You Can't Out-Recruit a Broken Culture: Why Your Provider Recruitment Strategy Is Failing

Are you a clinical director spending every non-clinical moment reviewing resumes and conducting interviews, wondering why you can't fill those open provider positions? In this solo episode, Jill Steeley reveals an uncomfortable truth: your recruitment problem isn't actually a recruitment problem. You cannot out-recruit a broken team environment. If you've tried increasing salaries, expanding your recruiting radius, hiring expensive recruiters, and nothing is working, this 15-minute episode will change how you approach both recruitment and retention.

The Vicious Cycle

The trap clinical directors fall into: Broken cultures create recruitment emergencies → Recruitment emergencies prevent culture repair → You get stuck recruiting instead of fixing the environment → Positions stay unfilled or quickly turn over

You can't fix the environment because you're desperately filling positions. You can't keep positions filled because the environment is broken.

If This Sounds Familiar...

You've probably tried:

Increasing the salary
Adding sign-on bonuses
Expanding your recruiting radius
Posting everywhere (Indeed, LinkedIn, specialty job boards)
Hiring expensive recruiters (who don't always deliver)

And yet:

Your position is still open, OR
You fill it and within a few months that person is leaving again

It's Not Your Fault (But It's Your Responsibility)

The reality most clinical directors face:

You inherited this team. You didn't create this culture.

You probably walked into:

High turnover before you arrived
Longstanding personality conflicts
A previous director who checked out months before officially leaving
An already messy situation

What happens three months in:

The veteran nurse who undermines every new hire
The provider who constantly complains but never offers solutions
Provider team won't see enough patients
Front desk staff who've formed their own kingdom and resent changes
Tense environment creating constant backfilling needs
Always in recruitment mode, never getting chance to fix culture

The promotion reality: You're a strong clinician with great technical skills who got promoted. On paper, exciting: more influence, better compensation, chance to shape better patient care.

The reality: Team dynamics are way more complicated than you anticipated.

Why You Can't Out-Recruit Your Way Out

Reason #1: New Hires Absorb the Existing Culture

What happens: When you bring someone into a toxic or dysfunctional environment, they don't change it. They get changed by it.

The pattern: That nice, idealistic, energetic provider you just hired? Give them 3 months with your negative veteran staff and watch what happens.

Only two outcomes:

They adopt those same cynical attitudes to fit in and survive
They leave because it's uncomfortable and goes against their values (becoming part of your turnover statistic)

Reason #2: Good Candidates Sense the Dysfunction

The reality: High-quality candidates are interviewing YOU just as much as you're interviewing them.

What they're watching during site visits:

How your staff interacts
Tension in the air
Passive-aggressive comments (to each other or to the candidate)

What really good candidates do: They decline your offers. And you won't really know why.

What they'll say:

"It's not a good time for me to leave my current position"
"I have another offer on the table"
"I just don't think I want to move to your state/area"

(But the real reason: they sensed the dysfunction)

Reason #3: Recruitment Fatigue Prevents Strategic Action

The problem: Every hour you spend in recruitment mode is an hour you're NOT spending on culture transformation.

What eats your time and mental energy:

Every interview you conduct
Every reference check
Every onboarding/orientation with a new person

What you should be doing instead: Investing that time and energy in addressing the root issues on the team BEFORE you start recruiting again.

The trap: You're treating symptoms instead of the disease.

Jill's Real-World Example

The situation when she was recruited as FQHC CEO:

One-on-one meeting with the medical director:

Hadn't recruited a doctor in 5 years
Hadn't recruited a dentist in several years
Medical director convinced it was: salary, schedule, job market (all external factors)

What Jill discovered after a few months: After interviewing staff and observing the culture, she sat down with the medical director again:

"This is not an external recruiting problem. This is because the culture here is very tense and very toxic. New people are going to feel very unwelcome because the current staff has been unhappy for a very long time. There's this undercurrent, this attitude that this is not a good place to work."

What changed: Once they addressed those attitudes and the toxic culture, their recruiting abilities began to stabilize almost immediately.

