Medical practice leaders should not overlook the untapped power of internal career development. When implemented effectively, internal pathways boost retention and fuel employee engagement, cultural growth, and leadership continuity.
Ascension Medical Group Texas’ Tracy Schwartz, EDD, FACMPE, vice president of operations, and Robyn Hoffman, PT, MBA, director of operations, detailed how they translated leadership theory into daily practice during their session at the 2025 MGMA Summit.
“Development pathways and career development [are] not just for emerging leaders,” Schwartz said. “It is an important piece of the puzzle for all associates.”
Schwartz, who recently completed her doctorate focused on reducing voluntary turnover in healthcare, partnered with Hoffman to develop strategies tailored to the needs of their organization. Their approach integrates personal storytelling, structured planning, and practical tools, all designed to help nurture talent from within and build a more engaged, agile workforce.
The problem: Engagement without growth is a dead end
Even before the COVID-19 pandemic reshaped the workforce landscape, voluntary turnover in healthcare was steadily climbing. Many employees who stay are not necessarily committed to the organization — they’re often stuck.
“Members of great teams don’t want to be stuck in their current role forever,” Schwartz said. “They can be recognized, they can be told how awesome they are. But if there’s nowhere for them to grow and develop, they will seek opportunities elsewhere.”
Hiring well and offering frequent praise isn’t enough. People need to see a path forward.
“Career development allows associates to feel like individual contributors, rather than just replaceable commodities,” Schwartz added.
Experience, Exposure, Education
To build meaningful development pathways, Schwartz and Hoffman apply a triad approach they call the “three Es”:
- Experience: Hands-on work like stretch assignments, job rotations, and real-time problem solving.
- Exposure: Mentorship, coaching, networking, and participating in work groups.
- Education: Traditional degrees, certifications, e-learning, workshops, and on-the-job training.
The framework is intentionally accessible, recognizing that while not every employee aspires to be an executive, nearly everyone wants to grow.
“Working in healthcare leadership roles over the years, we have learned that employees are looking to grow, whether within their own role or in different roles in the organization,” Hoffman said. “What they need from us is guidance and expertise to assist with their career development.”
Job rotations and stretch assignments: Growth without departure
Among the most powerful yet underused development tools are job rotations and stretch assignments.
Job rotations allow employees to explore different functions without leaving the organization. For example, rotating a medical assistant between specialties helps them see how the same role adapts to varying care needs. “It’s a lot different being a medical assistant in a cardiology department versus a plastics department,” Hoffman noted.
Stretch assignments give employees the opportunity to lead something new without necessarily changing jobs.
“Stretch assignments can be used to build leadership capabilities, improve cross-functional collaboration and prepare professionals for greater responsibilities,” Hoffman said. These experiential pathways give employees confidence, broaden their skill sets, and reduce the need to job-hop for advancement.
Exposure: Coaching, shadowing, and the power of mentorship
Beyond doing, employees also need to see. Schwartz and Hoffman touted job shadowing and mentorship as core exposure strategies that help employees better understand potential advancement paths while fostering cross-team understanding.
For job shadowing to be effective, it should include active participation, not just passive observation, as they learn about different areas of the company, Hoffman said.
Mentorship, meanwhile can take many forms that can work, from traditional pairings to peer and even reverse mentorship.
“Mentoring can be one-on-one, can be in a group setting,” Hoffman said. “It can be peer to peer, and you can even have reverse mentoring, where a junior employee may teach a senior employee new skills such as technology or diversity awareness.”
These exposure strategies help normalize mobility within the organization and give employees a realistic understanding of the responsibilities and culture of other roles.
Education: Learning as a cultural expectation
At Ascension MG Texas, Schwartz and Hoffman’s have made formal and informal learning essential to the organization as a priority, not a perk. This includes tuition reimbursement, CEUs, online courses, and leadership programs.
“Online courses help you acquire new skills or deepen expertise in a specific field,” Hoffman said. “They are flexible and convenient, allowing you to learn at your own pace while balancing work and personal life.”
They also pointed to their organization’s Manager Development Series, which combines a structured curriculum with real-world application. In Schwartz’s dissertation research, teams led by managers who completed the series had 145% lower turnover compared to those who did not — a powerful sign that education can directly impact retention.
Individual development plans: Putting structure behind the vision
Too often, career development never advances beyond a performance review. This is why Schwartz and Hoffman recommend making individual development plans (IDPs) a standard part of the organizational toolkit.
The IDP is a collaborative, living document created by the employee and their leader. It asks practical questions:
- What parts of your job do you enjoy most?
- Where do you feel less skilled or confident?
- What skills or competencies do you want to develop?
The plan then defines specific goals, success metrics, and a timeline, all anchored in the three Es framework.
“You want the associate to focus on three to five goals,” Schwartz said. “Trying to hit eight goals in a career development plan may be a little ambitious.”
By co-owning the development process, leaders model partnership and trust.
“The leader’s goal is really to look for ways to say yes, as the associate is working to craft this plan,” Schwartz added.
Scaling growth: The career development passport
For larger organizations, managing hundreds of different IDPs can be overwhelming. That’s where the presenters’ “career development passport” comes in: A colorful, easy-to-follow template that streamlines the process.
The passport outlines 12 development activities tied to the three E model, such as facilitating a meeting, joining a workgroup, attending a course, or being a mentor.
The passport approach gave employees and leaders a quick way to engage in career development instead trying to have 200 IDP conversations, Schwartz said.
When completed, employees are recognized with a certificate, lunch celebration, and a voucher to take someone special to dinner.
As Schwartz said: “It’s a way for [everyone] … to know what opportunities are out there. What do we value? What do we think is a good use of their time to develop their skill sets?”
This gamified approach encourages wide participation and helps embed a scalable, self-directed development culture across the organization.
A redefinition of success
A crucial element in the success of this program? Leaders set the tone. Rather than being gatekeepers of opportunities, they become gardeners who cultivate potential. It means embracing failure, celebrating wins, and keeping development front and center — not saving it for yearly check-ins.
“Associates should be the driving force behind their development with support from the leader,” Schwartz said. “They should own setting up the meetings, creating their career development plan, giving them the onus to take this on.”
By embedding development into everyday culture, leaders don’t just fill jobs. They build futures and, in doing so, they strengthen organizations from within.
“When you invest in your associates and give them a path forward and develop their skill sets, they are more likely to stay in your organization,” Schwartz noted.
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