Following these practical ideas for attracting and retaining providers is essential; the competitive landscape for provider talent has never been more challenging and is forecasted to remain that way for the foreseeable future
by Intelliworx
A recent survey of more than 700 doctors and advanced practice providers (APPs), such as nurse practitioners (NPs) and physician assistants (PAs), put a notable twist on provider compensation: it’s not all about money.
he survey found that while compensation is clearly an important factor in recruiting, there are a number of non-monetary factors that providers find persuasive. This finding isn’t an isolated example either. We’ve highlighted a wide range of credible statistics that suggest a career in medicine is still a calling.
This could well be an opportunity for rural healthcare. While healthcare is adding jobs faster than the economy, many rural facilities face financial pressures that strain their ability to match their urban peers. For many, it’s simply not financially viable to compete on compensation.
Even so, rural facilities are arguably better positioned to capitalize on factors such as autonomy, work-life balance and culture. Our research and unique view of the market suggest rural employers should lean into those non-compensation factors to attract and retain providers.
To that end, some actionable steps rural healthcare can take to attract providers besides compensation follow below.
1. Get your recruiting processes in good order
As the old saying goes, you never get a second chance to make a first impression. A survey we conducted of 107 U.S.-based healthcare providers found nearly half of providers (45%) will refuse a job offer if the recruiting process is disorganized.
Why? As one provider wrote in the comments, “Because [a] lack of organization from the beginning tells me a lot about the organization as a whole and what I could possibly getting into.”
The sample size in our survey is small; however, there are other data points that corroborate this finding. For example, in 2023, data from the Association for Advancing Physician and Provider Recruitment (AAPPR) found that despite open searches, vacancies went unfilled. More specifically, “47% of physician searches and 26% of APP searches were still open at the end of the year.”
More recently, a 2025 ProPublica investigation revealed similar challenges for the Veterans Administration. The report found, “40% of the doctors offered jobs at the VA from January through March of this year turned them down – quadruple the rate of rejections for the same period a year earlier.
Action step: Review and improve your recruiting processes from the perspective of the providers you are trying to attract.
2. Streamline onboarding and administrative burdens
Even after accepting an offer, the pressure remains to facilitate a smooth onboarding process. One study found as many as 4% of employees leave a job after the first day, and about 20% leave within 45 days when onboarding “goes poorly.”
More recently, Andrea Leland, MBA, CPRP, of Dartmouth Health, recounted examples of providers reneging on offers because credentialing took too long. That’s a business problem we aimed at addressing when we added credentialing to our healthcare recruiting platform.
The administrative burden extends well beyond onboarding, too. A separate survey of 211 U.S.-based healthcare providers we fielded found that 44% have considered leaving their position as a result of the claim denials.
More than 100 providers wrote open-ended comments about this question. Many pointed out that the second-guessing of their medical decisions is more than just extra work – it’s friction.
Action step: Implement periodic feedback mechanisms that surface the administrative burdens facing providers – and look for ways to reduce them. Feedback should be collected both quantitatively and qualitatively to ensure hot-button issues do not slip by unaddressed.
3. Bake schedule flexibility and work-life balance into your culture
Work-life balance ranks among the top factors by both physicians and APPs, especially younger clinicians. It may sound cliché, but even providers want to work to live, not live to work. Even the most caring provider needs a break sometimes.
Technology and modern life enable a range of options to address work-life balance:
- Limit office hours to 4 ten-hour workdays instead of 5 eight-hour days;
- Use telehealth and hybrid work options to improve flexibility;
- Grow a roster of qualified temporary staff to reduce the strain on full-time staff; and
- Develop systems – process and technology – to alleviate on-call pressure.
Action step: Flexibility has to be a bona fide leadership priority for this to seep into the culture. This may be an advantage for rural healthcare employers because the slower pace of life in rural areas naturally lends to work-life balance.