What they DIDN'T change:

Salary (stayed the same)
Provider schedules (stayed the same)

What DID change:

Retention improved
Recruitment improved
They were recruiting into a healthy culture

Strategic Culture Repair: The Three Foundations

This must happen BEFORE your next recruitment cycle, not after.

Foundation #1: Clear, Non-Negotiable Standards

What your team needs to know: Exactly what behavior is acceptable and what is not.

NOT this: Vague value statements on the wall (integrity, ethics, customer care)

THIS: Actual behavioral standards with consequences

Where most new clinical directors get stuck: Trying to keep everyone happy instead of establishing boundaries and clear expectations for performance and behavior.

The truth:

High-performing team members WANT standards
They want to know toxic behavior won't be tolerated
Your best people are waiting for you to address your worst people

Foundation #2: Transparent Communication Rhythms

Broken teams operate on: Gossip and assumptions

Healthy teams operate on: Structured, predictable communication

What this means:

Regular team huddles with clear expectations, agendas, and next steps
One-on-ones where you actually have hard conversations and address performance/behavioral issues
Decision-making processes people can understand (even when they don't agree)

The result: When communication is transparent, dysfunction has nowhere to hide anymore.

Foundation #3: Quick, Decisive Action on Culture Violators

The hard truth: If you have someone actively poisoning your culture, every day you delay addressing it is a day you are choosing that one person over the rest of your team.

Yes, it's uncomfortable:

Hard conversations
HR processes feel slow-moving
Worry about being short-staffed
Concern about patients going without a provider
Who's gonna pick up these patients if this person leaves?

But here's the reality: Keeping someone toxic in the culture is way more expensive than any vacancy or needing to move patients to a different provider. Full stop. Every single time.

The cost comparison: Keeping someone toxic = More expensive (directly and indirectly) than any vacancy ever would be

The Good News: What Happens When You Fix Culture

When you fix these three foundations and become a healthy culture, recruitment becomes exponentially easier.

Your Job Postings Attract Better Candidates

Your health center now has a healthy reputation in the community

Your Staff Become Natural Recruiters

When providers and staff are happy, they naturally start recruiting people they know:

Other providers
Nurses
Dental assistants
Support staff

They'll start telling people how great it is to work at your health center.

Your Interviews Go Better

Candidates sense the positive environment during site visits:

Friendliness in the air
Staff with great energy
Excitement around your health center

Your Retention Improves

People who are happy want to stay.

The shift: You're not just filling positions anymore with anybody who will take it. You are intentionally building a team.

Jill's Results After Culture Fix

What happened within a year: Providers were contacting them asking if they had open positions, wanting to join the team

What happened within a few years: Received the Employer of Choice award

What changed: Fixed the culture, and everything else followed.

Key Timestamps

[00:01:00] The recruitment problem that isn't really a recruitment problem
[00:03:00] It's not your fault (but it's your responsibility)
[00:05:00] The vicious cycle trap
[00:07:00] Reason #1: New hires absorb existing culture
[00:08:00] Reason #2: Good candidates sense dysfunction
[00:09:00] Reason #3: Recruitment fatigue prevents strategic action
[00:10:00] Jill's real-world example: 5 years without recruiting a doctor
[00:12:00] Foundation #1: Clear, non-negotiable standards
[00:13:00] Foundation #2: Transparent communication rhythms
[00:14:00] Foundation #3: Quick, decisive action on culture violators
[00:15:00] The good news: What happens when you fix culture
[00:17:00] Introducing the Clinical Director's Survival Guide

New Resource: Clinical Director's Survival Guide

Launching in January

What it includes: A guidebook walking you through exactly what to do in your first 90 days as clinical director

You'll learn to:

Assess your inherited team
Establish non-negotiable standards
Quickly identify who's poisoning your culture
Create foundation for sustainable recruitment and retention
Manage your own clinical responsibilities (including seeing patients if applicable)

Bonus resources: Specifically for clinical directors who inherited challenging team dynamics

Get notified: Sign up at jillsteeley.com

Key Takeaways

✓ You cannot out-recruit a broken environment. Period.

