of those three to three and a half million people that we care for every day are in the amazing care of our provider who truly go the extra mile and provide what I’m describing as intellectual and emotional support, going beyond the physical. It’s not just getting in to see the provider when you want to see them. That’s a given. To differentiate in a ‘sea of sameness’, it’s about that extra effort that we as an organization can deliver. We need to be the brand leaning in when others lean away. Remember, we care for people when they are at their most vulnerable. We have an awesome responsibility.

Drew: Let’s talk about a specific marketing initiative you’re particularly proud of.

Arra: I think this is somewhat unprecedented within the healthcare field; however, I had a vision when I arrived 16 months ago to create a brand management structure along lines of services like cardiology, oncology, women’s health, neuroscience, pediatrics, primary care, etc. This meant bringing professionals into the organization or nurturing those who were already here in marketing roles and focusing them all on these product lines and creating partnerships with clinical leaders who can help inform the content.

Drew: Sounds like P&G?

Arra: Exactly. These brand managers would build efficacy around their “products” and communicate the benefits to the mass market. I really wanted to understand what we do uniquely versus our competition. Where do we stand-alone as we service the consumers in our communities? With this new structure, we can get really specific and surgical. I call it ‘precision marketing’. You know there’s this movement called ‘precision medicine’ that’s become quite common. I think it really is about getting super targeted. I think about creating one to one relationships with three and a half million people and addressing topics that are of specific interest.

Drew: Makes sense. So how did precision marketing actually play out?

Arra: Well, for someone who’s suffering from coronary heart disease in a particular geography we can isolate by age and really dive in specifically to those individuals with a targeted message. Very, very different from the way most healthcare companies approach the challenge. I realized when I first arrived that lowest common denominator marketing is alive and well within the healthcare space. People talk about things like quality and expertise as if they’re differentiators. Seems to me that everyone expects when they go to a doctor to get quality care and that their doctor is an expert in their field, right?

Drew: Well, I certainly do.

Arra: Right, so let’s take it to a whole new level. When we talk about intellectual access it’s about being able to easily talk to the healthcare professional. Get clear information about things like pricing. Get the healthcare professional to lean in and not appear rushed. When I think about emotional access it’s treating the people that we work with like humans. Having our healthcare teams work together toward collaborative care so you are not being treated like a statistic–not being treated like a burden. These are the things that we as an organization are striving to do every day that really separate us.

Drew: Getting back to the brand management structure…

Arra: So when I implemented this brand management structure at this highest level we can, for example, sit with a cardiologist and ask him/her lots of questions: What really makes the work you do different and unique? What are the research breakthroughs? What’s helping you do better care for the people that we serve? By the way, we’re the second largest non-teaching research system in the country. This is a not for profit organization that truly understands the importance of giving back. Part of the way we give back is through this philanthropic effort of doing research in the community.

Drew: This must be a complicated branding challenge given the Sutter Health parent brand and now these service-specific sub-brands.

Arra: It’s actually even more complex because we were previously federated model with approximately 24 hospital CEOs, all managing in many respects, legacy brands that have somehow come together over the last 150 years under the Sutter Health umbrella. So in order to pay homage to those strong and uniquely positioned brands, particularly in our ‘out of home’ creative and even the via radio campaigns, we’ve put Sutter Health on center stage while paying homage to our affiliated brands, i.e., Palo Alto Medical Foundation, Alta Bates Summit, or Sutter Gould, for example; then we highlight the line of service, like cardiology, pediatrics, or urgent care before we do any discussion about the work that we do.

Drew: That is complicated. So how do you hold all of these communications together?

Arra: We created a very light-hearted campaign to start building familiarity in the marketplace and that’s called the “Smile Out” campaign. The whole idea is we choose somebody, for example, with a sinus condition and would say literally, “Sniffle in. Smile out.” Or for orthopedics, we say “Limp in. Smile Out.” When we talk about cardiology, we say, “Flutter in. Smile out.” Each of these is connected to a line of service, Sutter Health and our local, very community-based hospital systems. So yes, we have multiple challenges but it is very exciting that we can actually break through and create this connection across the multiple brands, the lines of service and the geography in which we are in.

Drew: How are you measuring and charting the success of your marketing initiatives?

Arra: We’re doing brand research in ways we’ve never done before. We’re also utilizing the amazing amounts of data that we already had more effectively. For example, we have the largest single installation of Epic, the hospital records management system, in the country. But all this wonderful data without insight, as you know, is useless. So effectively understanding, for example, that there’s a difference between awareness, familiarity and consideration is a big transformational idea in an organization that hasn’t really thought about marketing the way I describe. And incidentally, I’m the first Chief Marketing and Branding Officer this organization’s long and rich history.

Drew: Let’s dive into the research more. What kinds of things did you want to track?

Arra: Not surprisingly, our awareness is high and we are a trusted brand. We need to help consumers better understand what we really stand for; that which makes us uniquely different. 23.5 hours a day people don’t think about healthcare. So we want to make sure that the moment when you do have to think about your personal care or the care of a loved one, you think of Sutter Health…and it’s in the most positive light. That’s why making an emotional connectional is so important. I want them to feel confident, I want them to feel as if they’re in control and they own their own destiny. Because at the end of the day the brand strategy for me is to increase physical, intellectual and emotional access to healthcare so people can more confidently and independently engage with their health.

Drew: How did you persuade the folks internally to invest in this research?

