15 years into practice and I’ve watched private equity and for profit systems swoop in, buy out contracts, and squeeze them for every penny. The new “leadership” couldn’t care less about their clinicians and show it at every turn. They say things like “team” and “culture” when the real focus is on the immediate quarter’s profit margins and whatever it takes to roll into the next quarter in the black with rooms staffed. It doesn’t take long for the stronger clinicians to throw up their hands and either move on or jade out. To be fair, I agree on many of your points. I would love to work in an environment with strong culture, team satisfaction, be a respected partner, enjoy some autonomy and stability, and strive for work-life balance all the while being supported by leaders. However, I must submit to you that very little of what you write is based on reality in my experience. Must we strive to do better? Of course and at every opportunity. I simply haven’t been a part of the type of environment you are describing. In addition, I think your excerpt on valuing emotional intelligence is accurate but you may be seeing it backwards. Those that have it will wake up to the fact that they are being taken advantage of in most W2 situations simply because they are trying to be team players. Those clinicians are looking left and right at the locums providers making more per hour with way less skin in the game and are justifiably upset. Match that up with “leaders” that can’t give a lunch safely, communicate poorly if at all, and will gladly throw staff under the bus at the first sign of trouble. The truly emotionally intelligent won’t suffer that for long and will either change their situation or drop out. To finally land on a hypothesis that paying less per hour will somehow get you better clinicians? No sir. The comp package will only get someone interested enough to start a conversation and in the current market that number needs to be high. It is up to you as the hiring entity to figure out who will and won’t fit the culture you are trying to create. Add that to the fact that we are facing a shortage that is only worsening? Most places are only worried about getting enough clinicians to cover rooms. The time for wholesale culture change is when you have the good fortune of a full complement of solid staff. Now is not that time. Pay up or lose.