The other problem is the absence of a clearly defined recruitment process, a host of hospitalist programs have failed to create a well-planned and choreographed recruitment process, leading to missed opportunities and/or a hiring mismatch (Simone, 2009). The other problem is hiring mismatch, many programs hire providers who do not fit in with the practice “culture.” There is a mismatch between vision, values, and objectives of the hospitalist program and the newly hired physician (Harris &. Hartman, 2001). This can translate to disruptive behaviors within the hospitalist practice, low morale, and can result in poor provider and program performance. The last problem and which is the focus of this study is the lack of a retention plan. Most programs have been successful in finding a good physician-practice fit but failed in support and integration of the new physician into the practice, hospital, and community. A poorly developed retention plan or the absence of one can lead to physician turnover (Mathis &. Jackson, 2010). Physician turnover can result in staff shortages, which may lead to program instability, such as being disruptive to the “chemistry” of a practice, provider job dissatisfaction, provider burnout, and subsequent poor clinical outcomes. Provider turnover can be quite costly to a hospital program, as numerous costs are associated with the replacement of providers (Simone, 2009). These costs include those associated with recruitment, such as sign-on bonuses, medical school loan repayment, relocation expenses, lost productivity for hospitalist and hospital staff during the recruitment process, headhunter fees, and revenues lost.