Staff turnover in healthcare is costly — operationally and relationally. For concierge practices where patient relationships are central, losing a trusted team member disrupts the very continuity of care that defines the model.

In most small concierge practices, the physician is the culture. This is simultaneously an enormous advantage and a significant responsibility — one that most medical training never addresses and most physicians discover late, often when a valued team member is walking out the door.

Understanding that you are the primary shaper of your team’s experience — not just their employer — is the beginning of building a practice where excellent people want to stay.

The Stakes of Retention in Concierge Medicine

Staff turnover in healthcare is expensive and disruptive under any circumstances. In concierge medicine, the costs are compounded by the relational nature of the model. Patients do not just develop relationships with their physician — they develop relationships with the front desk coordinator who remembers their spouse’s name, the care manager who calls to follow up, the familiar voice on the phone. When those relationships are disrupted by turnover, patients feel it. And some leave because of it.

According to Press Ganey’s analysis of 2.2 million healthcare workers, one in five healthcare employees left their organization between 2022 and 2023, with even higher turnover among those with two years or less of tenure — one in four among that group. Press Ganey

According to Gallup’s 2024 State of the Global Workplace report, high levels of employee engagement are associated with a 51% drop in turnover, a 68% improvement in employee wellbeing, and a 23% increase in productivity. Lindauer

The inverse is also true: disengagement drives departure. And disengagement in a small practice often traces back to the physician’s leadership behavior — specifically, whether the team feels seen, valued, and part of something meaningful.

What Drives Retention in Small Practices

Compensation matters. But it is rarely the primary driver of retention among people who choose to work in a concierge practice setting. Those individuals — if they are the right hires — are motivated by purpose, relationships, and a sense that their work means something. The physician’s role is to make that meaning tangible and visible.

The number one driver of employee engagement in healthcare is feeling respected — and respect begets trust, and trust begets retention. Thriving workplaces are built by prioritizing trust, respect, teamwork, and inclusion — the building blocks of what researchers call social capital. Press Ganey

In practical terms, this means: knowing your staff’s names and something about their lives. Acknowledging good work specifically and publicly within the team. Creating clarity about what is expected and why. Involving the team in decisions that affect how the practice operates. Protecting their time and boundaries the way you ask them to protect yours.

The Physician as Cultural Model

In a practice of three to eight people, there is no organizational culture that exists independently of the physician’s behavior. If the physician is consistently rushed, dismissive under pressure, or communicates differently in good moods than in difficult ones, the team experiences that directly — and it shapes everything from their engagement to their willingness to go above and beyond for a patient.

This is not about being uniformly pleasant. It is about being consistently self-aware and intentional. High-performing leaders in small organizations are distinguished not by the absence of bad days but by how they handle them — and by the clarity and consistency of the standards they hold, including for themselves.

Building the Rituals of Culture

Culture is built and sustained through rituals — small, repeated practices that signal what is valued. A brief morning huddle that orients the team to the day’s priorities. A monthly practice conversation that invites the team to raise concerns and share ideas. A deliberate recognition of when someone goes above and beyond. An honest conversation when something isn’t working.

These are not complex. They require time — often less than people expect — and commitment. The return on that investment, measured in staff tenure, patient experience consistency, and physician peace of mind, is substantial.

The Concierge Medicine Forum addresses physician leadership development as a core element of practice sustainability — because a physician who leads well builds a team that stays, and a team that stays builds the practice that thrives. Learn more at conciergemedicinetoday.org.

Disclaimer: This article is for educational and informational purposes only and does not constitute medical, legal, financial, or accounting advice.