Contingency vs. Retained Recruiting

Not all recruiting firms are created equal.  One of the biggest differences is whether a firm works on a retained or a contingency business model.

So, what’s the difference between the two?  To put it simply, a retained recruiting firm must be paid to conduct your search whether they find your perfect candidate or not.  A contingency firm is only paid if a client decides to hire a candidate through them.

At Creative Healthcare Solutions, we are technically a contingency recruiting firm.  I say “technically” because two of the three partners behind the company come from a retained search background and wanted to incorporate what they know to be the advantages of that model into the accessibility and affordability of contingency recruitment.  In our firm, we truly believe our clients can have the best of both worlds and we’ve created a new model to provide that.

Many contingency recruiters believe in quantity over quality, but we prefer to do things differently.  Instead of blindly forwarding every resume in which a candidate looks good “on paper”, we take the time to have thoughtful conversations with every qualified applicant, so we can ensure they’re the right fit for the position on a deeper level and that their motivations and professional goals are aligned with our clients.  

We also invest time on the phone with our clients at the onset of every search.  We schedule an onboarding call with the hiring organization, so that we fully understand the opportunity, the company culture, and what makes an ideal employee.  We find that even a short call (that’s respectful to busy schedules) before we start recruiting can save hours later on in the process.  Having all the details and a clear understanding means we can do a better job screening candidates which, in turn, means clients only receive appropriate applications.

And our candidate presentations go beyond what most contingency recruiters provide.  In addition to the candidate’s resume or CV, we include an upfront summary with important information, such as whether they’re seeking full-time or part-time, how many years of experience they have, current licenses, certification status, communication style, etc.  

If you’ve ever struggled to decide between engaging a contingency or retained recruiter, we encourage you to consider using a hybrid of both.  At CHS, we provide retained quality services for the friendly prices and fee schedule of a contingency firm.

You're Probably Paying Too Much For Physician Recruiting

Right now, you may be thinking about hiring a new healthcare provider and asking yourself, “How much should I pay a physician recruiting firm?”  According to Forbes, placement fees are typically “a percentage of the employee's first year compensation package and can range from 15% - 25%” of the individual’s total annual income.  But what does that mean in dollar amounts

If we look at Medscape’s 2017 Physician Compensation Report, we see the average annual full-time physician salary is $294,000.  Even if we take the average salary for the lowest paid specialty (pediatrics) at $202,000, that equals a placement fee between $30,300 - $50,500.

There is certainly a cost to recruiting, especially in a field as competitive as physician staffing, but it’s difficult to see a justification for fees of $30,000 - $50,000.  As technology has improved, so has the cost of doing business - but the fees that recruiting firms charge have not changed.  Creative Healthcare Solutions was founded on the belief that recruiting services should be accessible to practices of all shapes and sizes.  Our fees are much lower than the industry standard, but our services are not.  We find savings simply by embracing modern technology and cutting out unnecessary frills, which reduces our overhead and allows us to pass on that value to our clients.  

Most recruiting firms try to hide their fees or drag prospective clients through a lengthy negotiation process.  We do the opposite.  Our fees are listed directly on our website, which can be seen here.  The short version of the story is that our highest provider placement fee is for a full-time physician (any specialty) and is $8,500.

Creative Healthcare Solutions is now in its fourth year of business and we’ve seen exponential growth every year.  This is largely due to satisfied clients returning to us, as we have been able to present qualified candidates to 90% of our clients within 30 days.  As with many industries, someone is going to come along and figure out how to get the job done cheaper, faster, and better.  We are proud to be one of those companies.

Internal Recruiters vs. Contingency Recruiters

They say only two things in life are certain: death and taxes.  Another April has come and another tax season has ended.  Now it’s time for budgets to be created and money to be allocated for the 2017 tax season.  As your practice grows, one of those budget items will be for recruiting new talent - whether that means paying for ad space to recruit more office staff and administrative personnel or hiring an internal or contingency recruiter to find mid-level providers and physicians.

Internal Recruiters

Hiring an internal recruiter makes sense when you need to onboard a high number of providers on a regular basis.  According to, the median physician recruiter salary is $72,844 per year, with the national range being $63,978 - $84,443.  Now, let’s not forget about those taxes!  A recent article by CNN Money asks, “How much does an employee really cost?”  While that depends on benefits and several layers of taxes, it typically ends up being 18% to 26% more than an employee's base salary (and even higher for large companies).  This means that if you hire a recruiter at $70,000, that employee will actually cost you closer to $88,000 per year.

