Persistent workforce shortages, rising compensation pressure, and expanding virtual care have made healthcare recruiting harder to execute well. This article is written for healthcare executives, HR directors, and talent acquisition leaders who need to make practical hiring decisions — not just track trends.

The sections below address six areas where the gap between common practice and effective practice is widest: diagnosing why a search is stalling, measuring the right outcomes, screening for virtual care roles, choosing a recruiting arrangement, where AI supports recruiting and where it does not, and treating workforce planning as a continuous practice.

Diagnosing Why a Search Is Stalling

Not every difficult search has the same cause, and the response should match the diagnosis. Few qualified applicants may indicate limited supply, but compensation, scheduling, restrictive requirements, or ineffective sourcing can produce the same result. A position that attracts qualified applicants who decline offers or disengage during the process is a different problem — compensation, schedule, or role design — and treating it as a sourcing problem by widening geographic scope or increasing volume does not resolve it.

Supply constraints are real and documented. The Association of American Medical Colleges projects a physician shortage of up to 86,000 by 2036, with primary care and certain specialties facing the steepest gaps. The Health Resources and Services Administration's national workforce supply and demand projections (covering the 2023–2038 period) identify registered nurse shortages concentrated in specific states and care settings, though national aggregate figures mask significant regional and specialty-level variation.

Before concluding that a role is simply hard to fill, it is worth asking whether the compensation is benchmarked to current market data, whether the schedule or call structure is competitive for the specialty, and whether the role description accurately reflects what the position requires. A search that stalls after offers are extended is rarely a sourcing problem.

Measuring Outcomes That Inform Decisions

Application volume is easy to count and often the least useful number to track. A high volume of unqualified applicants consumes screening time without advancing a search. The metrics that support better decisions are further along the funnel: the ratio of qualified candidates reviewed to interviews scheduled, time from first interview to offer, offer acceptance rate, and whether the hired candidate is still in the role at 90 days and one year.

Tracking these outcomes over time makes it possible to identify where a process is breaking down. Consistent interview-to-offer delays often reflect internal scheduling or approval bottlenecks rather than candidate availability. Low offer acceptance rates in a specific specialty or geography may indicate a compensation or benefits gap that benchmarking can quantify. The Society for Human Resource Management publishes benchmarking data on time-to-fill and cost-per-hire that can provide a reference point.

For organizations managing multiple open roles, a simple tracking framework — qualified candidates in pipeline, days at each stage, offers extended, offers accepted — provides more decision-relevant information than aggregate application counts.

Screening for Virtual Care Roles

Telehealth utilization has stabilized at levels well above pre-pandemic baselines, and virtual care delivery now spans scheduled video visits, on-demand consultations, asynchronous care, remote patient monitoring, and virtual nursing. These are not interchangeable. A clinician with strong experience in scheduled video visits may not have the availability, workflow familiarity, or patient-population experience required for on-demand or remote monitoring roles.

Effective screening for telehealth and virtual care positions requires matching candidates against the specific delivery model, not virtual care generally. For clinical roles, that means verifying current state licenses against required patient locations — not just willingness to obtain additional licenses — and confirming availability against actual service hours and time zones. A candidate's preference for remote work does not establish that they can cover a required schedule.

Virtual care roles also vary by engagement structure. Some organizations staff these positions as employees; others use independent contractors. The search process and candidate pool differ depending on the arrangement, and the role description should reflect the actual structure from the outset.

Choosing a Recruiting Arrangement

Healthcare organizations typically engage recruiting firms under one of several models. Understanding what each generally involves — and what to clarify before signing — helps set appropriate expectations before a search begins.

Contingency search means the firm is paid only when a candidate they present is hired. There is no upfront fee. Contingency arrangements may be exclusive or non-exclusive depending on the agreement; non-exclusive arrangements allow the client to work with multiple firms simultaneously, while exclusive arrangements give one firm sole access for a defined period. This model is common for roles with a reasonably broad qualified candidate pool.

Retained search involves a fee paid in installments — often structured across engagement, candidate presentation, and placement — in exchange for a structured search process. The firm commits dedicated resources to the engagement. This model is common for senior, specialized, or confidential roles where a thorough market assessment and careful candidate evaluation are warranted. The SHRM guidance on selecting an executive search firm outlines the questions worth asking before engaging a retained partner.

