Safely Practicing in a New Environment: A Qualitative Study to Inform Physician Onboarding Practices.

Area of Science:

• Medical Staffing
• Healthcare Administration
• Physician Professional Development

Background:

• Traveling physicians often face inconsistent onboarding processes at new institutions.
• Lack of structured onboarding hinders understanding of resources, care protocols, relationships, and institutional culture.
• Professional Service Agreements (PSAs) frequently involve physicians practicing at hospitals other than their primary affiliation.

Purpose of the Study:

• To investigate current physician onboarding practices for temporary or contract roles.
• To identify challenges faced by physicians transitioning to new hospital environments.
• To provide data for enhancing future onboarding protocols for visiting physicians.

Main Methods:

• Conducted semistructured, in-depth interviews with physicians working outside their home institutions.
• Performed a thematic qualitative analysis of interview data.
• Included 20 physicians across six medical specialties in the study sample.

Main Results:

• Basic care logistics are often omitted from onboarding, impeding physician efficiency and effectiveness.
• Interpersonal relationships are crucial for physicians seeking assistance in unfamiliar settings.
• Managing emergencies in new environments poses perceived patient safety risks due to care delays.

Conclusions:

• Significant opportunities exist to improve the onboarding process for physicians in new institutions.
• Future efforts should clarify institutional differences and provide essential information and professional connections.
• Ensuring physicians understand patient care boundaries in new settings is critical for safety and effectiveness.