Recruitment Is Leadership Work… And It Starts Before the Job Is Posted

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In healthcare, we spend a lot of time talking about growth, new service lines, expanding access, building programs that serve our communities.

Leaders will spend months and sometimes years  planning these initiatives. There are strategy sessions, financial models, board discussions, and detailed operational plans.

Yet, one of the most important pieces of that success usually gets brought in way too late:

Recruitment.

Not as strategy.
Not as leadership.
But as a task.

In today’s environment that approach just doesn’t work anymore.

Let’s Be Honest. Recruitment Has Changed

There was a time when recruitment was pretty straightforward.

A position opened.
A job was posted.
Candidates applied.
You filled the role.

That’s not the world we’re in anymore.

Today, we’re dealing with a physician shortage that isn’t theoretical. It’s something every leader, recruiter, and clinician is feeling every single day. Fewer candidates. Longer searches. More burnout. More pressure on the teams that are already there. What that really means is this: the margin for error is gone.

You don’t get ten great candidates anymore. You might get one. And if that one doesn’t align, or your process isn’t strong, or your offer isn’t competitive, you don’t just lose a candidate, you lose time. And in healthcare, time is access, revenue, and patient care.

So, recruitment can’t be reactive anymore. It has to be intentional. It has to be strategic. Most importantly, it has to be led.

Why This Is a Leadership Issue (Not Just a Recruiting One)

Every healthcare leader knows this: Physicians are the engine.

No physicians means:

  • No clinic access
  • No OR volume
  • No downstream revenue
  • No continuity for patients

But here’s where the disconnect happens. The function responsible for building and sustaining that engine, which is recruitment, is still often treated like it sits on the sidelines.

Something to “hand off.”
Something to “execute.”
Something to “report back on.”

The truth is pretty simple:

If physicians drive the system, recruitment determines whether the system even exists. That’s not an HR task. That’s leadership work.

Because recruitment impacts everything:

  • Growth strategy
  • Financial performance
  • Physician engagement
  • Team stability
  • Community trust

When recruitment struggles, it doesn’t stay contained. It ripples across the entire organization.

Where Things Start to Break Down

One of the biggest mistakes I see (over and over again) is when recruitment gets involved.

A new service line gets approved. The business plan is built. The financials are modeled. Then, at the very end, someone asks: “Can we find the physician?”

By that point, a lot of decisions are already locked in, without real input from the market or from the people who actually talk to physicians every day.

That’s when problems show up:

  • Compensation doesn’t match the market
  • Call expectations aren’t sustainable
  • Productivity assumptions aren’t realistic
  • Infrastructure isn’t fully ready
  • Timelines start slipping

And now you’re not just recruiting. You’re redesigning, while trying to hire and while trying to meet operational expectations. Usually under pressure and usually at a much higher cost.

What could have been built right from the beginning now has to be reworked in real time and candidates can feel that.

What the Best Organizations Do Differently

The organizations that are getting this right aren’t doing anything flashy. They’re just bringing the right people into the conversation earlier.

Recruitment is sitting at the table with:

  • Executive leadership
  • Finance
  • Operations
  • Physician leaders

Not to “fill a job,” but to help shape the opportunity itself.

Because recruiters bring something incredibly valuable to the table: real-time market intelligence.

They understand:

  • What candidates are actually asking for
  • What’s competitive (and what’s not)
  • What call models work in the real world
  • What geographic challenges exist
  • What will actually convert vs. what just looks good on paper

That insight matters more than ever.

When it’s used upfront, everything changes:

  • Roles are designed with the market in mind
  • Expectations are realistic
  • Offers are competitive
  • Timelines are achievable

And recruitment actually works the way it’s supposed to.

That’s not support. That’s a strategic advantage.

Here’s the Part Most People Miss

Recruitment isn’t just about bringing someone into your organization. It’s how your organization shows up to them.

Every interaction sends a message:

  • How quickly you respond
  • How aligned your team is
  • How clearly you communicate
  • How decisions get made
  • How much you value their time

Before a physician ever signs a contract, they’ve already formed an opinion about your leadership. In today’s market,  that matters more than ever. Because candidates aren’t just choosing a job anymore.

They’re choosing:

  • A team
  • A culture
  • A way of life
  • A leadership experience

Your recruitment process is giving them a preview of all of it. If the process feels disorganized, slow, or unclear, they assume the organization is too. If it feels aligned, responsive, and intentional, they lean in.

That’s leadership on display… whether you realize it or not.

From “Filling Roles” to Designing Them

The organizations that are winning right now aren’t necessarily the ones with the biggest budgets.

They’re the ones who:

  • Design roles intentionally
  • Align internally before going to market
  • Build sustainable call and workflow models
  • Focus on candidate experience
  • Move with clarity and purpose

They don’t treat recruitment as the last step. They treat it as part of the design. Because at the end of the day, you’re not just recruiting a physician. You’re designing the environment they’re choosing to walk into. And physicians today are paying very close attention to that environment.

A Simple Shift for Leaders

If I could encourage one shift, it would be this – Stop asking recruitment to fix problems that were created before they were ever involved.

Instead:

  • Bring them into strategy conversations early
  • Use their insight to shape the role
  • Get aligned as a leadership team first
  • Treat recruitment as a shared responsibility

Because when you do that, you start to see real impact:

  • Faster hiring
  • Better candidate alignment
  • Stronger retention
  • More stable service lines
  • Better access for your community

And ultimately you build something that lasts.

Final Thought

Healthcare is built on people. Behind every successful program, every thriving service line, every community that has access to care. There’s one common thread. Someone made recruitment a leadership priority.

The question is… will you?

Tammy D. Hager, MBA, FABC, CRPR

Tammy HagerTammy Hager has more than 25 years of healthcare experience and has worked in a variety of multi-specialty physician practices, hospital-based clinics/departments and health systems. She has a successful track record in practice operations and building operational and recruitment teams, processes, and technology.

Tammy earned an MBA from Liberty University with an emphasis in healthcare management. Additionally, she is a Fellow with the Advisory Board Company, a Fellow with the Association for Advancing Physician and Provider Recruitment, and certified by the American Academy of Medical Management.

Tammy, now serving as COO for Urology Locums, lead operations and clinician recruitment at Signify Health as the VP of Network Management; she was the Executive Director at Surgical Affiliates Management Group (SAMGI); the Executive Director for Mercy Health, based out of St. Louis, MO; and prior to that lead physician clinics and hospital operations as Executive Director for Carilion Clinic, based in Roanoke, VA. In addition, she served as Executive Director at PracticeLink, the largest physician and provider job board and magazine company.