Onboarding: Achieving Long-term Success for the Practice and New Radiologistlong term success

The many years of education and training physicians undergo provides them with multiple transitions to new environments as learners and professionals.

In each new setting, there are new systems and expectations that must be learned to ensure success. In business, this process is known as onboarding, orientation, or organizational socialization and the importance of this process goes beyond just fitting in. Successful onboarding can reduce turnover and overall costs through improved recruitment; therefore it is imperative that organizations and individuals understand and optimize this process.

In radiology, graduating trainees must adjust to new roles in the workforce after over a decade in education. Employers must accurately define and convey the organizational culture, ensuring that new hires have values aligned with these goals and are properly supported in their time of transition. Experienced radiologists moving between practices must often discard some traditions from prior groups in order to successfully integrate into a new environment. Failure to successfully navigate the onboarding process results in dissatisfaction decreased productivity and is ultimately detrimental to both the practice and individual radiologist.

Getting it right

The term ‘onboarding’ is used to highlight the progressive immersion of new employees across 6 dimensions: politics, history, people, performance proficiency, language, goals and values. In this context, there are three important tasks to improve integration in the new physical, environmental, social and psychological organizational setting:

1. Promoting employee job satisfaction, organizational commitment and fulfillment
2. Aiding adjustment to the environment and new roles
3. Aligning the individual values and ideology with the organization.

Recognizing that over one-quarter of US workers experience a career transition each year and that over half of hourly and senior hires leave within 18 months, the Society for Human Resources Management (SHRM) emphasizes the 4C’s as a framework for onboarding efforts to allow new hires to successfully contribute to the organization’s mission faster: compliance, clarification, culture and connection. This is important because businesses stand to lose significant value significant value when new hires do not fully understand their jobs. Additionally, encouraging new hires to apply their personal strengths on the job and to become more connected colleagues leads to greater workplace engagement and reduces turnover.

Recruitment Applied to Radiology

New theories in onboarding expand on the previous formal training include informal coaching with an increased emphasis on mentorship. For example, at Google, new employees receive traditional lectures and access to online resources, however their mentor also assigns a “starter” project designed for quick completion, confidence-building, and personal investment. Others have found that a follow-up orientation based on the earlier six dimensions in the first months of employment improves both knowledge of the organization and employee commitment.

The radiology job market appears to be improving, albeit in the midst of the transition to value-based reimbursement and ever-changing external pressures. Deliberate recruitment and onboarding in a competitive market benefits both practices and individual radiologists. Recruitment practices that match skills, clinical preferences, personality and location and family considerations are essential considerations [8]. Sending paperwork and orientation materials prior to the first day improves employee understanding and reduces stressors. Developing comprehensive indicators of performance is essential to ensure success of new hires and should include all areas of practice, not simply relative value unit (RVU) measurements of clinical output.

Fostering interaction between new hires and existing members is key to integration, and one helpful method is to involve these employees in initiatives and teams to gain a sense of ownership and familiarity with the company and build social connections with coworkers. As part of the interview and recruitment process, graduating trainees and potential hires should evaluate practices on how well they address the challenges of organizational onboarding.


By Christopher Mutter, DO; Andrew Moriarity, MD

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