Recruitment Is Only the First Challenge
Specialist and allied health practices invest significant time and energy in finding the right person.
The position description is written carefully. The advertisement is placed. Applications are reviewed. Interviews are conducted, references are checked, and eventually the right person accepts the offer.
That moment of acceptance feels like the finish line. In practice, it is the starting line.
Recruitment and onboarding are not two separate activities divided by an offer letter. They are a continuous experience for the person joining, and every part of that experience shapes whether a capable new staff member becomes a long-term contributor or a costly early exit.
This blog covers both sides of that challenge: how practices can approach recruitment more effectively, and why what happens after someone accepts the role matters just as much as finding the right person in the first place.
Recruiting the right person is only the first part. The next question is whether the practice has the structure to help them succeed.
What Top Candidates in Healthcare Are Looking For
The practices that attract capable, experienced staff are not always the ones that pay the most. They are the ones that offer the conditions people need to do their jobs well and build a career.
Based on what healthcare candidates consistently prioritise, these factors matter most:
| What Candidates Want | What This Looks Like in Practice |
| Competitive and fair compensation | Pay that reflects the actual scope of the role, not just the title. Practices that review pay regularly rather than only when someone resigns. |
| Realistic workload and work-life balance | Roles designed with enough capacity to manage a normal week without regularly working through breaks or staying late. Predictable rosters and protected admin time. |
| Professional development | Opportunities to learn, grow and take on more responsibility over time. Training that is structured rather than reactive. |
| Supportive leadership and clear communication | A principal or practice manager who is accessible, communicates expectations clearly and gives the team the structure to do their job well. |
| Efficient systems and good technology | A practice where workflows are documented and accessible. Where systems support the work rather than creating daily friction and relying on the knowledge held by a small number of experienced people. |
| Job security and practice stability | Confidence that the practice is well-run and has a clear direction. This comes from operational structure as much as from size or tenure. |
The thread running through all of these is the same: candidates want to work in a practice that is organised, structured and well-led. What attracts good people is also what retains them. The work of building a sustainable team begins before the first advertisement is placed.
What Is Working in Recruitment Right Now
Many practices are still using recruitment approaches that were common a decade ago. A few practical shifts make a significant difference to both the quality of candidates and the time it takes to fill a role.
What tends to work well
- Online platforms such as Seek, LinkedIn and Indeed reach a far larger candidate pool than print advertising or word of mouth. They also allow practices to specify experience, qualifications and location, which improves the relevance of applications received.
- Employee referrals, where existing team members recommend candidates, consistently produce strong hires. The people already in the practice understand the environment, the culture and the realistic demands of the role better than any external recruiter.
- A position description that is honest about the scope of the role, including its pressures and complexity, tends to attract candidates who choose to apply with a clear understanding of what they are accepting. Those candidates are more likely to stay.
- A structured interview process with consistent questions across all candidates allows for genuine comparison and reduces the risk of making a decision based on first impression rather than evidence.
- Moving quickly once the right candidate is identified. The healthcare job market is competitive, and delays in the offer process are a common reason practices miss the person they wanted.
What tends to create problems
- Position descriptions that focus on culture and values without accurately describing the actual work. When the role a candidate accepts does not match the role they arrive into, the gap becomes visible quickly and early exits follow.
- Treating the offer as the end of the process. For the candidate, the period between accepting the offer and completing the first month is when they form a real impression of the practice. Practices that go quiet after the offer is accepted often lose new starters before they have genuinely begun.
- Recruiting to fill a vacancy rather than a well-defined role. If what the role actually involves is not clear, no amount of effort in the recruitment process will produce a stable outcome.
| A note on employer reputation
In a small practice, employer brand is not a marketing exercise. It is the reputation the practice has built in the local professional community, shaped by how former and current staff describe their experience and how the practice presents itself during the recruitment process. A well-run practice with a positive team culture tends to attract the right candidates without needing to work particularly hard to do so. |
The Period Between Offer Accepted and First Day
One of the most overlooked parts of the recruitment and onboarding process is the period between the offer being accepted and the new person’s first day.
For the candidate, this period is not neutral. They are forming impressions about the practice, paying attention to how they are treated before they have even started, and in some cases beginning to reconsider whether they have made the right decision.
Simple, consistent actions during this period make a meaningful difference:
- A brief welcome message from the principal or practice manager confirming they are looking forward to the person starting.
- Clear practical information about what to bring, where to park, who to ask for on their first day, and what the first week will look like.
- An indication that there is a structured onboarding plan in place, so the new person knows the practice has prepared for their arrival.
These are not complicated gestures. They signal that the practice is organised, that the new person’s arrival matters, and that the experience ahead of them reflects the workplace they were shown during recruitment.
Onboarding: The Gap Between What Happens and What Works
Most practices have some form of onboarding process. It usually looks like this: the new person arrives, someone experienced shows them around, they shadow a colleague for a few days, and then they start doing tasks.
This approach is almost universal in small to medium practices. It is also the most common reason capable new staff leave within the first 90 days.
The problem is not the people involved. It is the absence of structure.
When onboarding depends on who is available to sit with the new person, what that person remembers to cover, and how much time can be carved out of an already busy day, the result is inconsistent. The new starter receives different information on different days. They develop habits based on observation rather than on what the process actually requires. They ask questions that leave them uncertain about whether they are progressing.
By week six or eight, many capable new starters are no longer confident that the role is right for them. The practice, watching the same pattern, concludes the person was not a good fit. The cycle begins again.
