Best Practices for Recruiting and Retaining Great PAs and NPs

Kevin Riggs , PA-C

Regional Lead PA

Published June 24, 2014

These days, it's hard to find a healthcare organization that isn't scrambling to recruit physician assistants (PAs) and nurse practitioners (NPs). These professionals are poised to play a key role in alleviating the physician shortage and caring for millions of newly covered patients.

Unfortunately, job-seeking PA/NPs are currently in short supply:

By 2025, the supply of PAs and NPs is expected to be 20 percent lower than the demand, according to a 2011 analysis published in the Journal of the American College of Surgeons.
Even if training programs expand their capacity to graduate 500 more of these professionals each year, this deficit will still run more than 15 percent.

Organizations also need to bear in mind that the PA/NP workforce is getting younger. Just a decade ago, most new professionals were in their 30s. Today, about 43 percent of PAs are under 35, and many new graduates are in their 20s. This has implications for employers, as younger, less experienced professionals may need extra support while adjusting to their new role.

Unfortunately, there are no manuals on how to attract the best PA/NP candidates to your organization. However, as a regional lead PA for Vituity, I've participated in a number of innovative recruiting practices that have helped me:

Nurture positive relationships with candidates
Attract top candidates to our organization
Create an organizational culture that fosters success and loyalty

The following practices have been developed and refined by our clinical and recruiting teams over a number of years. While my own experience is mostly with PA/NPs, I believe these ideas would also be helpful to recruiters of physicians, nurses and ancillary staff.

1. Be a willing mentor. One of the best times for organizations to develop positive relationships with PA/NP candidates is when those candidates are still in training. For example, when I was working at MacNeal Hospital in Chicago, I reached out to the PA program at Midwestern to create a new clinical rotation in emergency medicine. This occurred due to Vituity's Student Tracking and Retention (STAR) program. In addition to providing a valuable learning experience for health professions students, STAR offers our organization an early glimpse at candidates' potential and has led to several successful hires.

2. Be an awesome workplace. If I've learned anything from my recruiting work, it's that today's PAs and NPs don't want to be "physician extenders." They want challenging, rewarding careers that allow them to reach their potential and make a difference to their patients, colleagues and organizations. To many, the promise of a meaningful career is just as enticing — if not more so — than a competitive pay and benefits package.

A few things highly qualified PA/NP candidates may be looking for in a job opportunity:

Access to regular, hands-on professional development. Ideally this includes ample in-house educational opportunities plus funding to support outside learning
A stimulating work environment. For example, PA/NPs working in the emergency setting don't necessarily want to spend every shift in triage. They prefer variety, responsibility for managing complex care and a chance to relate meaningfully to patients and families.
Opportunities for advancement. Much like physicians, PA/NPs want a say in how their organization delivers patient care. Mentoring programs and academies that prepare promising providers for leadership roles can be a major perk for highly motivated candidates.

3. Practice outstanding onboarding. Congratulations! You've just signed an excellent candidate and begun the credentialing process. This "down" period is a great time to orient the employee to their new organization and colleagues. While they wait for their credentials (which can be a nerve-wracking process), invite them to get involved in group outings, journal clubs and staff meetings. This is also a good time for them to complete a couple of shadow shifts before their first day on the job. Including new hires in these activities helps them transition to the team mentality and gives them a chance to become comfortable with their peers before diving into the stresses of a new job.

4. Support new professionals. Recent graduates benefit from extra time and support to make a successful transition to the professional environment. They will likely need an extended "induction period" to get familiar with departmental procedure. In addition, your team needs time to develop confidence in their clinical and decision-making abilities.

One way to prepare new professionals for success is through an internship program. Interns work under the direct supervision of a seasoned physician or PA/NP. The internship can last weeks to months depending on the new hire's needs and experience. At Vituity, providers receive partial pay during their intern period.

5. Touch base. The first shift has come and gone. Check in with your newest employee and see how it went. This fosters a culture of caring and shows them that you're there to assist in their success.

Feedback is important. Schedule frequent evaluations (at least quarterly initially) to address any issues or recognize a job well done. And remember that feedback is a two-way street. Periodically ask questions to determine if the new hire's needs are being met and if there is anything else that can be done to improve the work environment.

6. Foster involvement. As mentioned above, the best PA/NPs want to grow as professionals and have a voice in the care they provide. Early on, encourage them to consider joining hospital-level committees. Provide information about available training and networking opportunities within your organization. Offer new and challenging work experiences that stimulate their learning and increase the potential for contentment on the job.

If all goes well, you will have an excellent addition to the organization who's satisfied with their work environment and optimistic about their future. These types of employees can be a catalyst to motivate others to be team players — and may even be utilized to help in future recruiting and onboarding programs.

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