Healthcare companies face stiff competition for staff

When the pandemic hit California in early 2020, Bicycle Health was a tiny company tiptoeing into the difficult business of treating individuals with opioid use disorder. Its care model was an in-person physical examination at a clinic in Redwood City, followed by telemedicine-based treatment. 

A single provider and medical assistant staffed the clinic. The entire company employed fewer than 10 staff. About 100 patients were being served. 

Then the public health emergency was declared, eliminating the regulation that patients must be seen in person before they could get care via telehealth. Bicycle Health pivoted to virtual-only care and began serving the entire state of California.

“That’s when we got really inundated by the demand and realized we could grow to meet the need nationwide,” said Ankit Gupta, founder and CEO. “Over the last year, we’ve gone from one city to one state to 22 states, and we’re serving over 7,000 patients.”

Bicycle Health has more than 150 staff members, including dozens of physicians and other clinicians—all but a couple of whom are employed full time—as well as clinical support specialists, software engineers and administrative staff.

“We’ve obviously been able to recruit really quickly and have been able to retain talent as well,” Gupta said. 

Meanwhile, Memorial Healthcare System, ranked on the Best Places to Work in Healthcare list for 12 of the past 13 years, recorded a 20% turnover rate in nursing for the fiscal year ended April 30, up from 13% the previous year. Overall, voluntary employee turnover for the fiscal year was 11%, according to information the system submitted for this year’s Best Places program.

The six-hospital system based in Hollywood, Fla., competes with healthcare organizations in Fort Lauderdale to the north and Miami to the south and travel nursing companies across the country.

“The pandemic has exponentially created a much more competitive space,” said Margie Vargas, Memorial’s chief human resources officer. “We’re going to need to really look at the future of work for clinical personnel. How do we do things differently in terms of compensation and in terms of staffing?”

The gulf between the two experiences reflects the fast-changing nature of healthcare work, accruing advantages to some employers and presenting challenges to others.

Virtual office is here to stay

Although remote-only was not its original concept, early in the pandemic Bicycle Health found that its performance on a key addiction-medicine outcome—retention in treatment—was 40% better than the average for in-person providers. Forevermore, Bicycle Health will be a remote-only company, and that has made recruiting easy, Gupta said.

“That is really attractive to talent, especially millennials who care about flexibility,” he said. “And it has allowed us to attract medical providers who are burned out from working at in-person clinics and, especially during COVID, don’t want the additional health risk of working in a healthcare setting.”

Remote work is also important to Memorial Healthcare’s future. Between 10% and 12% of the workforce started working from home early in the pandemic, and they won’t be coming back to an office on a full-time basis. “Our employees welcome and enjoy it,” Vargas said. “It’s been a great point of satisfaction.”

Of course, the vast majority of Memorial’s employees provide hands-on work, from sweeping floors in hospital corridors to saving lives in an emergency department, for which work-from-home is not an option. Vargas says creative solutions must be found to make healthcare careers attractive, and that will take different solutions for different types of work.

For nurses, offering flexibility is key, she said: “A nurse at the bedside typically works a 12-hour shift. Can we do job-sharing so that two nurses work six hours each to give them time to go home and be with family?”
For nonclinical workers, Vargas believes the opportunity for career growth at Memorial will be a good recruitment and retention strategy in a changing job marketplace.

Workers in high demand

Florida voters last year approved a gradual increase in the state’s minimum hourly wage from $8.65 to $15 over five years. Memorial had set its own minimum wage at $12 an hour in 2019 and raised it to $13 this year, but Vargas is seeing fewer applicants and lower job-offer acceptance rates for positions in environmental services, food/nutrition and patient transport.

“We are no longer competing just among healthcare providers,” she said. “We’re competing with retail and the food-service industry and with tourism and hospitality companies that are soon going to be forced to increase their wage to Memorial’s current minimum.”

Memorial had planned to increase its minimum wage to $15 by 2023 but may opt to do so earlier, Vargas said. In meantime, the system last year piloted a program that provides scholarships and flexible schedules to support service staff who want to train to become a patient-care associate, supporting nurses at the bedside.

The pilot envisioned six scholarships in the first year, but that was doubled because so many service workers applied.

“This fall, we’re going to introduce another cohort because it went so well,” Vargas said.

Florida is one of 25 states raising its minimum wage this year, and several are on track to hit a $15-an-hour minimum in the years ahead. For Morrison Healthcare, one of the largest food-service companies in healthcare, that means working with its hospital clients to reconsider wage strategy, said Andy Maus, senior vice president of human resources of Compass One, Morrison’s parent company.

Morrison employs more than 25,000 workers, serving 2,400 hospitals across the country. The company provides in-room meals served to patients and runs hospital cafeterias and gift shops.

“We have seen a lot of adjustments over the past year and a half where, based on the data and insights we have, it is clear that we needed to adjust our wages,” he said. “We’ve seen some clients want to go to that minimum $15 an hour but it is a market-by-market decision to do what’s needed to make sure we’re competitive.”

Morrison has had to recruit about 4,000 front-line hourly workers and management staff in the past year, up from some 3,000 the year before, Maus said. Most of that increase stems from new accounts; during the early months of the pandemic, turnover actually decreased although it has increased slightly in recent months, he said.

“We historically have not had a hard time recruiting, so this past year has certainly created a new challenge for us,” he said. “We definitely saw a decrease in applicant flow and available candidates.”

Morrison streamlined its application process to make it easy for job seekers to apply. For certain positions in certain markets, it is offering hiring bonuses, following the lead of McDonald’s and other companies that have never had to use such tactics before.

Its most strategic play is a brand campaign that differentiates Morrison from other food-service job opportunities. A “we’re hiring” poster says, “Our careers are filled with purpose and empower you to transform healthcare experiences. Apply today and start making a difference in your community.”

“We are really trying to market our culture and our purpose of making a difference in people’s lives, which is a big part of what we’re about,” Maus said.

Aggressive recruiting

In the IT sector, competition for talent has never been more challenging, says Dan Burton, CEO of Health Catalyst, a 1,200-employee healthcare data and analytics technology company based near Salt Lake City. By policy, the company pays above-market rates, and all employees have an ownership stake. The company is rewarded with extremely low turnover and happy employees; at least 40% of new hires come from employee referrals.

Still, the applicant pool is smaller than usual, and many job candidates who are interviewed have multiple offers to choose from. 

“We are finding that direct sourcing—reaching out to folks that are not active job seekers to let them know about our company—is critical,” said Linda Llewelyn, Health Catalyst’s chief people officer.

Burton works to make sure Glassdoor, the website on which current and former employees post anonymous reviews of an employer, helps attract top talent to the company.

“I respond to every review, and we highlight the reviews in our all-team member meetings so we all know what’s going well and especially the things that are not going well, so we can fix them,” he said. “Glassdoor has been a helpful recruitment tool, even in these times where it’s tough to hire software engineers.”

Lola Butcher is a freelance writer based in Springfield, Mo.


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