Recruiting and retention challenges extend beyond providers: 74% of healthcare leaders polled said they have been approached with a new job offer recently; nearly half plan to leave in the next 12 months
by Intelliworx
Healthcare facilities are already facing an uphill battle in attracting and retaining providers. Now it seems that the challenge is extending to the leadership ranks in healthcare as well.
That’s according to a new survey by B.E. Smith Leadership Solutions, a subsidiary of AMN Healthcare. The survey polled 588 healthcare professionals in leadership roles and spelled out the findings in a report titled 2025 Healthcare Leadership Trends.
The survey found that while most (79%) are generally satisfied with their positions, nearly half (46%) of healthcare leaders surveyed plan to leave their current role in the next 12 months. Further, more than 6 in 10 respondents (65%) said they plan to leave in a 3–5-year window.
The opportunity to take that step seems to be readily available too. Nearly three-quarters of respondents (74%) indicated they have “received a recent credible approach about a new job.” Of those, nearly one in five (17%) said they pursued that new position.
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Financial worries at the core
Healthcare leaders have been dealing with a range of problems in recent years. One pressing challenge has been recruiting and retention among providers. A persistent shortage of talent combined with provider burnout has driven healthcare employers to boost provider compensation.
That alone has put pressure on margins, but some of the angst providers are feeling cuts two ways for leaders. For example, several other studies show growing tension between providers and payers over claim denials and prior authorization. Meanwhile, healthcare organizations already struggle to recoup the full reimbursement for every dollar they spend on providing care.
The daily struggle over claims adds cost, effort and strains cash flow. This complicates the role of leaders who strive to both keep their teams motivated and balance the financial books:
“Leaders worry that critical financial and operational challenges are not transitory. Rather, they appear ‘baked in’ and resistant to near-term improvement”.
The AMN report elaborates by citing several assessments from financial analysts:
- “Moody’s believes ‘the steep rise in healthcare wages over the last three years remains a structural problem and credit risk for the hospital industry.’”
- “Advisory Board echoes the term ‘structural’ to characterize labor conditions such as higher workloads and lingering burnout that cause persistent ‘slower throughput and reduced capacity.’”
- “Fitch refers to a ‘fundamental disconnect’ between revenue and expenses that may be ‘here for the long term.’”
Rural hospitals have been hit hard in particular. AMN cites data from the Center for Healthcare Quality and Payment Reform warning us that 700 rural hospitals are at risk of closing – including 300 at “immediate risk.”
Consequently, perhaps, the survey found that “financial pressure and constraints” (57%) and “workforce issues” (50%) are the top two “dominant disruptive forces in the coming 12-24 months.” We’d argue, philosophically, that those two forces aren’t mutually exclusive, but rather interrelated.
Culture and colleagues eat compensation for breakfast
There’s an old saying in business that culture eats strategy for breakfast. That also may be true for managing talent. Indeed, the report notes, “A cornerstone of retention management is understanding what most motivates leaders to stay.”
The top two factors that “influence” talent to remain at their current organization are “intertwined,” according to the survey. “Organizational culture” (44%) and “colleagues” (39%) earned the first and second spot on the list, respectively. Compensation, which has grown steadily in the years since the pandemic, ranked third on the list (38%).
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It’s important to note there was nuance around this answer, depending on the leadership level:
“Culture was the top factor for 52% of C-level respondents, while 41% of director-level leaders named compensation as the leading motivator.”
Even so, the evidence for focusing on culture is compelling and the survey is highly suggestive that leaders start there. AMN cites advice from the healthcare management consultancy, Sullivan Cotter, in laying out a vision for addressing the matter:
“Culture building should include on-the-ground encouragement of colleagueship as part of a broader emphasis on fostering ‘strong relationships among leaders, vendors, payers, and the entire organization,’ a network that is “essential for achieving successful outcomes.”
The sentiment, judging from some of the open-ended comments from respondents captured in the report suggests there’s ample room for improvement.
“Culture here doesn’t support someone with specific experience of transitioning to a new role even if they are willing to gain needed skills,” wrote one respondent. “Culture of leadership does not support growth, especially for Directors,” noted another. “Leadership plays favorites,” opined a third.
Providers echo the sentiment about rural employment
Our polls of providers, which often focused on what rural facilities can do to attract providers, echo a similar sentiment. When we’ve asked providers about the benefits of working in rural locations – compensation aside – culture is readily apparent. In other words, rural healthcare inherently has some attractive cultural factors.
The top 10 benefits of working in rural healthcare providers have identified in our polling include the following:
- 47% said the lower cost of living;
- 46% said more time with patients; and
- 45% said better work-life balance.
- 31% said slower pace of rural life;
- 23% said job security;
- 17% said greater sense of purpose;
- 15% said cross-training and professional development;
- 11% said good organizational culture;
- 10% said more autonomy to manage work; and
- 10% said leadership opportunities.
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To that end, the conundrum of recruiting and retaining providers has a common denominator with healthcare leaders. For its part, Mary Newell, vice president of Physician and Leadership Search for AMN Healthcare summed it up nicely in a press release announcing the AMN survey:
“Turnover among both healthcare executives and clinical professionals such as physicians, nurses, and others remains a key strategic challenge facing healthcare facilities. “Post pandemic, many healthcare professionals are reassessing where, when and how they work.”
The full report is freely available online here: 2025 Healthcare Leadership Trends.
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