Healthy Outlook

Why Do Employees Leave?

There Are Many Reasons That Go Well Beyond Salary and Benefits

By John Veit

The labor market in Western Mass. is challenging. We have demand for many highly skilled positions, but don’t draw candidates like larger metropolitan markets.

As a result, many organizations — healthcare practices especially — see higher rates of turnover and have trouble filling labor gaps. Beyond a semi-limited labor pool in our market, however, there are many reasons why turnover happens that are within the realm of shareholders’ scope of influence.

A recent study by Gallup, “State of the American Workplace,” highlighted many of the reasons employees leave their jobs. You might be surprised that money typically isn’t the primary driver. This article will discuss some of the primary reasons for turnover (and low employee morale) identified in the report and potential considerations for curbing or eliminating these issues within your practice.

Job Fit

Job fit is a concept that refers to how well an employee is suited and prepared for their position. Job fit is inclusive of not just technical skills, but personality fit and aptitude to function well within the role, the team, and the environment.

When employees consider employment with another practice, the number-one consideration they make when determining if they should switch is whether the next opportunity will offer them the ability to “do what they do best.” In other words, they feel their personal and professional skillset could be better utilized and more highly valued with another organization.

To clarify, while job fit may not be the thing that makes employees decide to look for employment elsewhere in the first place, it is the number-one consideration when making their final decision to accept a new offer.

Addressing job fit begins with understanding team members, both from a personality and organizational fit perspective as well as from a technical-skillset and aptitude perspective. Consider before making a hiring decision whether that person is suited for a particular role.

For example, if a candidate will be responsible for medical billing or customer service, knowing whether they have an aptitude for client service or keen attention to detail before hiring will go a long way in establishing job fit. Employees who are a mismatch for the role can often struggle or become bored or outright disengaged. Personality-profile assessments can be helpful in this regard. Further, consider whether your employee-evaluation process gives employees opportunities to speak up when they feel they would like to change roles within your practice. People grow and change in their career, and providing opportunities for an employee’s roles and responsibilities to change is a helpful strategy in reducing turnover.

Career-growth Opportunities

Opportunities for career growth within an organization can often be problematic, as there are only so many positional promotions that are possible before a staffing model becomes unbalanced.

At the end of the day, if you need 20 nurses and only two or three supervisors, it’s difficult from an organizational-structure perspective to offer everyone an opportunity to become a supervisor. That said, career growth is not limited to positional or title changes, and can include professional development, coaching, leadership training, and increased responsibility.

Addressing this issue begins with ensuring that the employee understands their progress and job performance, their supervisor’s perspective on their quality of work, and how their role is helping them develop in their career.

This begins with a thorough evaluation process and well-trained supervisors. The evaluation process should be a frequent and communicative experience for the employee. It should help them understand their progress and how they can improve while recognizing the good work they do.

More importantly, their supervisors should be trained in the evaluation process and understand how to develop employees. If supervisors do not feel empowered to develop staff, direct-report relationships can often become transactional and may mitigate an employee’s real or perceived growth within their role.

Additionally, motivated and engaged employees often strive to learn more. In technical fields, it can be easy to limit the focus of an employee’s training and development to the scope of their role. However, introducing programs such as leadership training, project management, or even self-directed technical education can improve the engagement of employees and increase the breadth and depth of knowledge across your entire staff.

For example, a medical receptionist’s role might be inclusive of answering phones, scheduling patients, verifying medical insurance, and working with electronic medical records. However, beyond the scope of that role, how might this employee develop further?

Could they participate in extensive client service and communication training? Could they learn a second language through a practice-sponsored self-study course that might suit your patient base? Might they receive training regarding the advance use of certain software packages? While these things might not be essential for the role, growth-oriented employees will find them a rewarding part of their career growth. An effective supervisor could help them understand that growth and development and how it could help lead to future opportunities.

Management Issues

As already mentioned, having an ineffective manager or a supervisor whom an employee does not feel supports them, encourages their career growth, or helps them develop can be another major reason for turnover. Often, supervisors are promoted from within the ranks of staff-level employees. They are usually individuals who excelled at the core job, so it is assumed that their expertise and experience will make them good managers.

However, management and the technical work of the position which they will be managing are often two very different things. Identifying excellent leaders can be difficult, and often requires more than ‘they are really good at their job.’ Qualities such as active listening, emotional intelligence, and an ability to manage priorities and projects, to name a few, often go a long way in identifying effective managers.

Identifying and addressing poor management can be extremely challenging. When employees are unhappy with their manager, they will often remain quiet as they don’t want to be seen as a complainer. When they do speak up, their options are often limited. Going around their direct supervisor can be seen as inappropriate, and senior executives within an organization don’t always have the perspective to respond to concerns effectively.

Consider instead a 360-evaluation process, where managers are evaluated not just by their direct supervisors, but also by their direct reports and peers. This gives a manager information they need to continue to develop in that capacity, but also offers their employee base an opportunity to feel heard and work collaboratively with their manager to build a better team.

Further, providing training opportunities to managers on how to be an effective coach, how to productively hold employees accountable, and how to manage projects can be very effective facets in building an effective supervisory team.

Pay and Benefits

Pay and benefits are, collectively, the reason for employee turnover that people think of the most. And while it’s true that increased compensation can be a compelling reason to change jobs (or stay), there are many factors that an employee will consider (including those listed above) before they make their final decision.

Due to the competitive labor pool in Western Mass., candidates can and do ‘price shop’ with their employers. However, battling dollar for dollar on compensation isn’t always a battle you can win, nor is it the most financially advantageous method for improving retention rates. Gallup reports that, while compensation is a factor, other financial and benefit incentives are also extremely important.

Some options, such as commuting remotely, aren’t a practical solution for a healthcare practice in many situations. However, other benefits, such as flex time, do offer an opportunity to provide value to your employees without increasing compensation. In fact, Gallup reported that 51% of employees would change jobs to get flex time.

Additionally, there is a paradigm shift in the benefits expectations of Millennial professionals versus Gen X and Baby Boomers. Millennials are more family-conscious and want perks that have a direct impact on their personal lives. They will seek opportunities that provide a better work-life balance and an opportunity to raise a family as well as continue their education or ease the burden of student loans. Paid maternity and paternity leave as well as childcare reimbursement are all reasons why Millennials would change jobs. Tuition reimbursement is another valued perk.

Company Culture

Lastly, company culture can have a tremendous impact on the retention rates of employees.

An organization’s ability to provide an engaging corporate culture where employees feel appreciated, valued, and empowered to contribute to a corporate mission which they believe in drives employee engagement, and therefore retention, considerably. Evaluating corporate culture and employee engagement can be difficult, however, and driving organizational change is a long process.

One first step is surveying your entire staff with an employee-engagement benchmark survey. The website has a free employee-engagement evaluation survey that is thorough and allows for industry benchmarking, including healthcare. v

John Veit is the director of Recruiting and Marketing at the Holyoke-based public accounting firm Meyers Brothers Kalicka, P.C. He offers strategic outsourced recruiting services and consulting to a variety of industries; (413) 992-9910;