What structured onboarding looks like
| Period | What Good Onboarding Includes |
| Before day one | Welcome message sent. Practical first-day information provided. The new starter knows what to expect and understands the practice has prepared for them. |
| Days 1 to 5 | Practice overview, key contacts, communication standards, software orientation. No expectation of independent task performance yet. The focus is orientation, not output. |
| Week 2 | Core workflows introduced with documentation rather than verbal instruction. The new person follows a written process and asks questions against a clear reference point. |
| Weeks 3 and 4 | Supervised task completion with structured feedback. The emphasis moves from watching to doing, with support readily available. |
| End of week 1 check-in (or after 5 working days for part-time) | A brief but structured conversation: How are you finding the role so far? Is anything unclear? What would help you feel more confident this week? This catches concerns early, before they settle into patterns. |
| 30-day check-in | A structured conversation covering workload, confidence, clarity about the role and any workflows that still feel unclear. Documented, not informal. |
| 60-day review | Full capability assessment. Role clarification where needed. A discussion of what is working and what requires further support going forward. |
This framework does not require dedicated HR resources. It requires a deliberate decision to prepare for new starters rather than respond to them.
The employment promise is tested in the first month. Whether the practice delivers on it shapes whether a good hire stays or quietly starts looking elsewhere.
When Your Systems Are Documented, Onboarding Becomes Easier
There is a direct connection between how well a practice has documented its workflows and how well it can onboard new team members.
When the way a practice operates exists only in the heads of its most experienced people, a new starter has no reference point. They depend entirely on whoever is available to show them what to do, when, and how. That dependency creates inconsistency, slows the path to genuine capability, and places pressure on experienced staff who are already managing their own workload.
When workflows are documented, that changes. A new staff member who has access to a clear, written process for billing, bookings, patient communication, or referral management can work toward competency with a reference point rather than relying on memory and observation.
The practices that onboard most effectively are almost always the ones that have already done the work of documenting how they operate. That documentation serves the existing team by creating consistency and reducing dependence on any one person. It also serves every new hire who follows, in the same way, without requiring the same investment twice.
| A note on documentation and training
There are approaches to capturing workflow documentation that produce training resources at the same time, without requiring a separate project. This is something I work through directly with practices, and it is one of the areas where the investment in getting systems right delivers the most visible return. |
Documented systems also need to be maintained. A workflow that was captured twelve months ago may no longer reflect how the practice operates, particularly after software changes, team changes, or shifts in clinical volume. Building a regular review rhythm into how systems are managed ensures the documentation stays current and continues to serve its purpose.
Recruitment, Onboarding and Retention: One Continuous Experience
Retention is often treated as a separate concern, addressed only when a valued team member signals they are thinking about leaving.
A more effective approach treats recruitment, onboarding and retention as one continuous experience, shaped by the same operational decisions from the first advertisement to the point at which a long-term team member is well established.
The team members most likely to stay long-term are those who:
- Were given an accurate and honest picture of the role during recruitment.
- Received a structured onboarding experience with clear reference points and regular check-ins.
- Are working in roles designed with realistic workload rather than optimistic assumptions.
- Have access to documented workflows that allow them to do their job without depending on a specific colleague being available.
- Feel their contribution is recognised through how the practice is designed to support them, not only through verbal acknowledgement.
Research from Ahpra identifies the primary reasons healthcare workers consider leaving as burnout, feeling undervalued, lack of professional satisfaction and a sense that the work is no longer fulfilling. None of these are solved by a pay review. All of them are shaped by how the practice is designed and led.
The practices that build stable, committed teams have not done so through exceptional luck or exceptional people. They have made deliberate decisions about how they recruit, how they onboard, how they structure roles and how they document the way they work. Those decisions accumulate into a workplace where good people can build a sustainable career.
The practices that keep good people are the ones that make it genuinely possible to do the job well, every day.
Building the Practice That Keeps the Right People
Recruiting well matters. Finding the person with the right skills, experience and fit is genuinely difficult, and getting it right saves significant time and cost.
But recruitment is only the first investment. The return on that investment depends on what follows: the pre-start experience, the onboarding process, the quality of the role design, and whether the systems in place give a capable new team member a genuine chance to succeed.
When those foundations are in place, good people stay. The cycle of recruiting, onboarding informally and losing capable staff early begins to break. The practice becomes a place where knowledge accumulates rather than walks out the door, where new starters reach genuine capability faster, and where the team’s experience of working there reflects what they were told when they accepted the role.
That is not an aspirational outcome. It is the result of practical, deliberate operational decisions that any practice can make.
Finding the right person is only the first challenge. Building the practice that keeps them is the work that follows.
Ready to Strengthen Your Recruitment and Onboarding Process?
If your practice is experiencing early turnover, inconsistent onboarding or difficulty attracting the right people, I would love to have that conversation.
Pace MediSystems works with specialist and allied health practices to document workflows, design onboarding frameworks and build the operational structure that makes sustainable employment possible.
Reach out directly or book a clarity call through the Contact page.
Denise Pacey | Pace MediSystems | Practice Management Consultant
Working With Denise Pacey
If the operational picture described in this blog feels familiar in your practice, or if you are heading into the new financial year knowing that the way you recruit, onboard and retain people needs to change but not knowing where to start, this is exactly the work Pace MediSystems is designed to support.
Denise works with specialist and allied health practices across Australia to systemise operations, redesign workflows and build the structural foundations that allow practices to grow without depending on specific people showing up every day to hold things together.
About Denise Pacey
Denise Pacey is the founder of Pace MediSystems and a Certified SYSTEMologist with over two decades of experience in specialist medical practice management. She works with medical practices across Australia in three areas: practice systemisation, Xestro implementation and coaching and mentoring.
Pace MediSystems. Systemise for Success.