A physical therapist interviews at a clinic on Monday. She likes the owner. The owner likes her. He tells her the team will talk it over Thursday and he'll be in touch. By Wednesday she has an offer from another practice. By Friday she has said yes.
Nobody did anything wrong in that story. That's why it keeps happening.
I lose more searches this way than any other. Not on pay, not on location. On the calendar.
Nobody measures this, so I'll tell you what I see
No public dataset tracks the days between a clinician's interview and an offer. BLS JOLTS counts openings, hires and separations by industry. It says nothing about speed inside a single hiring process.
What I have is a desk. I've been on the phone with clinicians since 1997 and I've run Great Bay since 2008. The pattern is the same in outpatient therapy, home health, pediatrics and skilled nursing. The candidate worth hiring is talking to several employers at once. The first one to put a real offer in writing usually wins.
Your process isn't being compared to an ideal. It's being compared to the two other processes she's in.
The slow part is almost never the decision
Employers think they're slow because the decision is hard. Mostly it isn't. The delay is in the handoffs.
The owner wants the clinic director's read. The director is with patients until Thursday. The director wants the billing manager to confirm the productivity numbers. The billing manager is out. Each of those is two or three days, and none of them feels like a delay from the inside.
Small and mid-size employers do this more than large ones, which surprises people. A five-clinic group has fewer people to consult than a hospital system, but also fewer people who can say yes. When the one person who can is treating patients all day, the process stops.
Decide who decides before the posting goes live. Then give that person a standing hour to make the call.
Silence gets read as an answer
A clinician who hasn't heard back in four days doesn't assume you're busy. She assumes you're unsure, or disorganized, or that someone else got the nod.
She's also making an inference about what it will be like to work for you. A practice that can't return a call in a week is a practice where her schedule changes will sit in somebody's inbox.
I tell clients to send a two-line message the same day, even when there's nothing to report. "We're meeting Thursday. You'll hear from me Friday." That's enough. It costs nothing and it keeps her from filling the silence with a competing offer.
Holding out for a better one is a bet
This is the part owners don't like hearing. Sometimes the delay is deliberate. There's a good candidate in hand, and you want to see two or three more before you commit.
In a market where rehab and advanced practice clinicians are scarce, you are usually comparing one person who exists against a pool that mostly doesn't. The candidate you're holding is not waiting in a queue. She is interviewing elsewhere, and the ones you're hoping for may never come.
An empty PT or NP chair is also a schedule you can't fill. Every week of it is visits you don't deliver and referrals that drift to someone who has capacity. I'd put that cost on the table next to the risk of hiring someone who's merely good.
Find out what kills the offer in week one
Most offers that fall apart do so on a short list. Base compensation. Start date. Caseload or productivity expectations. Schedule flexibility. Sign-on terms. Every one of those is knowable before the first interview.
I'd rather know in week one. If the range the owner approved is lower than what the market is asking, I want that conversation before a clinician has met the team and fallen for the clinic. A candidate who falls for the clinic and then sees the number is a worse outcome for everyone than a candidate who never got that far.
Get the range approved, the start date flexible and the offer letter drafted before you interview anyone. Then when the right person walks out of the room, you can send it that afternoon.
Most of the clinicians I lose are gone by Thursday.
Sources: Great Bay Staffing Group search activity, 2008 to 2026 (internal observation; not published as a dataset and not independently verified). BLS JOLTS program documentation, release date not confirmed for this post; JOLTS reports openings, hires and separations by industry and does not measure interview-to-offer time.