When a physician signs a contract, in-house physician and provider recruiters may breathe a sigh of relief and shift their attention to one of the many other searches they are likely managing. However, a new study from Jackson Physician Search and the Medical Group Management Association (MGMA), “From Contract to Connection: How Authentic Relationships Foster Early-Career Loyalty and Retention,” reveals that this hands-off approach may be undermining long-term retention efforts. While 69% of administrators expect new physicians to stay six or more years, more than half (59%) of physician respondents reported leaving their first job within three years. 

The report explores the factors driving new physicians to leave their first jobs so soon (spoiler alert: compensation doesn’t top the list), and while the reasons are complex, some of the solutions are surprisingly simple. For example, the study reveals that the pre-boarding phase—the median 180 days between signing and starting—is one of the most influential periods for building a foundation of loyalty and engagement. So, rather than stepping back after the contract is signed, recruiters must step up to ensure the relationship continues to grow during this critical window. 

The in-house recruiter is uniquely positioned to serve as the consistent thread connecting all pre-boarding touchpoints. After all, recruiters have already established rapport during the search process. Candidates trust them. They know how to reach them. The relationship already exists; it simply needs to be intentionally sustained. Keep reading as we explore exactly what this looks like. 

Five Strategic Communication Practices for In-House Recruiters

The Jackson Physician Search and MGMA report identifies a “loyalty formula” centered on respect and communication, fair workload policies, and compensation with clarity. As the recruiter, you can model that formula during pre-boarding and ensure the new hire experiences it from day one.

1. The Day-After-Signing Touchpoint

Within 24 hours of contract signing, send a personal message that goes beyond congratulations. Acknowledge the significance of their decision, reaffirm why they’re a great fit, and outline what they can expect in terms of communication frequency and next steps. If you will not be their primary contact, let them know who they will be hearing from going forward and reinforce that you will remain accessible to them throughout the transition.

2. Establish a Predictable Cadence

The study found that regular check-ins—even brief ones—significantly improved physician preparedness and cultural alignment. In the report, 76% of physicians who received weekly communication rated their pre-boarding experience as “excellent” or “good” compared to 24% who received communication rarely. Those who received weekly or monthly communication reported feeling more prepared for the non-clinical aspects of the job. 

Create a communication calendar that includes weekly emails during the first month, transitioning to bi-weekly touchpoints. Schedule monthly phone or video calls to address questions and maintain a personal connection, and be sure to communicate key events, such as credentialing completion or the 30-day countdown to the start date. Consistency matters more than length. A five-minute call every two weeks builds more trust than a single hour-long conversation three months before the start date.

3. Be the Connector, Not Just the Communicator

More than two-thirds of physicians in the study said peer relationships were the most influential factor in their decision to stay. Recruiters can facilitate these early connections by arranging informal virtual coffee meetings with future colleagues, sharing team rosters with brief bios, coordinating pre-start shadow days or site visits, and creating opportunities for the new hire’s family to connect with other physician families in the community. Your role is to orchestrate these touchpoints, not necessarily to be present for each one. Follow up afterward to ensure they happened as planned and were a valuable use of time.

4. Proactively Address the Non-Clinical Concerns

New physicians are simultaneously navigating credentialing, licensing, relocation, and life transitions. They also may be making decisions about schools, housing, and spousal employment. While they may not ask for help with these matters, offering resources demonstrates that the organization understands and cares about them as people, not just providers. Create a resource package that includes moving company recommendations, school district information, spouse career resources, local physician testimonials, and answers to common logistical questions. Share this early in the pre-boarding process, then check in periodically to see if they need additional support.

5. Make the Administrative Process Human

Credentialing, IT setup, and compliance requirements are necessary but notoriously frustrating. Rather than simply forwarding emails from other departments, add context and empathy. Explain why each step matters, provide realistic timelines and who to contact with issues, acknowledge when processes are cumbersome, and check in when you know they’re waiting on approvals. Simple messages like “I know credentialing feels like a black hole—I checked in with the team and your application is moving along as expected” can prevent anxiety and demonstrate that someone is watching out for them.

The ROI of a Quality Pre-Boarding Program 

Pre-boarding isn’t just a “nice-to-have.” Research shows it’s a strong predictor of long-term engagement. Every interaction between signing and day one either builds trust or erodes it. Of course, recruiters are already juggling multiple responsibilities, and may not have the bandwidth to develop and manage a high-touch pre-boarding program. The data in the new report will help you make the case for investing time in this process. If you need to outsource less critical tasks or expand your capacity with a physician recruitment partner, the impact of pre-boarding on retention makes it a strategic imperative. 

When you show up consistently during pre-boarding, you 1) validate the candidate’s decision to choose your organization over others, 2) model the communication and respect they can expect from leadership, 3) surface and address concerns before they become reasons to reconsider, and 4) build a foundation of trust that will carry through into their first years. 

Consider developing a formal pre-boarding program that includes:

• A documented communication plan with specific touchpoints and responsible parties
• A welcome kit that arrives at the new hire’s home with branded items and practical resources
• A pre-boarding survey at 90 days to assess how the process is going and identify gaps
• Metrics to track communication frequency, new hire satisfaction, and early retention
• Continuous improvement based on feedback from physicians who’ve been through the process

The Bottom Line for In-House Recruiters

The recruitment process doesn’t end at contract signing—it extends through the entire pre-boarding period. In-house recruiters have both the skills and the relationships to ensure this critical window becomes a competitive advantage rather than a missed opportunity.

By maintaining consistent, personal, strategic communication during pre-boarding, you transform your role from talent finder to retention champion. You prove that the organization does what it says it will do. And you give every new physician a powerful reason to stay, long before they see their first patient. If we hope to lengthen the average tenure for early-career physicians, the 180-day investment in consistent pre-boarding communication isn’t optional—it’s essential.