Healthcare Executive Search
Retained search and contingent recruitment can both support healthcare appointments, but they operate in different ways. This guide explains which model may be more appropriate for senior and specialist healthcare roles.
When a healthcare organisation needs to appoint a senior executive, one of the first decisions is how the recruitment process should be structured.
Some appointments are managed through contingent recruitment, where a fee is generally payable only if the recruitment firm introduces the successful candidate.
Others are conducted through a healthcare executive-search process, where the organisation appoints a search partner to undertake a dedicated and comprehensive assignment.
Both models can be effective in the right circumstances. However, they are designed for different types of recruitment challenge.
For a senior, confidential or difficult-to-fill healthcare appointment, understanding the distinction can help boards and executives choose the approach most likely to produce a strong and sustainable outcome.
Under a contingent recruitment model, a recruitment firm generally receives a fee if a candidate it introduces is appointed.
The organisation may engage one recruiter exclusively, or it may brief several agencies at the same time.
The recruiter will usually search its existing database, advertise the position, contact relevant people within its network and present candidates who appear suitable.
Contingent recruitment can work particularly well when:
The model can be efficient because the organisation generally pays the recruitment fee when an appointment is made.
However, the amount of research and proactive market engagement undertaken may vary depending on the recruiter, the assignment and the likelihood of a successful placement.
Retained executive search is a research-led and consultative recruitment model typically used for senior, specialised or business-critical appointments.
The organisation appoints a search firm to lead a defined assignment. The fee is usually paid in agreed stages during the search rather than being entirely dependent on the final placement.
The retained search partner may support the organisation with:
A retained search is not simply a payment arrangement. It is a commitment by both the organisation and the search partner to conduct a thorough process.
The main difference is the scope and structure of the assignment.
Contingent recruitment is generally focused on introducing an appointable candidate.
Retained search is generally focused on conducting a comprehensive examination of the relevant candidate market and helping the client make an informed appointment.
This affects how the work is approached.
A retained search partner is usually appointed exclusively and is expected to invest significant time in research, stakeholder consultation, candidate engagement and assessment.
A contingent recruiter may be working alongside other agencies and may therefore focus first on candidates who are already known, readily available or likely to move quickly.
Neither approach is inherently better in every situation. The most appropriate model depends on the level of the role, the complexity of the search and the risk associated with making the wrong appointment.
Senior healthcare leadership roles often require an uncommon combination of capabilities.
A successful candidate may need to demonstrate:
The available candidate market can narrow quickly once all of these requirements are considered.
A hospital may need a Chief Operating Officer who understands complex clinical operations. A health service may require a Director of Medical Services with the right professional qualifications, leadership experience and willingness to relocate. A board may be seeking a CEO capable of managing significant reform while maintaining the confidence of clinicians, employees, government and the community.
In these circumstances, the strongest candidates may not be actively applying for advertised positions.
They may need to be identified, approached and engaged in a confidential conversation before they will consider the opportunity.
Contingent recruitment may be suitable when the organisation is confident that a reasonable number of qualified candidates are available and likely to respond.
It may also be appropriate when:
For some healthcare management and professional appointments, an experienced contingent recruiter with a strong network may produce an excellent result.
The organisation should still clarify how the recruiter will approach the market, assess candidates and manage communication throughout the process.
A retained search may be more appropriate where the appointment is senior, specialised, confidential or strategically important.
This can include situations where:
A retained process can also be valuable where the organisation wants a search partner to represent the opportunity carefully and consistently to senior candidates.
One of the most important distinctions between general recruitment and executive search is the level of proactive candidate engagement.
Senior executives may not be monitoring job advertisements or actively submitting applications. They may be performing well in their current positions and would only consider moving for a compelling opportunity.
A search process should identify potential candidates across relevant organisations and approach them directly.
This requires more than sending a generic message.
Senior candidates are likely to want an informed discussion about:
The person representing the organisation needs sufficient knowledge and credibility to conduct that conversation effectively.
A retained search should provide the organisation with insight into the wider candidate market, not only the candidates who reach the final shortlist.
Market mapping may help the organisation understand:
This information can influence the current appointment and support longer-term succession planning.
For example, if several credible candidates express concern about the scope of the role, reporting structure or remuneration, the organisation may need to revisit those elements.
A search partner should communicate this feedback honestly, even when it is difficult to hear.
Retained searches are generally conducted exclusively.
This gives one search partner responsibility for managing the organisation's message, candidate contact, research and reporting.
Exclusivity can reduce the risk of senior candidates being approached repeatedly by different recruiters about the same opportunity.
It can also support:
Using several agencies can increase the number of recruiters contacting the market, but it does not always increase the depth of the search.
In a limited senior candidate market, multiple approaches can sometimes create confusion or make the opportunity appear less controlled.
Contingent recruitment fees are commonly payable when a candidate introduced by the recruiter accepts or commences the position.
Retained search fees are generally paid in stages, reflecting the work undertaken throughout the assignment.
The exact structure varies between firms, but staged payments may be connected to:
Boards and executives should compare more than the headline percentage.
They should also examine:
A lower fee does not necessarily represent better value if the process does not reach the strongest potential candidates.
Equally, a retained fee should be supported by a clearly defined and rigorous search methodology.
No recruitment model can guarantee that a particular person will accept the role or succeed after appointment.
A retained process does not remove the need for strong client decision-making, careful assessment or effective onboarding.
It should, however, provide the organisation with a more comprehensive view of the available market and a structured basis for making its decision.
The quality of the outcome will depend on factors including:
Search is one part of a successful appointment. The organisation must remain actively involved throughout the process.
An executive search should not begin with an outdated position description and a request to find someone similar to the previous leader.
Before choosing a recruitment model, the organisation should define:
A search firm can help facilitate this discussion, but the board or executive team must ultimately agree on the mandate.
Without that clarity, even a comprehensive search can produce candidates who meet different stakeholders' competing interpretations of the role.
A retained search partner should offer clear deliverables and consistent communication.
The organisation should expect:
The search partner should also be willing to advise the client when expectations are unrealistic or when the market is responding differently from anticipated.
Boards and healthcare executives may find it useful to consider the following questions:
The answers will help determine whether a contingent process is sufficient or whether a retained search is justified.
Some organisations use a hybrid or exclusive contingent model.
Under this arrangement, one recruitment firm may receive an exclusive period to work on the appointment, while all or part of the fee remains linked to a successful outcome.
This can work where the role requires more commitment than a standard multi-agency assignment but does not require the full scope of a retained executive search.
The important issue is not the label applied to the model.
The organisation should clearly understand:
A clearly documented process helps prevent different expectations developing after the search has commenced.
Contingent recruitment can be an effective and efficient option for many healthcare appointments.
Retained search is generally most valuable where the role is senior, specialised, confidential or difficult to fill, and where the organisation needs a comprehensive assessment of the available candidate market.
The decision should reflect the complexity and importance of the appointment rather than being based only on the initial fee structure.
For boards and executives, the central question is:
What level of research, engagement and assessment is required to give the organisation confidence that it has considered the strongest available candidates?
Vitalis Recruit supports Australian healthcare organisations with executive search, medical-leadership recruitment, confidential appointments, interim leadership and proactive market mapping.
We tailor the search approach to the organisation, the position and the realities of the candidate market.
Planning a senior healthcare or medical-leadership appointment? Contact Vitalis Recruit for a confidential discussion about the most appropriate search approach.
Written by
Vitalis Recruit is an Australian executive-search firm specialising in senior healthcare leaders.
Speak with Vitalis Recruit about retained executive search, confidential appointments, interim leadership or proactive market mapping across the Australian healthcare sector.
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