Most practices treat retention as something that happens (or doesn't) years into someone's tenure. The truth is blunter: whether a clinician stays is largely decided in their first 90 days. Get the start right and you keep people for years. Get it wrong and you're re-advertising by spring.
The first 90 days do the heavy lifting
A new clinician forms their lasting impression of you almost immediately. A structured start signals that you're organised, that you invest, and that they made the right choice:
- A written first-90-days plan — what good looks like at week 1, month 1, month 3.
- A named buddy — someone who isn't their manager to ask the small questions.
- CPD mapped from day one — show the development path before they have to ask for it.
- Early, low-stakes wins — set them up to succeed in front of the team quickly.
The things that keep people (that aren't money)
- 1A protected diary — the single biggest driver of clinical burnout is a list that grew every quarter.
- 2Real supervision — not a box-tick, but genuine clinical support and development.
- 3Being heard — a manager who acts on what staff flag, not one who only appears when something's wrong.
- 4Fair, transparent progression — people stay where they can see a future.
Retention is recruitment
Every clinician you keep is one you don't have to replace at six-to-nine months of salary. The cheapest hire you'll ever make is the one you didn't lose. Onboarding and supervision aren't HR overhead — they're the highest-return spend in the practice.
Audit your own churn
If people leave within 18 months, the problem is usually onboarding or management, not pay. Ask your leavers honestly why they went — and look for the patterns you can actually fix before the next hire walks the same path.