Healthcare organizations are trying to do two things at the same time. Hire more carefully and hire faster. The problem is that many hiring processes aren’t designed to do either one particularly well.
The healthcare labor market remains tight. Hospital employment was approximately 5.78 million in August 2026, and unemployment among people previously employed in hospitals was only 1.9%. For registered nurses alone, the Bureau of Labor Statistics projects roughly 180,800 openings annually, on average, through 2035.
Good candidates have options, and lots of them! They generally aren’t going to sit around indefinitely while an organization changes the job specification, adds another interview, gets another opinion, or waits three weeks to decide what to do next. There are more delays this year with recruiting processes than delayed flights at Denver International during a snowstorm!
Executive recruiting makes this even more complicated.
A hospital might technically have thousands of CNOs, CFOs, COOs or CEOs it could recruit nationally, but the actual candidate pool is much smaller.
The right candidate has to fit the size and complexity of the organization. They have to understand the ownership structure. Their experience needs to match the work that actually needs to be done. Compensation has to make sense. Geography also has to work.
Let’s not forget the personal considerations too. A spouse may have a career. Kids may be in school. There may be relocation issues or contractual obligations with a current employer. This is why the quality of the hiring process matters.
Speed doesn’t have to mean lowering the bar, but it can mean eliminating wasted time between decisions. One of the biggest opportunities is getting much clearer about the assignment before the search starts.
“We need a CNO” isn’t really a hiring specification.
“We need a CNO who can stabilize turnover, rebuild the nurse manager team, improve productivity, and prepare the hospital for accreditation” gives us something we can actually recruit against.
That clarity makes sourcing better and interviewing better. It also prevents one of the most common problems we see. I’m sure some of you may have experienced this personally:
- The CEO is looking for transformation.
- The board wants stability.
- Physicians want someone accessible.
- HR is focused on tenure and traditional qualifications.
Five interviews later, everyone likes the candidate, but nobody is evaluating the person against the same definition of success. That is an alignment problem.
Before a search starts, stakeholders should agree on three or four outcomes the new executive needs to deliver.
- What experience is absolutely required?
- What can the person learn?
- What leadership characteristics really matter in this organization?
- What would success look like 12 or 24 months from now?
Compensation needs the same level of clarity, as does relocation.
Organizations tend to avoid those discussions early because they don’t want to scare away candidates, only to be disappointed when their offer is not competitive or doesn’t meet the candidate’s needs.
In my experience, ambiguity wastes everyone’s time.
If a candidate learns late in the process that the compensation doesn’t work, relocation isn’t realistic or the travel expectation is very different from what they were told, you haven’t protected the candidate pool. You’ve just delayed the point when they leave the process.
Internal candidates deserve clarity too. Running a national external search doesn’t mean the internal person isn’t qualified. Sometimes the search gives the board or executive team a much better understanding of how its internal candidate compares with what is available in the market. The important part is evaluating everyone against the same criteria.
Candidate experience is another area where organizations can overcomplicate things.
Most senior executives don’t need a highly choreographed recruiting process. They want straight answers.
- Why is the job open?
- What is going well? And what isn’t?
- What does the CEO/board expect at 6mo, 1 yr deliverables?
- How are decisions actually made?
- Most importantly, does the person have the authority necessary to deliver what they are going to be held accountable for?
That becomes particularly important in health systems.
A candidate may think they are interviewing to run a hospital and later discover that many of the decisions they expected to own are made at the regional or corporate level. There is nothing inherently wrong with either model. The problem is discovering it after several interviews.
This is one of the areas where specialized executive recruiting can add real value.
Because we spend our time in acute care, we can identify many of these issues before a candidate enters the formal interview process.
We understand how different systems are structured. We know what candidates are likely to question. We can test compensation, geography, reporting relationships, and scope before everyone invests a lot of time.
Our process can protect both the candidate and the organization. The goal isn’t to rush an executive search. The goal is to spend less time interviewing people who were never realistically going to take the job and move with purpose when you find the person who will. Having a strong partner in the market who is constantly mapping talent can be how you deliver both quality and speed to fill.
