Bringing Healthcare Recruiting into the 21st Century

There is no industry that is more archaic in recruiting and talent management than healthcare. The approach, tools used, and overall degree of science found in many healthcare recruiting functions is more than just a little antiquated ó the practices hail from the Stone Age! This not-too-positive assessment is based upon years of observation and experience working with a number of healthcare organizations and professionals to improve the impact of recruiting and retention efforts. This is not to say that all healthcare organizations are awful at recruiting; those who have mastered 21st century recruiting approaches achieve phenomenal success. Unfortunately, the vast majority (90%) seem as dedicated to generating excuses for their shortcomings as the leading 10% is to making a difference. If you work in healthcare and you’re tired of “continual failure, here are some things to think about. Organizations That Excel While most talent management professionals in healthcare have dedicated hours to coming up with excuses why they can’t recruit and retain a sufficient quantity of high-quality staff, other firms have found a way to overcome macro-level obstacles. Some of the benchmark firms to evaluate include:

What the Worst Have In Common It generally takes significant time and an open mind to audit the typical recruiting function, but you can identify the major shortcomings with talent management in healthcare in less than an hour! Here are the most common weaknesses in healthcare talent management:

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  1. Afraid to poach. Hospitals routinely compete and “poach” patients away from other hospitals (particularly those seeking specialty procedures) without raising ethical issues, but for some reason poaching talent from competing facilities always raises the ethics flag. It’s a statistical fact that there is no shortage of talent in most major metropolitan regions for any particular facility, even if one is present on the macro level. It’s time to admit that the real reason why most shy away from poaching isn’t ethics, but rather the all-out war for talent that would emerge if the timid stopped being timid.

    Solution: Drop the conjured-up ethics excuse and make effective local poaching your number-one recruiting approach. Led by a courageous, well-trained recruiter, a poaching strategy can draw away poorly treated, high-caliber talent from local competitors without evoking World War III. A world-class employee referral program is the weapon of choice, followed closely by a managed employer brand.

  2. Doctors can be jerks. Too many healthcare organizations put doctors in management roles simply because they have the credentials required to actually carry out the organizations charter and often have more education under their belt. Unfortunately, most of these individuals are poorly trained in management and develop on the job into mini-dictators (with huge egos) who simply don’t know how to motivate, challenge, or excite others.

    Solution: Develop a bad manager identification program and then either fix or replace poor managers before they drive double-digit turnover. In addition, tie their pay to their performance as managers. (Note of caution: Do not expect management training programs to turn all bad managers around. Some just don’t have the interest or the mentality to be good managers.)

  3. A weak employer brand. Most healthcare organizations make only a minimal effort to build their brand as a good place to work. Without having an image of excellence, current employees see no real reason to stay and recruits see no differentiation between their current situation and that your organization can offer.

    Solution: Develop an effort to become a “talked about” organization. Do an inventory of your best management practices and people programs and utilize it to spread the word in local and industry publications. In addition, it’s essential to get on both local and national best-place-to-work lists to further enhance your image.

  4. Ineffective retention efforts. Few healthcare organizations have a retention function in spite of horrendous turnover rates. In addition, managers are rarely provided with easy-to-use retention tools or rewarded for excellence in retention.

    Solution: Benchmark the very best retention programs (both within and outside of healthcare) and then develop your own. It should identify “who” is at risk of leaving and develop a program to rapidly share internal best practices in the area of retention.

  5. Not quantifying the impacts of bad management. Managers at all levels fail to pay attention to recruiting and retention primarily because they underestimate the financial damage that underperformance in these two areas can cause.

    Solution: Work with the finance department to put a dollar impact on position vacancies, turnover, and the negative economic impact of putting “warm bodies” in key positions. Next, calculate the ROI of great recruiting and retention. Once managers see the dollar impact on their departments and their individual bonuses, they will come running for help in managing their talent more effectively.

  6. Embarrassingly weak recruiters. For some reason, the healthcare industry routinely allows “burnout” nurses and other healthcare professionals to become recruiters and HR professionals. Unfortunately, the same helping attributes that make them great healthcare workers make them horrible recruiters.

    Solution: Ban the practice of transferring healthcare professionals into recruiting and HR. Instead, seek out the most aggressive and successful recruiters with strong business acumen from other industries. Then reward your recruiters heavily for recruiting top-performing hires in mission-critical positions. One final step is to make recruiting and retention positions so glamorous that the individuals in them will not want to leave the field after a year or two in order to become HR generalists.

  7. Eliminate the focus on tactical metrics. Talent management is a science, not an art. Developing and maintaining excellence in recruiting and retention are impossible without the extensive use of metrics. Unfortunately, most of the people in healthcare HR have no degree in business, and they often hate metrics because they feel metrics depersonalize people.

