practice management

When Hiring is Hard: Employee Retention in Pediatrics

Changes required of employers by the COVID-19 pandemic made swift but significant shifts to how pediatricians organize their practices and the tools they use to accomplish these goals. Priorities have shifted for practice administrators, and they have shifted for employees too, which can make hiring difficult. We spoke to Tim Rushford of PedsOne pediatric billing for his insight on the changes of the hiring landscape post-pandemic, and how independent employers can improve retention and hire the staff who can perfectly fit the practice’s needs and culture.

Changes in Hiring Post-Pandemic

Tim Rushford is the general manager and owner of PedsOne, and while he works indirectly with practices via PedsOne’s work in pediatric billing, he’s also a thought leader in hiring practices, especially for independent businesses like independent pediatricians. When considering the effects of the pandemic on hiring strategies and employee retention, Tim acknowledges that even with the expected changes in unemployment rates, the job market has changed in some surprising ways.

“Things [such as the increased unemployment rate] that you think would drive available employees to a pediatric practice or to a company like PedsOne, a billing service, are not happening as much as we thought they would. So it's a little bewildering.” 

Tim considers the perennial problem of hiring employees, despite circumstances that employers might hope would make hiring easier, is a matter of fit. While the pandemic resulted in an unemployment rise from 3% to 15% in PedsOne’s home state of Vermont in April of 2020, a rate similar to that of the rest of the country, a high proportion of job-seekers does not necessarily mean that these seekers have the same qualifications as professional roles like nurses, billers, or office administrators that practices demand.

“The other reason,” Tim says, “Is that studies show that a certain portion of unemployed workers don't have the facilities or the tools to go out and get a job. So it's easier for some people [than others]. For example, if you have broadband available to you 24/7, well, it’s a lot easier to jump on job hiring websites like Indeed and find out what's going on in the job market, but if you don't it's a lot more difficult. Or if you are a single mother with three kids at home, well, can you really look for a job from 10:00 PM to 1:00 AM?”

The pandemic made life for job-seekers and employers tough, and while individual circumstances and fit make the list of qualified healthcare or administrative professionals for pediatric practices narrow, hiring your perfect fit is still very possible.

Shifting to Remote Work in Pediatrics

“I can say for me, and probably for pediatric practices, how do you have a remote front desk person? That'd be pretty tough. Telehealth, yeah, but tele-front desk, I’m not so sure.”


The necessary shifts to telemedicine for practices across the country mirrored the enormous changes made necessary throughout the pandemic in other industries. Many employers needed to switch quickly from in-person to remote work to protect employees and meet consumers’ needs. Media, news coverage, and political discussion have debated the pros and cons of remote work as being great for employee morale or bad for productivity, while the true answer probably depends on the individual workers at hand. 

What about remote work for pediatrics? Can employees take new meaning from the phrase “medical home”? As Tim notes, remote work isn’t always possible for such a physically demanding job as a front desk person or a triage nurse, but remote work has entered the public consciousness, and as such, can be a valuable insight into the qualities of an employer job-seekers most want to work for.

Despite shifts in unemployment rates, the job market for pediatrics is now and often remains a “buyer’s market”, that is, remains an industry that candidates can more easily find and change jobs without much personal cost. 

According to Tim, this buyer’s market perspective is important to understanding employee retention and, once they’re hired, keeping employees engaged in a field like pediatrics. “I'm told by a lot of other business owners that trying to find candidates is pretty crazy right now. When employees feel more secure and more confident that they can safely move around the job market, then it sometimes leads them to make a change in an appointment for smaller reasons so, a slight pay increase, a slightly shorter commute, but one of the big ones that we hear a lot is, the opportunity to work from home.”

When employers can offer remote work, such as telehealth opportunities, they can stand out from competitors and attract candidates for whom flexibility is important. However, even work that isn’t possible to complete remotely can be attractive to candidates when employers can work in flexibility elsewhere, such as ongoing flexibility for childcare, or generous paid leave. This is also where Tim highlights the key importance of asking the right interview questions to find the perfect fit for your practice:

“A key question when [pediatric practices are] recruiting is to ask candidates, what are you looking for in your next job? There are certain common things that we hear when we ask that. It's a good question to ask because if you don't have what the candidate is looking for, well, even though it might be a terrific pediatric practice, well, maybe it's not a good fit.”

Changes in Employee Engagement and Retention

The pandemic’s shifts in the hiring landscape also presents opportunities for pediatric practices who seek them out. Tim says that after a period of instability and uncertainty, it’s natural for candidates to prioritize flexibility in order to commit time to their families, hobbies, or interests, but many candidates are also seeking one thing that pediatric practices have in abundance: a workplace that feels fulfilling and stable over time.

“A professional home,” Tim clarifies, “Like a place where a candidate wants to stay long term. And what I think they mean by that is they're looking for security and stability and growth and learning. And when someone says that they mean that there's a strong sense of community here at this practice or this business.

“A pediatric practice would be well advised to give people they’re recruiting a sense for what's going to happen there in the next 20 years. What is the future like, and what could it be for a person like them? Give them a long view of the future. Is it going to be fulfilling and rewarding and well-paid and fun and challenging and interesting?”

Understanding both your practice’s and your potential candidates’ priorities can help make hiring less stressful and even more rewarding for everyone involved. In the end, it all comes down to the right questions. If you’d like to learn more about the questions Tim recommends during an ideal interview with a candidate at your practice, be sure to check out the webinar he hosted for PCC that explains the “inner-view” process, building a talent pipeline, and much more. Are you hiring the right people?

Watch the Webinar

Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.