Turnover in your practice is more preventable, and more expensive, than your P&L makes it look.
The staffing panic of 2021 has passed… kind of. In MGMA’s May 2026 poll of 303 medical group leaders, 69% said turnover was about the same (39%) or lower (30%) than the year before. That is real progress, and it is also the trap: a “calmer” year is the best possible time to fix the systems that produce turnover, and the easiest time to convince yourself you don’t have to.
Because the pressure points haven’t moved. The same poll found churn concentrated where it always is: medical assistants, clinical support, and front-desk and administrative staff. Separately, 47% of practice leaders told MGMA that MAs are the single hardest role to recruit, nearly triple the figure for nurses.
And the cost is not a rounding error. SHRM’s widely cited range puts the price of replacing an employee at 50% to 200% of their annual salary. A University of North Carolina study measured a single medical-assistant departure at $14,200, roughly 40% of an MA’s salary at the time. Gallup estimates that 42% of voluntary turnover is preventable.
That last number is the one worth sitting with, because it means most of this spend is a choice.
Here is what the research says actually holds people, ordered by how quickly a practice can act on it.
1. Fix the first 90 days before you fix anything else
Roughly a third of new hires leave within three months, and only 12% of employees say their organization onboards well. SHRM-cited research found that structured onboarding makes an employee 69% more likely to still be there in three years. In a practice, this is rarely a training problem. It is a nobody-owns-it problem: the MA starts on a Monday, shadows whoever is free, and reverse-engineers the job.
Do this: Write one 30-60-90 plan for your highest-churn role. Name the person responsible for each check-in. That is the whole intervention.
2. Make recognition a cadence, not a personality trait
Gallup and Workhuman followed roughly 3,500 employees from 2022 to 2024, which makes it one of the few retention studies that watched what people actually did rather than what they said they might do. Well-recognized employees were 45% less likely to have left after two years, and employees whose recognition met four quality markers were 65% less likely to be job hunting. Yet only 22% of employees say they get the right amount of it.
Do this: Add a standing five-minute recognition item to your existing staff huddle. Specific contribution, named person, out loud.
3. Train the manager, because that is who people quit
Most turnover decisions are made about a supervisor rather than a salary. The uncomfortable backdrop is how little support those supervisors get: research cited in Enboarder’s 2025 HR leader report found 83% of managers have had no formal training in people management. In independent practices the office manager is usually a promoted top performer, handed a team and no playbook.
Do this: Pick one skill: running a one-on-one. Give managers a two-question template and hold them to it monthly.
4. Show people the next rung, especially at the front desk
MAs and front-office staff leave for hospitals and health systems offering clearer paths, not just better pay. MGMA’s 2026 polling found the practices holding turnover steady were the ones describing deliberate tactics: stay interviews, scheduling flexibility, cross-training, and advancement pathways, rather than a scramble to backfill.
Do this Monday: Run stay interviews with your three strongest at-risk staff. One question: what would make you leave, and what would make you stay?
5. Take the manual work off the people you want to keep
Retention conversations default to pay and culture and skip the actual content of the day. Front-desk and RCM staff spend hours on eligibility checks, claim status lookups, and payment posting that a well-engineered workflow handles without them. MGMA found practices holding turnover steady were centralizing tasks and retraining staff specifically to reduce burnout. Automation is not a cost play here, but it is what makes the job survivable.
Do this: List the five tasks your team most dreads. Ask which are repetitive enough to automate inside the system you already own.
None of these five require a bigger payroll. They require someone to own the system: the onboarding plan, the recognition cadence, the manager training, the career path, the automation. In most independent practices, that someone is already doing three other jobs.
How We Can Help
Orchard Medical Management has a seasoned professional team that can help your practice with needs from human resource to workflow automation. We can also guide you through employee management, from onboarding and offboarding to developing and maintaining talented and valued staff.
Learn more at orchardmedicalmgt.com
Sources: MGMA Stat, May 26, 2026 poll (303 respondents); MGMA Stat, May 6, 2025 poll; Gallup; SHRM; Gallup/Workhuman longitudinal study of ~3,500 employees, 2022-2024; University of North Carolina, financial cost of medical assistant turnover; Enboarder, Winning the First 90 Days HR Leader Survey, 2025.
