Recruiting and retaining physicians and midwives

For an OB-GYN practice, recruiting is an operating discipline, not a last-minute response to a resignation or a full schedule. The work begins with a credible picture of the role, continues through a respectful and consistent selection process, and succeeds only when the new colleague can build a sustainable place in the practice. Owners and partners should manage the full path together: define the need, make the opportunity legible, assess candidates fairly, make a complete offer, and keep listening after acceptance. The details below focus on staffing, management, and practice operations rather than clinical or patient advice.

1. Start with a workforce plan and a defined role

Before advertising, agree on the work the practice needs done and the conditions under which the hire can succeed. Review appointment availability, call and coverage schedules, planned leave, turnover, growth plans, and administrative work that falls to physicians or midwives today. Look across at least a full operating cycle so seasonal variation or a single busy month does not drive a permanent staffing decision. Separate a temporary capacity problem from a lasting gap, and distinguish a need for another clinician from a need for better scheduling, support staff, or redesigned work.

Write a role brief that states the position, reporting relationship, employment status, expected schedule, coverage model, locations, administrative responsibilities, and the decision rights the clinician will have. Describe how physicians and midwives work together in the practice, including how responsibilities and escalation pathways are governed, without implying that every team member has an identical scope. Explain what the role will not be asked to absorb. If the job includes leadership, teaching, quality improvement, or committee work, specify the expected time and how that work is recognized.

Build a simple capacity model to test whether the position is financially and operationally supportable. Estimate compensation, benefits, recruitment costs, onboarding time, support staffing, and the ramp period before a new hire carries a steady workload. Compare the estimate with available capacity and the practice’s actual revenue assumptions. Keep assumptions visible and label them as estimates. Partners should decide in advance which terms are flexible, who can approve an exception, and what evidence would prompt a change to the role.

Common mistakes include opening a search with a vague title, describing an unbounded workload as “flexible,” and assuming a new hire will repair a broken process. Another is writing a job around the departing person’s habits rather than the work that must continue. A role brief exposes these problems before they become promises to candidates. Review it with the people who will share coverage and with the operations lead who will implement the schedule.

2. Make the opportunity concrete and credible

Candidates need enough detail to decide whether to invest time in a conversation. A useful posting names the practice, location and work arrangement, relevant team structure, expected schedule, coverage approach, employment type, compensation range or transparent compensation method, benefits, and application steps. Explain what makes the work distinctive in plain terms: partnership structure, mentorship, team stability, decision-making, or a planned service expansion. Avoid generic claims such as “great culture” unless the posting shows what that means in day-to-day work.

Use consistent language for physicians and midwives while being precise about the role-specific qualifications and responsibilities. Do not imply that one profession is a substitute for another or that a candidate’s credential automatically determines every task. Have a qualified employment or human resources adviser review the description for applicable hiring requirements, including any rules about compensation disclosure, accommodations, equal opportunity, and credentialing. The posting should invite a broad pool without asking candidates for irrelevant personal information.

Select channels based on where suitable people are likely to hear about the role. That may include professional associations, training programs, alumni networks, referral conversations, and general job boards. Ask colleagues to share the same approved description rather than improvise a pitch that omits important conditions. Track source, response time, and candidate progression so the practice learns which channels produce qualified conversations. A referral should open a door, not bypass the same evaluation used for other applicants.

Recruiting also happens in the practice’s ordinary interactions. Candidates notice whether inquiries receive timely replies, whether interviewers arrive prepared, and whether staff can explain how decisions are made. Give one person responsibility for candidate communications and a service standard for acknowledging applications, scheduling meetings, and closing the loop. A warm introduction loses value when the process then goes silent for several weeks.

3. Run a structured, respectful selection process

Use a small, trained selection group with defined roles. One person owns logistics, one leads the role and work discussion, and the group agrees on evaluation criteria before meeting candidates. Criteria may include relevant experience, collaboration, communication, adaptability to the stated work model, and interest in the practice’s operating priorities. Define what evidence would count for each criterion. Avoid selecting on “fit” alone, which can reward similarity to existing partners instead of job-related strengths.

Use a consistent sequence for each candidate: an initial conversation, a deeper role discussion, a structured meeting with relevant colleagues, and a final opportunity to clarify mutual expectations. Ask comparable core questions and use the same scorecard, while leaving room for follow-up based on each candidate’s experience. Invite candidates to describe examples of teamwork, handling change, or contributing to a group decision. Ask what conditions help them do strong work. Keep discussion focused on qualifications and the role, and train interviewers not to ask about protected personal characteristics.