4. Support provider autonomy and clinical decision making
Provider frustration over payers denying claims is just one form of interference. Autonomy is important to both 1099 providers and seasoned full-time professionals alike. This includes NPs and PAs, who fill upwards of 25% of the primary care positions in rural areas – and it’s growing.
Some states have restrictive policies regarding treatments APPs can provide. Data indicate that states with less restrictive policies have an easier time filling open vacancies. Of course, this makes sense – no professional in any industry wants to feel micromanaged.
Action step: Lobbying to change such laws aside, healthcare employers must follow the laws and guidelines of their local jurisdiction. However, even those in the most restrictive states can consider APPs for business leadership positions. At a minimum, these clinicians should be asked for input when designing your in-house protocols and procedures.
5. Leverage perks with high perceived value
Aside from salary, many health organizations leverage lower-cost perks with high perceived value. Moving expenses, tuition reimbursement, signing bonuses, and modest expense accounts all fit into this category. Sometimes, just a little bit more money for out-of-pocket expenses can eliminate stress.
Moving homes to take a new job, for example, is incredibly disruptive. Helping an employee with it is a relatively low-cost way to solve what feels to an individual like a huge challenge. This is a straightforward business decision that builds employee loyalty from the first day. The benefits can be easily justified in a spreadsheet, such as lost billings that stem from a vacant provider position.
It doesn’t always have to be cash, either. Extra PTO days or career assistance for provider spouses can be very persuasive perks. Another creative idea is for an employer to help employees pool resources to lower the cost of childcare. Perhaps that means providing in-house daycare or using the collective buying power of employees to negotiate discounted childcare with a trusted partner organization.
Little things can go a long way as well. Simply putting some structure for regularly recognizing performance, or milestones, like birthdays and work anniversaries, can make a lasting impact. The most underused tool in a leader’s toolkit is a compliment, which doesn’t cost anything.
Action step: Talk to providers to learn what perks motivate them the most – and then design programs that put their feedback into action. Be sure to periodically check back and re-validate your conclusions as they change over time.
6. Segment recruiting and retention strategies by demographics
What providers want from healthcare employers evolves over time. This is logical because what’s important to a provider early in their career, when they are young and single, is certain to vary from a veteran provider who is married with children.
The cliff notes from the aforementioned survey of 700+ clinicians broadly break out segments this way:
- Younger physicians tend to value mentorship, career development and culture;
- Older physicians prioritize stability, autonomy and perks; and
- APPs desire flexibility, recognition, autonomy and respect.
Action step: Providers have more employment options than ever. Successful healthcare human resource leaders and recruiters will develop detailed recruiting and retention plans by demographic segment. Periodic re-evaluation of these plans must be continuous.
7. Identify provider turnover signals and proactively respond
One of the most counterintuitive findings from that same survey of 700+ providers was around job satisfaction. For example, 76% of providers surveyed said they were satisfied with their current position. Even so, more than one in four (28%) said they were still “considering looking for another position within the next two years.”
This is a puzzle to be solved – employers have all the pieces – they just need to organize those pieces in the right way to make sound conclusions. Common burnout signals include falling employee engagement or a pattern of calling in sick. Yet there’s often nuance that can only be coaxed out with interpersonal engagement.
Many employers conduct exit interviews to understand why an employee is leaving, but it’s too late to retain them. A better approach is to conduct “stay interviews” – structured interviews conducted at a regular cadence, which enables employers to get ahead of emerging issues.
Action step: Develop systems and processes to identify when providers may feel stuck, unappreciated, or unheard. Take care to listen for understanding, rather than listening to respond.
Action is required
None of these action steps is simple or easy. However, you don’t have to do it all at once. We suggest picking one or two of these options to start and then building on that success.
The competitive landscape for provider talent has never been more challenging – and it’s going to remain that way for the foreseeable future. Too much listening and no action will invariably fall flat. You’ve got to demonstrate you are acting on provider feedback in tangible ways.
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See the software for yourself! Healthcare Workforce Management is designed with rural healthcare recruiting in mind because in our assessment, rural areas have the greatest need. Contact us for a no-obligation demo.
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