The Challenges of Healthcare Recruitment

Recruitment is an ever-changing process. Less than 20 years ago, when I first worked in recruitment, almost all advertising was in print media, and most résumés arrived via mail, with a few sent by fax. I even remember receiving a few handwritten résumés! We had file cabinets, not databases or applicant tracking systems. Today, recruitment happens in many different forms and by many different means. Recruitment and executive search firms, headhunters, and in-house recruitment/HR staff conduct research; advertise in print, online, and in other forms of media; troll the internet in new ways, such as by visiting social networking sites; attend job fairs and association conferences; build networks and partnerships; follow up on referrals; and even make cold calls and do direct mailings, competing for the right people to fill jobs.

The People Factor

For as everyone knows, recruitment is all about people – recruiters seek to find the best employees for their organizations, and the people problem is typically cited as the main challenge for staff in all types of recruitment settings. Looking online, it's easy to find articles voicing concern about the lack of qualified people to fill roles in high-demand/lower supply fields like nursing, pharmacy, and medicine. Helen Ziegler, president and owner of the international healthcare recruitment firm, Helen Ziegler & Associates, Inc., summarizes the problem: "The main challenges in healthcare recruitment are the acute shortages in most of the clinical areas; everyone is trying to recruit them, and as a recruiter, you have to move quickly and be able to make attractive and creative offers."

Jack Penaligon, a partner with Knightsbridge Executive Search, focuses on executive-level searches in healthcare, education, government, associations, charities, and foundations, and finds that while the challenges are still about people, the focus of the challenge differs based on the type of organization hiring. For example, he explains, with hospitals, "(T)he challenge is to find executives in healthcare who really understand what accountability is all about and who have a good vision, as this is so often missing. Boards want individuals who are operationally sound and who are strategically visionary. Ten years ago, they wanted individuals to be strategic leaders. In the last five years, they were looking for operational leaders. Currently, they want both."

Individual Issues

But it's not a simple or single issue, for individual locations and niche areas have their own problems. Consider organizations in smaller or rural settings. A 2007 segment on rural recruitment in the AHA's Hospitals & Health Networks magazine reported that rural America continually struggles to find enough doctors and nurses willing to work in relatively remote and isolated locations. They wrote, "While 19 percent of the nation's population – about 56 million people – live in rural areas, only 17 percent of the nation's physicians practice in those communities. The registered nurse workforce is somewhat better distributed, but shortages continue."

Ziegler's international recruitment firm, with its clients located in the Middle East, suffered a major downturn in applications from their American and Canadian applicant base in the period after 9/11. Additionally, they cope with issues of fluctuating currencies. For example, the currency of one of their client locations, Saudi Arabia, is tied to the US dollar, so it is stable. However, a few years ago when the Canadian dollar was weak compared to the US dollar, Canadian hires earned an added bonanza of thousands of dollars when converting the income into their home currency. This resulted in an upsurge in Canadian applications. Now that the Canadian dollar is almost at par with the US dollar, the windfall of a few years ago has disappeared.

Recruitment costs are another frequently cited challenge. In fall 2007, The Delta Companies conducted a survey at the Medical Group Management Association annual conference, which saw 73% of respondents reporting that 2007 physician recruitment has been more challenging than the previous year, and that in order to attract physicians, 70% of groups have needed to improve their offers from last year. Added to the financial impact of improved offers are higher costs for advertising online and in print, attending job fairs and conferences, interviewing (in the case of site visits or in-person rather than telephone interviews), technology (e.g., applicant tracking systems, website development), background checks, etc.

Other Challenges

But there are other challenges, as well. Rocky Hanak, RN, BSN, founder of Healthcare Recruitment Solutions, LLC, a search firm that specializes in the permanent placement of healthcare professionals, points to the intertwined challenge of new technology, new modes of searching, and funding. Hanak explains, "Most candidates aren't reading newspapers or magazine ads anymore. The candidates are seeking new opportunities online as passive job seekers. They like to remain anonymous until they find the right opportunity. They are seeking those opportunities in the 'off hours,' away from work, or even surfing while at work. Recruiters need to have an adequate budget to promote their organization or positions in enough online sites that they will be seen. They need to know key words for their ads, since candidates are doing key word searches. They need to have a good ATS to store the candidates in for positions available today and for positions that they may have available in the future so that with a single key stroke, they can access past candidates in the ATS for their current needs."

Solutions?

Since the problems are numerous, there's no one solution to them. Money is often touted as a solution to recruitment woes, and while it's important, both for staff compensation and the basic costs of recruitment and advertising, if money is the sole factor that is attracting a staff member, they won't stay long once they see that more money is offered elsewhere.

And the limited draw (and amount) of money is one reason why another recommendation is to listen to people to find what they really want. For example, June 2007's Hospitals & Health Networks magazine quotes a survey of 1,626 nursing students, which found that respondents believe that quality medical facilities are most important when they are considering job opportunities, followed by low nurse-to-patient ratios and favorable work hours/shifts. Pay rates ranked fourth on the list while the geographic location of the job ranked fifth.

Similarly, a 2007 survey of almost 14,000 employees in 23 countries, including the USA and Canada, by FDS International cited six factors in job satisfaction, of which money was on the bottom. The survey, entitled "What Workers Want: A Worldwide Study of Attitudes to Work and Work-Life Balance," found that the top factor for job satisfaction was "opportunities to do an interesting job," which was followed by recognition for your performance, work-life balance, prospects for advancement, job security, and finally, salary/pay.

A March/April 2008 article in Nursing Economic$ discusses the benefits to recruitment of promoting the "employment brand" of the workplace, which is defined as the positive or negative view of working at the organization conveyed by those who work there, and which, depending on the view, could attract or repel potential employees. As a result, the article explains, nurse leaders and human resources professionals must work together to sustain an open and positive work environment, in which employees feel connected to their organization.

Another tactic, whether recruiting for a smaller or larger center, is to "sell" things peripheral to the hospital. In the case of smaller communities, for example, the rural recruitment article talks about selling options such as the shorter commute times available in smaller cities/towns, the scenery, and/or the outdoor recreation opportunities. Different locations could sell factors like lower cost of living, excellent schools, availability of arts and/or sports venues, the uniqueness or adventure of the experience (such as with international recruitment), tax-free income (in the case of some international placements, such as in the Middle East), etc.

Back to the "simple" problem of lack of people in certain clinical areas – the unfortunate reality is that the shortages are unlikely to be solved any time soon. For example, it's not that people are not entering the nursing profession; programs are full, and schools regularly receive far more applicants than they have places to fill, with a December 2007 news release from the American Association of Colleges of Nursing reporting that enrollment in entry-level baccalaureate nursing programs increased by 4.98% from 2006 to 2007, and that more than 30,000 qualified applicants were turned away from these programs last year. Instead, it's a spate of problems: there aren't enough places in nursing programs (maybe it's time for everyone to lobby their elected representatives for more money for education programs); there aren't enough nursing professors; the nursing workforce is aging; the workforce is highly mobile; there are many opportunities beyond the area of greatest need, the bedside, so not everyone stays at the bedside.

But most recruiters will tell you something else: They love working with people, and they love the multiple challenges involved in recruiting them, so they're up for these challenges, and will always develop new strategies to serve both their organizations and their applicants.

Discuss This Article

Have something you'd like to say? Tell us what you think! Read and post comments for this article.

Find a Job

Choose your career:

MedHunters is the world's biggest healthcare job board. Our job directory has 17,372 jobs with 2,414 hospitals and other direct employers.

We want you to find your next job on MedHunters. Need Help? Call us at 1-888-884-8242, email us at info@medhunters.com or sign up now.