Give candidates an honest preview of the work. Share a sample schedule or a realistic description of a typical work week, the coverage arrangements, the administrative load, and the support available. If the practice is changing a process, say so and describe what is already decided versus what remains open for staff input. A candidate should be able to judge the actual opportunity, not a polished version that disappears after signing.

Make interviews accessible and efficient. Offer reasonable scheduling options, explain who will attend and how long each meeting will take, and ask about accommodation needs through an appropriate channel. Do not require unpaid assignments that create substantial work unless they are necessary, proportionate, and handled consistently. If the practice uses references or credential checks, explain the stages and obtain appropriate consent before contacting anyone. Close the loop promptly with candidates who are no longer under consideration.

After each conversation, interviewers should record evidence before discussing impressions as a group. Compare notes against the criteria, identify unanswered questions, and distinguish a genuine concern from a preference. If a candidate appears strong but the team is divided, agree on one additional job-related conversation or reference check rather than extending the process indefinitely. A transparent record supports consistent decisions and helps partners explain why a choice was made.

4. Make a complete offer and reduce avoidable uncertainty

An offer should be a written summary of the agreed job, not a headline salary followed by scattered details. Include compensation structure, expected work time, benefits, leave, professional expenses, administrative duties, reporting relationship, start-date assumptions, and any applicable production or incentive terms. Explain how call, coverage, and schedule changes are handled. If partnership, ownership, or a future leadership pathway is discussed, identify the actual criteria, timeline, decision makers, and whether it is guaranteed or only a possibility.

Avoid negotiating one term at a time in separate conversations where different partners give conflicting answers. Designate one authorized negotiator and keep a record of terms discussed. Before issuing an offer, confirm that the role brief, interview discussion, and written agreement align. Allow candidates time to review the terms and seek independent professional advice if they choose. Have qualified counsel or human resources support review of the agreement, classification, restrictive provisions, and applicable employment obligations.

Discuss practical matters that often determine whether an offer is workable: schedule predictability, call distribution, leave coverage, location expectations, support staffing, and the ability to raise operational concerns. State which items are fixed and which can be negotiated. Avoid assuring a candidate that a policy will change unless partners have approved that change. If the practice has to resolve a material open issue, give a named owner and a reasonable decision date rather than relying on verbal reassurance.

Common mistakes include treating compensation as the only retention tool, promising future partnership without a process, and presenting a schedule that has not been tested against actual coverage needs. A rushed offer can produce acceptance followed by early disappointment. A thoughtful offer makes trade-offs visible before the clinician has invested in relocation, credentialing, or a start date.

5. Plan onboarding as a managed transition

The first months should have structure beyond completing forms and touring the office. Assign an onboarding lead who coordinates credentialing, system access, workspace, staff introductions, policy orientation, and the schedule build. The lead should maintain a checklist with owners and due points. Begin administrative prerequisites early enough that delays do not leave the new clinician unable to perform agreed work. Protect time for orientation rather than assuming it can be fitted around a full schedule.

Create a written transition plan with goals for the first month, first quarter, and later review. These might cover relationships, workflows, team communication, documentation systems, and administrative responsibilities. Goals should be realistic and tied to support the practice will actually provide. Pair the new hire with a named colleague for questions and a separate manager for employment or operational concerns where feasible. A mentor should not be expected to solve every scheduling and compensation issue informally.

Introduce the new colleague to the whole team, not only the partners. Explain reporting lines, meeting cadence, how decisions are recorded, who owns scheduling, and how operational problems are raised. Ask staff what information they need to work well with the new hire. Share a short internal introduction that uses the clinician’s preferred professional biography and clearly describes their role. Respect privacy about personal information and do not pressure a new colleague to share more than they wish.

Review workload and support at regular checkpoints. Ask what is clearer than expected, what is harder, whether the schedule matches the offer, and which obstacles need an owner. Keep a written record of agreed changes and follow up. Early feedback should be two-way: the practice can explain expectations while the new hire can identify friction before it becomes a reason to leave. A manager should distinguish a learning curve from a structural mismatch and respond accordingly.

6. Retain people through fair workload and meaningful participation

Retention depends on whether the daily job matches the agreement and whether people have a credible voice in how the practice operates. Review schedules, call distribution, leave access, administrative load, and committee assignments across the team. A policy can look neutral while repeatedly placing the least desirable work on the newest clinician or the person least likely to object. Make allocation rules explicit, check exceptions, and explain how coverage is handled when someone is away.

Create a regular one-to-one conversation between each clinician and an appropriate leader. Use it to discuss workload, goals, team relationships, resources, and concerns. Do not turn every check-in into a productivity review. Ask specific questions and record commitments, including who will act and when the issue will be revisited. Provide a separate route for concerns that involve the direct manager or a conflict of interest. Close the loop even when the answer is that a requested change cannot be made.