Contingency Recruiters

Alternatively, opting for a contingency recruitment firm like Creative Healthcare Solutions is much more cost-effective, especially if you are hiring at a lower volume or have intermittent needs.  Our rates are far lower than the typical contingency recruiter, who charges 15-20% of an employee’s first year salary.  With the average physician annual salary at $189,000, many contingency recruiters are charging $28,000-$38,000 per placement.  Being a small, streamlined firm, Creative Healthcare Solutions is able to charge a flat placement fee of $8,500 for a full-time physician.  Again, let’s not forget taxes … but, this time, you’re using a vendor and your recruiting expenses are a deduction.  At $8,500 per full-time physician hire, it only makes sense to hire an internal recruiter if you plan to bring on more than 10 full-time physicians per year.

In conclusion, we’d like to leave you with this handy image to illustrate the internal vs. contingency recruiter decision-making process:

Time Is Money

With February being the shortest month of the year, it has us thinking about time and how important that can be in the world of recruiting.

As a contingency recruiting firm, we get asked one question more than any other: how quickly can we present candidates?  We’re proud to say that we are able to present candidates in less than 30 days to 90% of our clients.  But, despite that quick turnaround, it’s how quickly the hiring manager responds to those presentations that makes the biggest difference in whether or not the candidate moves forward.

After we’ve presented a candidate, it’s up to the hiring manager to review their CV and decide whether they want to move forward or not.  We try to make the decision as easy as possible by including a summary of the candidate’s motivations and personality along with their CV, as well as concisely highlighting all of the most relevant information in an easy-to-read email.  It should take about 10 minutes to review a candidate’s summary and CV but, often times, we’re left sending follow-up emails days - sometimes even weeks - after the presentation has been sent.  

As healthcare providers receive upwards of 10 notifications about job openings every day (and for physicians that can be much higher), we recommend that presentations are reviewed and responded to within 24-48 hours.  Anything longer and there’s a good chance the candidate will have already moved forward with another opportunity or they will no longer be interested due to lack of communication dampening their enthusiasm for the role.  Delaying a response on a candidate presentation not only means the loss of the candidate, but will also reflect negatively on the practice and can impact future hiring options.

When trying to recruit a new nurse practitioner, physician assistant, or physician, time really is money.  Being responsive and keeping the candidate engaged is paramount to the success of the search.  A 24-48 hour turnaround on a candidate presentation will ensure that the candidate stays engaged and that your practice will have an opportunity to secure a great new employee.

Disrupting The Healthcare Recruiting Industry

2017 is here! Now that the dust has settled and holidays are firmly in the rearview mirror, we decided to take a look back at 2016 and reflect on how we were able to help healthcare practices like yours hire key talent at a fraction of the cost of other firms.

First, let’s take a look at the average physician recruitment placement fee. According to, “Contingency agreements are entirely performance based and you don't pay a recruiter until they successfully recruit an employee for your company. Typically, this is a percentage of the employee's first year compensation package and can range from 15% - 25% of that individual’s pay.” With the average full-time physician salary being $202,000 and the average full-time mid-level salary being $94,500, that puts most recruiters’ placement fees at $30,000+ for a physician and $14,175+ for a mid-level. Let’s compare that to our fees at $8,500 for a physician and $6,500 for a mid-level:

Placement Fees ($ in thousands)

How do we keep our fees so low? Well, we came into this industry realizing most small-to-mid size practices can’t afford typical recruitment fees. With that in mind, we decided to be disruptors and offer quality provider recruitment at affordable rates. We work smart and keep our business streamlined - and technology enables us to keep expenses much lower than a traditional recruiting firm. Why pay for landlines when we all have cell phones? Why buy an expensive printer/fax machine when we all use email and an e-fax number is $10/month? Why waste money on business cards and brochures when we have our contact information in our email signatures and can send PDF brochures? The status quo in the recruiting industry is expensive - and unnecessary. We trim that fat, keep expenses down, and pass on the savings to our clients.

Because of this, our lower fees never result in lower quality in service. Your search will always be directly handled by a Managing Partner and candidates will always be thoroughly vetted before being sent to you. We’re proud to report that in 2016, 85% of our clients had qualified candidates presented to them within 30 days. We want to emphasize the qualified, as many clients tell us other recruiters present more candidates and do so faster - but they’re not properly vetted and result in wasted time on all sides, due to issues that could have been easily discovered during a proper phone interview by the recruiter. While it may seem exciting to get 10 candidates within 48 hours, how valuable is that if none meet the requirements or are interested in the opportunity? We ensure that every presented candidate is qualified for and interested in the job at hand.

If you have a need for a provider this year, please consider using Creative Healthcare Solutions.  We are a contingency recruiting firm, so you have nothing to lose by working with us - you don’t pay anything unless you hire a candidate we presented and we will consult with you and provide feedback along the way. Don’t pay standard fees for standard recruiting. Partner with Creative Healthcare Solutions and get quality recruiting at affordable rates.