Arra: So interestingly we’ve already made that investment. We have all the data, it’s really about peeling the onion back to understand how the data can inform the way we think about communicating with different segments of consumer. So, customer segmentation and segmentation research is absolutely at the forefront of our new strategy. Doing panel research, understanding really what makes people emotionally tick so that we can do the right thing when, for example, they’re giving birth. I love to tell people because I found this out really by accident. At Sutter Health; we give birth to three kindergarten classes a day! Funny enough, one of every three consumers that I meet throughout our Northern California footprint introduce themselves to me as either having given birth or having being born at a Sutter Hospital. That’s a meaningful statistic. In fact, we take care of one out of every 100 Americans, one out of every 4 Northern Californians. These are truly remarkable statistics. We have in our DNA the spirit of doing amazing things for people every day – we just need to bring those stories to light.

Drew: What’s your advice for your fellow marketers?

Arra: It’s funny — about a week ago I was at an even at the Avaya Stadium in San Jose, we’re a partner to the San Jose Earthquakes, a Major League Soccer team they serve the same 100 communities that we serve. And it happened to be Saturday so we brought our ambulances, helicopters, and providers and it was great opportunity to activate the brand with the 10,000 people in the stands and generate some good will.

So my six-year-old son, my youngest with three of his friends clamored into Sutter Health mobile clinic and within minutes, they tried out a stethoscope and other cool tools. They then switch their roles; first doctor then patient. I watch their intellectual curiosity, their flexibility, and their focus and realize that they could change the world if given the opportunity. If we look at the world through their lens, we could change the world. And in this period of rapid evolution requiring great curiosity, determination and adaptability, we have the opportunity to do so. So I encourage marketers to have the courage to think way outside the box. It’s okay to fail. I tell people all the time, “What would you do if you weren’t afraid?” I want them to really think differently; I think that’s paramount to success. Take some calculated risks; I think that’s super important.

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Healthcare in the U.S. is provided across a frighteningly broken and fragmented system of providers and institutions. As a result, the quality of American healthcare is consistently ranked among the worst in the developed world, and costs incurred per patient are 2-5 times higher than in comparable countries. Our problem isn’t that we’re incapable of providing high-quality care – in pockets throughout the country, we provide the most effective care in the world. Our problem is that for every five-star healthcare system we support, there are a dozen systems struggling to stay up-to-date.

Our healthcare system is broken because it’s fragmented. Information fails to flow freely, and best practices are treated as competitive, proprietary elements. In a healthcare culture that spends millions advertising “We’re #1,” it comes as no surprise that someone else has to be #2, #3, or even #50. This is entirely intentional. This situation is created by the restriction of information – and it can be salvaged, in turn, by improving information flow. This is where social media can pay big dividends.

The Value of Social Learning

If you ask physicians what they like best about the continuing education courses they take, they’ll tell you that they enjoy engaging with other doctors in the hallways; they love the interactivity of the sessions. If you followed those same physicians back to their workplaces and asked how they answer the questions that are raised over the course of a normal workday, they’d tell you that they consult with a colleague. What they won’t say, probably because they lack the perspective, is that the majority of learning that occurs over a medical career is social learning. My proposition is that social media applications, like Twitter, are the natural evolution of the social learning that takes place in hallways and lecture halls throughout the country. The added benefit is that social media can extend learning across time and space so questions can be posed, and answered, by broader audiences of healthcare professionals.

How Should Medical Practices Utilize Social Media?

Social media applications have three primary uses for physicians and healthcare systems. The first is the provision and coordination of patient care. Here the general, open applications like Facebook and Twitter should not be used, or should be used only in very narrow circumstances, because of issues pertaining to privacy and liability. There are new enterprise platforms being developed that add a social layer to the workflow of healthcare professionals to enable a collaborative care model. The second use is as a vehicle for engaging the public in a broad conversation about preventative health and disease management. Here the general, open applications like Facebook and Twitter are the perfect vehicle to disseminate new information about health and wellness. These channels also help the practice or institution promote itself across the community. The third use is as a vehicle for education and staff development. Here a combination of general, open applications and enterprise platforms ensure that information flows across the organization and that novel best practices and latest advances are integrated quickly and effectively into the organization as needed.

Of the three uses, it is the first that offers the greatest upside, but also the greatest challenge; the second may not have the greatest return for the effort. For this reason I advise organizations and healthcare professionals to embrace bucket #3 – to implement a model for effective learning and professional development through social media. This is a safe and relatively simple first step to extract the greatest value from the first and second buckets.

How Should Patients Use Social Media?

Patients’ perspectives on health are, understandably, very different from their doctors’. One of the first questions that patients ask themselves after being diagnosed is, “Am I alone?” Being a patient is frightening, and feeling isolated in your diagnosis makes the experience much, much worse.

Social media ensures that patients can find one another, they can offer support, and they can offer counsel. Facebook groups allow patients to support a cause. Hashtags and tweetchats on Twitter allow patients to share, to curate, and to engage in dialogue. Platforms like ACOR and CaringBridge allow for more in-depth conversations when Twitter character limits just won’t suffice. Importantly, patients may just want to lurk or they may want to remain anonymous in their plight or affliction, and many social media applications have been developed with that need in mind.

In closing, I offer a few words of caution: what you share online may never be truly protected. Data breaches happen, and information can live in “the cloud” forever. Regulations have been slow to protect health-related information that’s shared through social media channels. My advice is to be protective of your personal information, but to not be paralyzed – the benefits of supporting health and wellness through social media far outweigh the risks.

Brian S. McGowan, PhD, is a research scientist who has worked as a medical educator, mentor, accredited provider and commercial supporter. McGowan is author of the forthcoming fall 2012 release of #SOCIALQI: Simple Solutions for Improving Your Healthcare. Connect with Brian on Twitter: @BrianSMcGowan

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