Fixed-fee or flat-fee arrangements set a predetermined fee regardless of the placed candidate's compensation. This structure can overlap with either contingency or retained models depending on how the engagement is scoped. As with any arrangement, the scope of deliverables — market mapping, candidate assessment, reference verification — should be defined in writing before the search begins.

Recurring or volume-based arrangements are used by organizations with ongoing hiring needs across multiple roles or locations. The specific structure varies: some are subscription-based, some are project-based, and some involve a preferred-vendor relationship with negotiated terms. This model works best when the organization has sufficient hiring volume to justify the relationship and internal capacity to manage it actively.

A separate category worth distinguishing is locum tenens and temporary staffing, which places clinicians or other healthcare workers on a short-term or contract basis to cover coverage gaps. This is not a permanent recruiting arrangement — the primary purpose is coverage, not workforce building. That said, temporary assignments sometimes convert to permanent hires depending on the arrangement and the parties involved. Organizations that rely on temporary coverage for extended periods in the same roles should examine whether the underlying issue is compensation, scheduling, or role design.

For executive and senior leadership searches, the scope of the engagement should be defined in writing before the search begins, regardless of the fee structure.

Where AI Supports Recruiting and Where It Does Not

AI-assisted sourcing tools can surface candidates who match defined criteria across a broader set of sources than manual search alone. They are useful for expanding the initial candidate pool and reducing time spent on early-stage screening of clearly unqualified applicants. SHRM research on AI in the workplace documents efficiency gains in sourcing and screening, particularly for high-volume roles.

AI tools can assist with screening and assessment, but their output does not replace recruiter judgment or direct candidate conversations. Assessing whether a physician's practice style fits a specific group culture, whether a nursing leader has the change-management experience a turnaround situation requires, or whether a candidate's stated availability matches the actual demands of a role requires a recruiter who understands the position and has spoken with the candidate. Sourcing efficiency and candidate evaluation are separate functions, and conflating them leads to over-reliance on screening tools for decisions they are not designed to make.

For healthcare organizations building or reviewing their recruiting technology stack, the useful question is not whether to use AI but which parts of the process benefit from it and which require human judgment that the tools cannot replicate.

Workforce Planning as an Ongoing Practice

Healthcare workforce planning is most useful when it is treated as a continuous process rather than an annual exercise. Turnover in nursing, advanced practice, and allied health roles is high enough that organizations waiting for a vacancy to begin recruiting are already behind. Tracking current vacancy rates and time-to-fill by role type, identifying which roles have historically been difficult to fill and why, and maintaining relationships with sourcing partners before a critical need arises produces better outcomes than reactive hiring alone.

Practical workforce planning at the department or service-line level does not require sophisticated modeling to be useful. A simple tracking discipline applied consistently — open roles, days vacant, pipeline status, recent hire retention — provides more actionable information than a detailed annual plan that is not maintained between cycles.

For a closer look at how recruiting timelines affect workforce planning decisions, see the article on physician recruiting timelines. For organizations evaluating their overall healthcare recruitment strategy before sourcing begins, that framing is worth reviewing before engaging a search firm.

Summary

  • Diagnose whether a stalled search reflects supply scarcity or compensation, schedule, requirements, or sourcing problems — the response differs
  • Track qualified candidates, interview delays, offer acceptance, and post-hire retention rather than application volume alone
  • Screen virtual care candidates against the specific delivery model, current license coverage, actual availability, and engagement structure
  • Clarify the terms of any recruiting arrangement before engaging — contingency, retained, fixed-fee, and volume-based models vary in cost structure, exclusivity, and scope
  • Distinguish permanent recruiting arrangements from locum and temporary staffing, which address coverage gaps and may or may not convert to permanent hires
  • Use AI tools for sourcing efficiency; their output does not replace recruiter judgment or direct candidate conversations
  • Treat workforce planning as a continuous practice, not an annual event

AlediumHR provides healthcare recruiting services across specialties, including physician recruiting, nursing and clinical recruiting, and behavioral health recruiting. Organizations working through broader workforce strategy questions can learn more about our healthcare talent advisory services.