Some hidden costs of faculty turnover in clinical departments in one academic medical center

PURPOSE: To calculate the costs of clinical faculty turnover in clinical departments at The University of Arizona College of Medicine, including some aspects of lost clinical income. METHOD: Turnover was defined as the number of faculty in each department who left in any given year, divided by the total number of faculty with appointments in the department during the same year. Turnover rates for generalists, surgeons, and nonsurgical clinical faculty by rank were computed from 1999 through 2004 for all clinical departments at the University of Arizona College of Medicine. Associated recruitment costs, hiring costs, and selected lost clinical income costs-the net clinical practice income lost until the faculty member was replaced-were computed for the 17 clinical faculty members who left the departments of medicine and surgery during 2004. RESULTS: Turnover rates in the two clinical departments ranged from 4.9% to 8.3% per year for FY2000-FY2004. Turnover was highest among assistant professors and did not differ by gender. The recruitment, hiring, and lost clinical income cost of replacing a generalist was $115,554; for replacing a subspecialist, the cost was $286,503; and for a surgical subspecialist, the cost was $587,125. The average annual cost of turnover for the departments of medicine and surgery exceeded $400,000. CONCLUSIONS: Estimates of the financial impact of clinical faculty turnover need to include the costs of lost clinical income. The magnitude of these costs, although not inclusive of all the financial and nonfinancial costs from clinical faculty turnover at an academic medical center, warrants additional efforts to foster faculty success and retention.