Perhaps the most common issue I hear during my conversations with fundraising executives at healthcare organizations across the nation is the multifaceted challenge of staffing. Recently, one such conversation shed light on the significant obstacles healthcare organizations face when seeking to fill crucial vacancies, specifically director level and above roles responsible for institutional fundraising. These positions, pivotal for high-level grant funding, have become particularly difficult to fill due to several nuanced factors. Understanding these issues, and more importantly, identifying strategies to address them, is paramount to grant funding sustainability and growth.
According to the 2023 Nonprofit Salaries and Staffing Trends report, two-thirds of survey respondents note that they are finding it more difficult than at any other time in memory to fill positions.
Three pressing challenges
Industry-Specific Experience is a Rare Commodity
One of the primary hurdles in hiring for senior fundraising positions in healthcare is locating candidates who are not only great fundraisers, but also have in-depth knowledge of the healthcare sector. This dual requirement becomes a significant challenge, especially in fields like healthcare where the intricacies of the industry demand a leader who is both a generalist and a specialist. These positions must navigate the nuanced channels and address the unique obstacles healthcare organizations face, from regulatory changes to internal bureaucracies to shifting funding landscapes.
In a recent conversation with a senior executive at a regional healthcare system, the executive noted that the candidates they are speaking with tend to be qualified generalists but lack the industry experience required to navigate the challenges unique to a health system setting, such as working across multiple specialties and locations, while also looking out for “big picture” opportunities as members of system leadership teams.
Looking at the challenge from the fundraiser side, a board colleague of mine with extensive fundraising expertise – but limited healthcare experience – took on a key role as a major gifts fundraiser at a large local healthcare system about a year ago. Recently, I asked him how things were going in the new job, and he replied that the job was great, but that it took him almost the full year to feel fully caught up on the industry-specific nuances of the role. Unfortunately, this blend of skills and industry-specific experience is rare, leading many healthcare organizations to feel stuck between overly long searches for a candidate with the exact experience they require, or committing to long ramp-up times for new hires.
For the second year in a row, workforce challenges, which includes personnel shortages, topped the list of hospital CEOs’ concerns, according to the American College of Healthcare Executives’ annual survey.
Bridging the Salary Expectation Gap
Healthcare organizations often operate under tight budget constraints (“financial challenges” was the second top concern cited in the aforementioned American College of Healthcare Executives’ annual survey), which makes it challenging to match the salary expectations of highly qualified candidates. This disparity is leading more organizations to consider outsourced alternatives for their executive needs. The scenario is further complicated by the evolving work dynamics in a post-pandemic world, where many prospective candidates prioritize flexibility, including the option to work remotely—a condition that not all healthcare leadership teams feel equipped to support, especially at the executive level where in-person leadership and mentorship are traditionally valued.
According to a recent report by the National Council of Nonprofits, almost three out of four respondents (72.2%) said salary competition affects their ability to recruit and retain employees.
The Mentorship Dilemma
Speaking of mentorship, a recurring theme in discussions with healthcare fundraising leaders is the challenge of fostering a culture of independent personal development among their staff. Often, teams lack the experience or confidence to take lead on projects or navigate complex processes without substantial guidance. Leadership, stretched thin by their own array of responsibilities, find themselves unable to provide the level of mentoring and supervision necessary for staff development. Compounding the issue, some nonprofit leaders have stopped providing mentorship altogether for fear of blowback.
Forbes Nonprofit Council outlines 10 Ways Nonprofit Leaders Can Boost Their Team’s Current Skill Sets.
Don’t go it alone
Leveraging External Partners for Internal Growth
Even before COVID, but much more loudly after, I’ve heard a recurring mantra that echoes across the healthcare industry (spanning roles from providers to administration and beyond): “We are too busy surviving to thrive.” Staff are stretched in every direction and getting through the day-to-day work of keeping a hospital running and healing patients is a massive challenge. Few people feel like they have the capacity to take on a 30,000-foot view and develop long-term strategies. In fundraising, this disconnect is at odds with funders—especially grant makers—who want to know that their generosity will have a strategic impact on the hospital.
This also leads to fundraising staff working to address many competing priorities within the hospital system. In the case of grants, which are most often restricted to a specific project, fundraising staff struggle to keep up with all the grant opportunities that are available to fund these different priorities and/or they do not have the resources to develop competitive proposals. All of this is exacerbated by ongoing struggles to fill the senior fundraising positions that can help tame this chaos.
However, none of us need to go it alone. External partners, fractional staff, and consultants offer specialized, high-level expertise that can adapt to an organization’s mission and industry-specific requirements without the long hiring times, long-term commitment, and financial strain of employee churn. In addition to providing critical bridge-the-gap grant writing support, they can step in to mentor existing staff, offer strategic insights based on a wealth of diverse experiences, and act as catalysts for professional development within the organization.
Perspectives from nonprofit peers: 20 Reasons Why Nonprofits Should Hire Consultants
In my career as a consultant, I’ve supported many healthcare leaders across both their strategic leadership and managerial functions. This has gone far beyond grant writing, and has included developing grant seeking strategies, helping to prioritize “grant-friendly” programs, and working to mentor staff and provide “fresh” feedback on team deficiencies and needs. In most cases, this freed up the fundraising leaders I worked with to work at a more strategic level knowing that a lot of the day-to-day work was being handled.
By leveraging the expertise of external partners, healthcare leaders can utilize flexible, cost-effective solutions that not only address the leadership gap but also enhance the collective competence of healthcare fundraising teams, positioning your organization for long-term, sustainable grant funding growth.
About the Author
Matt Carter is a Senior Advisor at Grants Plus and President of The Association of Fundraising Professionals Greater Cleveland Chapter. Matt has over 20 years of experience designing and executing institutional fundraising strategies for healthcare, cultural, educational, policy, and human service organizations across the country.
