You Can’t Grow What You’re Losing

It started with another exit email.

“Effective immediately, Dr. Kwon will be leaving her position with our neurology team. We wish her the best in her future endeavors.”

I sat there staring at the message, barely surprised. That was the third physician departure in as many months. Dr. Kwon had only been with us for four. No warning. No announcement of her joining. No meaningful goodbye.

That was the problem. No one even noticed she had arrived, let alone left.

I’m a physician liaison at a mid-sized hospital system in the Midwest. It’s my job to make sure providers are connected, supported, and aware of the resources around them. But how can I do that when no one even introduces the new specialists to the right people?

I didn’t blame Dr. Kwon. If I had spent four months wandering an unfamiliar hospital without a support system, I’d leave too. I knew our physician onboarding process was lacking, but this was the moment I realized it wasn’t just inefficient—it was sabotaging our strategic growth.

A Missing Link

“I think HR handles that.” That was the answer I kept getting when I asked about the onboarding process.

We had hired nine new physicians in the last year. I could name two. We were so focused on recruitment that we treated onboarding like an afterthought. But if we didn’t set our new hires up for success, what were we even building?

Our Chief Strategy Officer shrugged when I brought it up in a hallway chat.

“We can’t babysit every new doc,” he said. “They’re professionals. They’ll figure it out.”

But they weren’t. And we were bleeding talent.

What really clicked for me was the conversation I had in the parking lot later that week. Dr. Ahmed, a new neurologist, was leaning against his car when I asked how things were going.

He gave me a tired smile. “Honestly? No one’s shown me where anything is. I don’t even know who I’m supposed to refer to for post-stroke rehab. So I’ve been sending patients to a private clinic I knew from my residency.”

My stomach dropped. Referral leakage—straight from day one.

And no one was tracking it.

Connecting the Dots

That night I sat on my couch with my laptop and pulled the last 12 months of data.

Referrals were dropping in the neuro and ortho departments. Our average time-to-productivity for new hires was pushing six months. And more than a third of new physicians had left before their first anniversary.

It was clear now: we weren’t failing at onboarding. We were failing at retention.

I built a one-pager for our next leadership meeting. At the top, I put a big red arrow: “You can’t grow what you’re losing.”

I walked them through the numbers. But more importantly, I told them what Dr. Ahmed had told me. That story landed harder than the graphs.

“This isn’t about babysitting,” I said. “This is about treating onboarding as a function of strategic growth for healthcare systems. We spend thousands recruiting talent we don’t retain. We’re losing referrals, relationships, and credibility.”

The room was quiet. Then the VP of Medical Affairs cleared his throat.

“What would it look like if we fixed it?”

Building Belonging

We didn’t reinvent the wheel. But we gave it a steering wheel and a map.

With support from the VP, I designed a pilot onboarding process for our next round of new hires. We paired each new physician with a mentor from a different department. We held small welcome breakfasts. We gave them a calendar with key contacts and expected referral patterns.

We also scheduled check-ins at 30, 60, and 90 days—not with HR, but with me or another liaison.

The goal was simple: build connection, build context.

Dr. Patel, one of our new cardiologists, told me at her 60-day check-in, “I actually feel like someone wants me here. That changes everything.”

And it did. Early referral activity increased. Our pilot hires reached productivity benchmarks three weeks sooner than the last cohort. And none had left.

Turning the Tide

By the time the fiscal year ended, we had data—and stories. Stories of physicians who didn’t leave. Stories of relationships that led to collaborative care instead of fractured handoffs.

Our leadership team approved funding to formalize the program across all locations.

I’ve learned that onboarding is not a paperwork process. It’s not about name tags or e-learning modules. It’s about creating a sense of welcome that translates into trust, productivity, and loyalty.

I still flinch when I see an unexpected exit email. But now, I know we’re building something stronger.

Something that grows.