    Solution: Integrate great metrics into everything you do in talent management. Utilize strategic metrics to identify what works and what doesn’t work. Make being a metrics fanatic an absolute requirement for anyone to be considered for hire or promotion within HR.

  8. A painfully weak referral program. Most employee referral programs in healthcare are so weak that they make meeting a target of over 50% referrals impossible.

    Solution: Benchmark the best practices in high-tech and utilize them to dramatically upgrade your referral program. Then drop all of the silly rules and administrative regulations that routinely kill referral programs. Measure and reward managers and departments for referring excellent candidates.

  9. Reactive hiring and retention. Starting the hiring process for key positions the day that a requisition opens up almost guarantees weaker candidates and a large number of position vacancies.

    Solution: Minimize the damage done by long position vacancies by beginning the recruiting process long before a position becomes vacant. Identify potential candidates prior to an open requisition and use the extra time to assess them and build long-term relationships with them. Have a strong candidate pool and talent pipeline for every mission-critical position.

  10. Weak to nonexistent strategic recruiting plans. Less than half of the healthcare recruiting departments I encounter have a recruiting plan that is actually used to make resource allocations in recruiting.

    Solution: There must be a clearly defined strategy for a recruiting department to be successful. The strategy must be written up and distributed to everyone within HR. Processes must be developed so that the recruiting department allocates its time and budget in line with the corporate goals.

Honorable Mentions The preceding items highlighted the very worst in healthcare recruiting and retention. There are some other practices that hamper recruiting and retention in healthcare that also deserve some attention. These other problematic recruiting practices include:

  • Focusing on “active” candidates rather than employed, top-performing passive candidates
  • Poorly designed and largely ineffective diversity recruiting programs
  • Nonexistent diversity retention efforts
  • Unbelievably ugly corporate “career” websites that fail to excite or fully inform potential candidates
  • Failing to measure the on-the-job performance or quality of hires
  • Failing to track source effectiveness and to ensure that dollars are spent where they have the most impact

Conclusion You might think that I have been overly harsh in describing the status of most recruiting and retention efforts in healthcare in this article. I find that those that feel that way generally have not taken the time to undergo a recruiting and retention audit in order to identify areas where they are painfully weak. One need only listen to the dozens of excuses and witness the huge number of vacancies and record-breaking turnover numbers in order to get a sense of how bad the state of affairs that most healthcare recruiting is in. I’m not optimistic that most departments will improve, because most people in the field actually believe that everyone has the same problems. This misconception can be rapidly over come by merely visiting the website or talking to the people at Baptist Healthcare System or other healthcare organizations that embody excellence in this industry. Can healthcare talent management be fixed? Unfortunately, the answers is “not easily” ó unless management has the courage to find the people in HR that are the root cause of the problem and take them out of the function.

Dr. John Sullivan, professor, author, corporate speaker, and advisor, is an internationally known HR thought-leader from the Silicon Valley who specializes in providing bold and high-business-impact talent management solutions.

He’s a prolific author with over 900 articles and 10 books covering all areas of talent management. He has written over a dozen white papers, conducted over 50 webinars, dozens of workshops, and he has been featured in over 35 videos. He is an engaging corporate speaker who has excited audiences at over 300 corporations/ organizations in 30 countries on all six continents. His ideas have appeared in every major business source including the Wall Street Journal, Fortune, BusinessWeek, Fast Company, CFO, Inc., NY Times, SmartMoney, USA Today, HBR, and the Financial Times. In addition, he writes for the WSJ Experts column. He has been interviewed on CNN and the CBS and ABC nightly news, NPR, as well many local TV and radio outlets. Fast Company called him the "Michael Jordan of Hiring," called him “the father of HR metrics,” and SHRM called him “One of the industry's most respected strategists." He was selected among HR’s “Top 10 Leading Thinkers” and he was ranked No. 8 among the top 25 online influencers in talent management. He served as the Chief Talent Officer of Agilent Technologies, the HP spinoff with 43,000 employees, and he was the CEO of the Business Development Center, a minority business consulting firm in Bakersfield, California. He is currently a Professor of Management at San Francisco State (1982 – present). His articles can be found all over the Internet and on his popular website and on He lives in Pacifica, California.



2 Comments on “Bringing Healthcare Recruiting into the 21st Century

  1. LOVE this article. Most of my searches are in the healthcare industry for providers. I have come across more than one internal recruiter that just doesn’t want to do the work to find the people in their own backyard. Thanks for the insight.

  2. This article describes quite well most of the things that healthcare facilities don’t do very well; thus the reason that the healthcare staffing agency model is so prolific out there. Docs, nurses, and healthcare administrators are in the nearly all-consuming business of caring for patients. This leaves very little time, money, or expertise to recruit. The third party payor system also creates a certain dynamic that affects everything that goes on including staffing. Recruiting becomes akin to driving a car at high speed with the emergency brake on.

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