Offer development that connects to real opportunities. Some clinicians may want leadership, teaching, quality projects, or a defined specialty in practice operations; others may prefer to deepen their current role. Ask about interests rather than assuming a single career ladder. Set aside time and budget where possible, specify how development work affects other duties, and recognize contributions in compensation or role design when appropriate. An opportunity that is added on top of a full workload can feel like a penalty.

Treat flexibility as an operational design question, not a vague benefit. Define how schedule requests are submitted, who decides, what notice is practical, and how coverage impacts are assessed. Consider whether work can be organized around shared calendars, predictable blocks, or cross-coverage plans. Apply criteria consistently while allowing documented exceptions where the circumstances justify them. Partners should review patterns, not just individual requests, because repeated difficulty arranging leave may point to inadequate staffing.

7. Address conflict and departure signals early

Silence is not evidence that a colleague is satisfied. Watch for repeated schedule friction, withdrawal from meetings, delayed responses, persistent mismatch between promised and actual duties, or a loss of interest in development. These are prompts for a respectful conversation, not proof of a person’s intentions. Ask what has changed, listen without immediately defending the practice, and agree on a concrete next step. If the concern involves harassment, discrimination, safety, or other formal obligations, use the practice’s established reporting and response process with appropriate professional guidance.

When colleagues disagree, clarify the issue and the decision path. Separate facts, impact, and proposed solutions. Identify whether the matter is within the individual’s authority, the manager’s remit, or a partner-level decision. Set a follow-up date and document commitments neutrally. If the same conflict recurs, look for a policy gap or a workload pattern rather than treating each episode as a personality problem. Do not ask peers to mediate a serious concern without training and authority.

An exit conversation can offer useful information, but it should not be the practice’s only listening mechanism. Invite candid feedback through a neutral interviewer where possible, explain how the information will be used, and avoid arguing with the departing colleague. Ask about the difference between expected and actual work, management support, schedule fairness, and what might have changed their experience. Share themes with partners and assign action owners while protecting confidential details.

8. Track results and improve the process

Measure a small set of indicators that can lead to action: time from approved role to accepted offer, candidate response times, offer acceptance, onboarding milestones completed, retention at defined tenure points, unplanned departures, vacancy coverage burden, and reported workload or schedule concerns. Interpret each measure carefully. A fast hire is not a success if the person leaves quickly, and a low departure count may hide a team that has stopped raising concerns. Pair numbers with regular conversations and consistent exit feedback.

Review the measures at a partner meeting on a set cadence. Ask whether a channel produces candidates who match the role, whether delays come from scheduling or decision-making, and whether onboarding tasks repeatedly remain incomplete. Choose one process improvement at a time, assign an owner, and state how the group will tell whether it helped. Keep a short decision log so the practice does not reopen settled questions or lose the reason behind a change.

Consider this illustrative worked example. A five-clinician practice identifies a recurring coverage gap and approves one additional full-time role. The partners estimate that a search will take twelve weeks, onboarding will require four protected hours weekly for six weeks, and steady-state work will take another three months to reach. These figures are illustrative, not a benchmark. The practice assigns one partner as decision lead, an operations manager as candidate contact, and a clinician as onboarding mentor. It publishes the schedule model and compensation range, screens candidates against five agreed criteria, and records response times. After the hire starts, the team finds that access setup is repeatedly delayed. The operations manager takes ownership of a pre-start checklist, and partners review completion at the next meeting. The example shows how a workforce plan connects hiring, realistic expectations, transition support, and process correction.

Common mistakes in measurement are collecting data nobody reviews, treating every departure as an individual failure, and changing several policies at once so the effect is impossible to understand. Keep definitions stable enough to compare periods, but do not let a dashboard replace judgment. Where figures are small, protect confidentiality and discuss patterns rather than attributing an isolated result to a person. The purpose is to identify preventable friction and make the practice a more dependable place to work.

Action checklist

• Confirm the staffing need, role boundaries, budget assumptions, and decision authority.
• Publish a specific role description with a clear schedule, coverage model, and compensation approach.
• Use consistent job-related interview criteria and close the loop with every candidate.
• Put complete offer terms in writing and reconcile them with what candidates were told.
• Assign onboarding owners, protected orientation time, and regular review points.
• Review workload fairness, schedule predictability, development, and concerns with the team.
• Track a small set of recruiting and retention measures, then assign an owner to each improvement.

Questions about your own practice? Contact richard@doctorsinvestorclub.com.