You've probably seen the headlines by now. Healthcare added 76,000 jobs in March. It accounted for 63% of all new U.S. jobs in January. In 2025, the sector added 693,000 jobs while every other industry combined barely cleared 181,000.
If you work in healthcare hiring, none of this surprises you. You already knew there were more open roles than qualified people. What the headlines don't capture is why those roles stay open as long as they do.
I'll tell you, because I hear it every week.
The Conversation That Keeps Repeating
A hiring manager calls. They've had a role open for three months. They're frustrated, and I get it. But when I start asking questions, the pattern is almost always the same.
"We need someone with 5+ years, three certifications, and experience in our exact EHR system. Competitive pay. Great culture."
The job description is a wish list, not a job. The comp is 15% below market. The interview loop takes six weeks. The last two candidates accepted other offers while waiting for a decision.
They're not losing candidates because of a shortage. They're losing candidates because of their own process. And that's a harder conversation to have than "the market is tough."
The market IS tough. But tough and broken are two different things.
The Numbers Behind the Frustration
Here's what I want people to sit with for a minute.
RN turnover is at 16.4%. Replacing a single nurse costs over $61,000. Annual nursing turnover costs hospitals between $3.9 million and $5.7 million. Labor is 84.4% of total hospital expenses.
Organizations are bleeding millions in turnover and then nickel-and-diming the hiring process that's supposed to stop the bleeding. They'll spend $5 million losing nurses and then drag their feet on a $90,000 offer because someone needs to "check with finance."
The Quiet Crisis Nobody's Headlining
Everyone talks about nurses. The nursing shortage is real and serious. But there's a parallel crisis in the roles that keep hospitals compliant, paid, and operational.
34% of healthcare group leaders say coders are the hardest role to fill. Coder demand is projected to grow 13% this year. Certified coders earn 20.7% more than non-certified, and that gap is widening.
Meanwhile, AI coding platforms are automating routine encounters and routing the complex cases to human reviewers. That sounds like it should reduce the need for coders. It actually raises the bar for who qualifies.
The easy work is getting automated. The hard work still needs a person. And the pool of people who can do the hard work is shrinking.
This isn't just a coding problem. It's a pattern across compliance-sensitive roles. The work is getting more complex, the qualified talent pool is getting smaller, and the organizations that need these people the most still treat hiring like a checkbox exercise.
What Actually Works
I also talk to organizations that fill roles quickly. Consistently. Even in this market. They're not doing anything revolutionary. They have three things in common:
Not a wish list. The actual job. They can describe the daily workflow, the metrics that matter, and the kind of person who thrives in it. When I screen candidates against that, the hit rate goes up immediately.
First screen to offer in under two weeks. Not because they're cutting corners. Because they've already done the internal work of knowing what they want. The decision doesn't take long when the criteria are clear.
Timely communication. Transparent process. Honest comp conversations upfront. It sounds basic. But in a market where candidates apply to six places and hear back from one, basic is a competitive advantage.
That's it. It's not complicated. It's just not convenient.
What I'm Watching Next Month
The conversation is starting to shift from "we can't find anyone" to "we need to fix how we hire." I'm hearing it from more directors and VPs than I was six months ago. That gives me some optimism.
But the gap between knowing the process is broken and actually changing it is where most organizations stall. Knowing isn't the hard part. Doing something about it is.
National unemployment is 4.3%. In healthcare, the real competition isn't between candidates. It's between employers. And the employers who figure out how to attract, assess, and close specialized talent quickly are the ones who will pull ahead. The rest will keep writing the same job post and wondering why nobody's applying.
Thanks for reading the first edition. I'm writing this because the data is easy to find but the context behind it usually isn't. That's what this newsletter is for.
If something resonated, forward it to someone who needs to hear it.