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The Employment Quandary

Will the industry continue to bank on experienced healthcare professionals over new grads?

The workforce shortage, an underperforming economy, changing laws and a host of other factors come into play when filling an open position. But the biggest question facing nearly every healthcare organization is: Should we hire a green employee or one with experience?

While the demand for experienced workers continues across the industry, many organizations are recognizing the value of new graduates and are shifting gears to implement training programs.

"As healthcare continues to transform, organizations are re-making themselves, which requires hiring new talent," said James T. Gibson, president of Gibson Consultants, an executive search firm specializing in digital health companies. "As organizations implement change, they will need help. There will be some expertise to draw on, but not enough so the rest will depend on training new hires."

Alison Kuhns, managing director of The Execu|Search Group's healthcare recruitment division, believes the demand for more experienced employees derives from healthcare's national workforce shortage.

"It's a catch-22. On one hand, an easy solution is to hire recent graduates to meet the rise in demand for health services," she said. "However, organizations affected by state and federal funding and the economy don't have the resources to train these recent graduates."

As a result, many healthcare providers look for staff who can hit the ground running on the first day. "Organizations need to be profitable and will ultimately turn to the person who can make an economic impact earlier," Kuhns said.

Even with employee shortages, the experienced practitioner is the more sought-after candidate, said Tim Lary, vice president of physician staffing for IPC The Hospitalist Company, Inc. Lary directs the physician, physician assistant and nurse practitioner recruitment and retention strategies for the organization, which provides staff in about 400 acute care and 1100 post-acute care facilities nationwide.

"Experienced individuals will usually impact the practice in a positive way more quickly," Lary said. "New grads are sought after, too, just not at the same level as experienced providers."

The question of experience depends on the structure of the organization. "Large organizations with strong infrastructure have the ability to assign mentors to new grads," Lary said.

A blended combination serves most organizations well, noted Michael Bunch, managing director of resource management at CTG Health Solutions. "What it comes down to is hiring the right employee for the job-experienced or not," he said.

According to Bunch, the right experienced hires add immediate value to organizations and projects, whereas the right new graduates are trainable and affordable and, even in today's market, have some sense of loyalty.

Bunch and his team have filled more than 300 positions during the last 2 years. With more than 18 years' experience recruiting and retaining quality talent in healthcare, Bunch believes in the value of college recruiting and partnering with leading universities.

New Graduate vs. Experienced Worker

Kuhns believes hiring recent grads can help solve the workforce shortage and benefit organizations in a number of ways. "Recent grads can be trained and mentored to be the employee you need; they are more flexible with schedules and roles because they are trying to gain experience; and are typically more technology savvy than older generations."

The impending transition to ICD-10, for example, has required the entire industry to learn on the job, Gibson said. "Sometimes a training need is an opportunity to hire less expensive, more moldable talent, such as recent grads."

Hiring a new grad, Kuhns explained, requires more training and supervision. Because new grads are often unsure what they want to specialize in, employee turnover may increase. An experienced professional, however, may bring undesirable expectations and opinions about processes and responsibilities.

Bunch believes the shortage of experienced professionals in some areas is driving the need for both new grads and experienced workers. "Due to the complexity and the urgency to get traction on projects, many organizations find themselves in a competition for talent, however, they are often at the mercy of highly skilled, incredibly expensive, less than loyal, high demand resources," he said. 

New grad NPs are in a unique position, Lary said. NPs who have previously worked in ICUs or as charge nurses may be as desirable as other applicants with more experience because they have acute experiences.

"The sky's the limit for PAs and NPs because healthcare reform will bring more patients and fewer providers," he said. "They are in the right place at the right time and need to stay with it for a few years while things continue to work themselves out."

According to Bunch, organizations with the right infrastructure and vision to support new graduates will realize long-term benefits by establishing an effective college recruiting campaign. "Once established, a recruiting program produces long-term benefits and a pipeline of resources," he said.

How to Stay in the Game

The pendulum swings in two directions in today's healthcare industry. "I have witnessed facilities being driven by the economics to pay market prices for providers," Lary said. "But other facilities may be reducing the employed workforce. It all depends on which market you are in."

According to Bunch, healthcare organizations and their leadership face tremendous pressures to do more with less. "Facilities are challenged to figure out regulatory changes and compliance deadlines and incorporate them into daily operations," he said. "There are those that, for a variety of reasons, have not paid close attention to their hiring and retention processes in line with economy projections."

Kuhns and her team are seeing a strong uptick in demand for more experienced professionals to fill full-time positions. On the other hand, Execu|Search's temporary staffing division has observed a need for less experienced candidates to fill both temporary and temporary-to-permanent openings, specifically for nurses and physical and occupational therapists.

"The nature of temporary positions allows employers to evaluate a less experienced employee's performance before committing to a full-time hiring decision," she said.

As for new graduates, Lary stresses the importance of remaining flexible in order to gain the experience to move forward. "New grads may need to be more flexible in their salary expectations, the setting they work in and the types of patients they treat," he said.

"Hiring new grads is an important part of ensuring the future success of healthcare," Kuhns said.


Rebecca Mayer Knutsen is on staff at ADVANCE. Contact:




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