✓ You CAN repair the culture driving your recruitment struggles

✓ New hires don't change toxic cultures, they get changed by them

✓ Good candidates sense dysfunction during interviews and decline offers

✓ Recruitment fatigue prevents you from doing the strategic work needed

✓ Three foundations: Clear standards, transparent communication, quick action on violators

✓ Keeping toxic people is more expensive than any vacancy

✓ When culture is healthy, recruitment becomes exponentially easier

✓ Your best people are waiting for you to address your worst people

✓ What you do in your first 90 days (or starting today) determines if you're still fighting these battles a year from now

✓ You have more power to change this than you think

Memorable Quotes

"Your recruitment problem isn't actually a recruitment problem."

"You cannot out-recruit a broken team environment."

"Broken cultures create recruitment emergencies and recruitment emergencies prevent culture repair."

"When you bring someone into a toxic or dysfunctional environment, they don't change it. They get changed by it."

"High-quality candidates are interviewing you just as much as you are interviewing them."

"Every hour you spend in recruitment mode is an hour you're not spending on culture transformation. You're treating symptoms instead of the disease."

"This is not an external recruiting problem. This is because the culture here is very tense and very toxic."

"Your best people are waiting for you to address your worst people."

"Every day you delay addressing it is a day you are choosing that one person over the rest of your team."

"Keeping someone toxic in the culture is way more expensive than any vacancy or needing to move patients to a different provider. Full stop. Every single time."

"You're not just filling positions anymore with anybody that will take the position. You are intentionally building a team."

"You have more power to change this than you think. You need to start with the culture and watch how everything else, including your recruitment, becomes a lot easier."

Sponsor Mention: RetroCaid

The opportunity: Health centers are leaving between $9,035,000 every single month on the table

What RetroClaim does: Helps health centers recover retroactive Medicaid reimbursements (money you didn't even know existed)

Results: Health centers recovering anywhere from $120,000 to over $1 million annually

The benefits:

Completely risk-free
No upfront costs
No EHR integration required
Month-to-month contracts
They only get paid when you do

Stop losing money to expired retroactive Medicaid claims.

Visit: jillsteeley.com/partners for free introductory call

Coming Next Episode

Guest: Murray Steinman, CEO and Founder of Flying Horse Communication

Topic: Marketing and branding for FQHCs

How to position your health center in your community as provider of choice
Offering high-quality healthcare
Specializes in marketing/branding for federally qualified health centers

Action Steps

If you're a clinical director right now:

Immediate (This Week):

Take inventory of your current team culture honestly
Identify who on your team is poisoning the culture
List the behavioral standards you need to establish

Short-term (This Month):

Establish clear, non-negotiable behavioral standards
Set up structured communication rhythms (team huddles, one-on-ones)
Have that hard conversation you've been avoiding
Stop recruitment efforts temporarily to focus on culture

Before Your Next Hire:

Fix the three foundations (standards, communication, action on violators)
Ensure current team is healthy before bringing someone new in
Make sure your reputation in the community is improving

Long-term:

Sign up at jillsteeley.com for the Clinical Director's Survival Guide (launching January)
Make culture maintenance an ongoing priority, not a one-time fix
Let your happy staff become your natural recruiters

Resources

Clinical Director's Survival Guide: Sign up for notification at jillsteeley.com (launching January)
Bonus resources: For clinical directors with challenging team dynamics
Weekly tips: Subscribe at jillsteeley.com
RetroClaim: jillsteeley.com/partners for free call

Final Message

If you inherited a messy situation, that's not a reflection of your leadership capability.

But what you do in your first 90 days (or starting today if you're past that window) will determine whether you're still fighting these same battles six months from now, a year from now, or whether you've built the high-performing clinical team you envisioned when you took the role.

Start with the culture. Watch how everything else becomes easier.

Lead with confidence. See you in the next episode.