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Written with insights from the ETS Pediatric team: Evyn Duff, Jaclyn Padgett, and Melissa Willis.

You find a pediatrician who checks every box. The first call goes well. Then another interview gets added, a partner wants to meet them, and feedback takes two weeks. By the time you’re ready to make an offer, they’ve signed somewhere else.

Our recruiters work with hiring teams and pediatricians every day, and we’ve watched this exact scenario cost strong practices great candidates. More often than not, a slow, disorganized, or overcomplicated process is what costs them the hire. Here’s what our recruiters see working, what slows practices down, and how to keep your next hire on track.

The Typical Pediatric Interview Process

1. Recruiter screening. A 10 to 15 minute call to talk through the candidate’s experience, preferences, and the opportunities that fit. The recruiter then introduces the candidate directly to the hiring team, so there’s no application to go through.
2. Initial interview. A 15 to 30 minute phone call with the practice owner, hiring physician, office manager, or a hospital’s internal recruiter.
3. Follow-up conversation or leadership interview. If needed, a virtual meeting with other physicians, partners, staff, or hospital leadership.
4. Onsite visit. An in-person interview at the practice, sometimes with shadowing or lunch. Timing depends on whether the candidate is local or needs to travel.
5. Reference check. The practice requests professional references and contacts them.
6. Offer or letter of intent. Smaller practices often extend an offer within one to three weeks of the onsite visit. Hospital systems may take longer.
7. Contract review and signing. The formal contract is prepared, reviewed, and signed. This can add about two weeks, especially if the candidate has an attorney review it.

All in, this usually takes one to three months, sometimes longer. It depends on the size of the employer, how many candidates are being considered, how quickly both sides respond, travel, and contract negotiations.

The Ideal Interview Process

For most outpatient practices, two to three touchpoints are enough: an initial interview, a meeting with decision makers if they weren’t on the first call, and one onsite visit. Interviews should wrap up in two to three weeks, with an offer within a few days to two weeks of the onsite. If both sides are interested and the key questions are answered, another round rarely adds anything.

Not every process will fit this exactly. Hospital systems may have required steps outside the hiring manager’s control. Some residents can have a hard time scheduling onsite visits around their rotations. What matters is that every step has a reason to be there.

What Great Clients Do

The practices that hire well tend to do a few things consistently.

Before interviews start
They know what they want, including must-haves, compensation, and schedule. Many also have an offer letter ready by the onsite visit, so the candidate can sign there or take it home to think it over.

During the process
They set the next step at the end of every conversation, make time for interviews, and keep the appointments they set. They also bring up compensation during the onsite instead of waiting until the offer.

After each interview
They follow up within a week, even without a decision. Something as simple as “We’re finishing a few interviews and will get back to you next week” is enough.

Red Flags

Candidates see your hiring process as a preview of how your practice runs, and every misstep sends a message.

Rescheduling interviews again and again tells a candidate your office isn’t organized. Adding new interviewers or requirements late tells them the people in charge aren’t on the same page. And asking them to have the same conversation with three different people makes them wonder whether anyone is talking to each other.

When the calls and visits keep coming without any movement toward an offer, candidates start to feel like you aren’t sure about them. Not having an offer ready after a strong onsite sends the same signal right when their interest is highest.

Changing compensation late without a real conversation can undo a lot of goodwill. A lower salary with a small bonus that doesn’t close the gap tells a candidate that promises might change after they’re hired.

Silence says the most. If we submit a candidate on a Monday and don’t hear back until the following week, the candidate may assume you’ve passed. Practices that are only passively searching tend to have the longest gaps. We say it often: time kills all deals.

What Drives Over-Interviewing

Most practices over-interview because they want to get the hire right. In practice, it usually comes from:

• Not being sure what the role needs
• Several people who need to agree but haven’t aligned
• Holding out for a perfect candidate when a strong one is already in front of you
• No clear final decision maker
• Busy schedules that make interviews hard to book

The causes look a little different depending on the size of the practice.

Larger organizations: In hospital systems, resumes often go through HR, department leaders, and committees before an interview is even scheduled. Large private groups run into the same problem when several partners need to sign off.

Smaller practices: With fewer decision makers, smaller practices can usually move faster, but things can still stall if the physicians don’t agree. Solo physicians hiring an associate are often stretched thin with patients, and if they haven’t hired in a while, they may not know what an efficient process looks like today.

What Over-Interviewing Costs You

Candidates

Strong pediatricians are usually talking with more than one practice. They understand hiring takes time, but they need to see that you’re serious. Here’s one example from our recruiters:

“I worked with a client who was confident in a candidate I had presented, and they had already started contract negotiations. I recommended they also schedule a phone interview with a second candidate I had recently submitted, just in case things fell through. Ultimately, the first candidate accepted another position. By the time the client reached out to the second candidate, they had also accepted another position after not hearing back.” Evyn Duff, ETS Pediatric

This is why we ask clients to talk to every qualified candidate we send. Nothing is final until the contract is signed.

Who Is Most Affected

Every candidate appreciates a quick process, but we see that timing matters most for these groups:

• Residents and fellows are juggling graduation, licensing, credentialing, and relocation, and they’re usually interviewing in several places.
• Physicians relocating with family are working around a spouse’s job, housing, and schools, often with a set move date.
• Currently employed physicians have notice periods to manage and little reason to wait.
• Late-career physicians are often planning around a specific timeline and have clear priorities when it comes to benefits, so a predictable process matters.

Other Costs

A long search also means coverage gaps, harder patient access, extra work and burnout for the physicians you already have, and lost productivity. If your top candidate walks, others in the pipeline often go too, and you’re starting over.

Your reputation takes a hit as well. One candidate told us they wouldn’t consider a client’s opening because that practice had ghosted them years earlier. Close the loop with every candidate, even after the job is filled.

How to Prepare Before You Interview

A faster process starts with preparation. Before your first interview:

• Define your ideal candidate and must-haves
• Set compensation ranges for new graduates and experienced physicians, including bonuses, and know how your benefits compare
• Be clear on schedule and expectations
• Decide who’s involved and who makes the final call, and bring them in early
• Agree on a timeline and share it with candidates
• Have an offer letter or letter of intent and an employment contract ready to go

How We Help

At ETS Pediatric, we sit between the practice and the candidate to keep things moving. We screen candidates and introduce them directly, so there are no applications to wade through. We can schedule first interviews if you send us your availability. After each step, we check in with both sides, pass along feedback and questions, and make sure everyone knows what’s next. If things start to stall, we’ll let you know and help work through any hesitation. When it’s time to make an offer, we’ll help guide you through the offer letter and contract, including providing a template if you need one.

Interviewing Goes Both Ways

While you’re evaluating a candidate, they’re evaluating you, and the best ones have options. Even when every interview goes well, slow follow-up can be the dealbreaker. Keep each step purposeful, stay in touch, and move quickly when you find the right person.

If you’re hiring a pediatrician, or think your process might be costing you candidates, reach out to ETS Pediatric. We’ll help you find the right fit and keep the process on track.