Episode 6: Reach out and hug someone - Staffing during the Great Resignation, with Tim Bosse from System One

Justin Steinman:
Definitively Speaking is a definitive healthcare podcast series recorded and produced in Framingham, Massachusetts. To learn more about healthcare commercial intelligence, please visit us at definitivehc.com.

Justin Steinman:
Hello, and welcome to the latest episode of Definitively Speaking, the podcast where we have data driven conversations on the current state of healthcare. I'm Justin Steinman, chief marketing officer at Definitive Healthcare and your host for this podcast. I'm joined today by Tim Bosse, senior vice president, talent solutions at System One and my colleague Todd Bellemare, senior vice president of strategic solutions here at Definitive Healthcare.

Justin Steinman:
System One is the 25th largest staffing company in the United States. They deliver recruitment and specialized workforce services across six core high growth areas, including healthcare. Tim is the leader of the healthcare practice at System One. He recruits talented people from across the healthcare industry for roles ranging from nurse leadership to clinical and scientific leadership to physician department leadership and frankly, I can think of no one more qualified to talk with us today about the current staffing and hiring and challenges and how the great resignation is impacting the healthcare industry.

Justin Steinman:
So Tim, thanks for joining us today. For our audience out there, can you just give a quick overview of like who System One is and what role you play there?

Tim Bosse:
Sure. Thank you. I appreciate the time to speak with you, Justin and Todd and as you did say, System One is the 25th largest staffing company in the United States. We are a leading staffing workforce solution and integrated services organization. I do lead our healthcare practice which is under one of our 10 different brand names under System One, which is called Joule.

Tim Bosse:
We are headquartered in Pittsburgh, Pennsylvania. We have over 60 offices just in throughout the United States and Europe, 300 plus recruiters and talent sourcers in the company and we're privately held with over a billion dollars in annual revenue and over a thousand clients that we serve within those key strategic sectors, over 10,000 consultants and hundreds of direct placements on a annual basis. So I'm real honored to talk to you about some of the challenges and solutions within the healthcare, recruitment and staffing workforce solutions.

Justin Steinman:
Great, great, great. You know, so Todd and I are New England Patriots fans. We won't hold the fact that you're a Pittsburgh Steelers fan against you. You do have my ultimate respect for having the [inaudible 00:02:38] and junior jersey league behind you here on the recording session. So A plus on that one.

Tim Bosse:
Well, the only thing I'll just have to interject there is I'm from Baltimore originally so I'm a Baltimore Ravens fan so saying that about Pittsburgh is difficult, but we do have headquarter there. It's a great city. I'm just not a Steeler fan.

Justin Steinman:
I don't know which is worse.

Todd Bellemare:
I don't either.

Justin Steinman:
We can have a whole other podcast Todd, a whole other podcast.

Todd Bellemare:
Right.

Justin Steinman:
All right. So Tim, let's just jump right in here. We are in the middle right now of what is called the great resignation. Across every industry, people are quitting their jobs and moving onto quote unquote "greener pastures." Sometimes it's for more money in the same field. In other situations, people are changing fields altogether. How is all this playing out in the healthcare industry?

Tim Bosse:
Well, it's we use this term, the great resignation that has been used a lot. I've seen other names, the turnover tsunami. I just think it's an incredibly crazed, chaotic and complex market right now for recruiting, especially in healthcare. It was that way two years' ago, it was still very competitive and very complex because of the supply and demand challenges. Then in the last 24 months and you have COVID so a lot of C's there with craze, chaotic, complex, competitive, and now on COVID. It is definitely a time in my 30 years of being in the workforce solutions sector I haven't seen anything like it.

Justin Steinman:
In November, according to the US Department of Labor, the number of Americans who voluntarily quit their jobs hit a record of 4.5 million. In December, that number declined all the way down to 4.3 million, which is just the second highest number on record. Are you seeing the same rate of people quitting their jobs in the healthcare space?

Tim Bosse:
We are. So we continue to bring on new clients as well as have longstanding strategic relationships with hospitals, small community based, critical access hospitals, and then large, very well named hospitals throughout the United States. There's resignations going on and in all areas from the physicians to the nursing, to ancillary services, allied health and one of the key areas that we're seeing right now, especially now that we're hitting a 24 month mark of the pandemic is we're starting to see managers and leaders resign. So where you had the frontline workers such as the physicians and the nurses, now we're starting to see the leadership resign and that is a very critical state right now because many of them would stay and were staying through the crisis, now they are beginning to resign and either retire and or look for other opportunities.

Justin Steinman:
And does that seem like it's obviously part of the burnout that the frontline workers are seeing is a leadership, obviously, there's a rub off effect there where they are also getting burnt out as well. Is the rationale for them leaving kind of correlating to what we, you see from the frontline workers?

Tim Bosse:
I think there is, I think the burnout piece, the just the workers being exhausted, whether you're coming in and in the registration side all the way through laboratory services, ancillary services, allied health, up to the physicians. You're seeing burnout, you're seeing exhaustion, but the piece with the management and leaders, and I'm talking more specifically around department heads. So managers, directors that stayed on and provided unbelievable amounts of time and resources and sacrifices are starting to resign on top of Todd and Justin, what you said just with the front line, which are usually defined as the physicians and nurses.

Justin Steinman:
Right. I can imagine that when you're managing a group of people that are under that amount of stress, that it must just rub off on you quite a bit to, not only the stress that you're feeling in your job to do your work, but you know, all that excess stress compounding almost on those leaders too so that makes a lot of sense. When you look at things by specialty, for ancillary services, like you said, so PT, the therapists, even social workers, I would imagine that, do you see that type of specialty having the same high turnover rates that you do for maybe emergency care workers? I was just trying to see what the sort of the groupings might be in terms of higher versus lower might be.

Tim Bosse:
Yeah. I think that those areas, if we separate the physicians and the nurses, and then we look at, as you said, the allied space and the ancillary services that provide the additional support to those other departments, I think there's a level of obligation and possibly guilt not to leave like some of the nurses and physicians and go to other opportunities during the pandemic. They felt a obligation to stay at that facility or stay at that health system so now that we're hitting a two year mark, it's become even more critical if you're a hospital executive and one of the administrators, now you're seeing the consistent challenges around staffing and retention and now you're having it at the leadership ranks and that's becoming more paramount every day with us.

Justin Steinman:
Yeah. So I've got some interesting stats here to kind of back up what you're talking about here, Tim, I'd love for you to react a little bit to this. So according to a recent American Medical Association study, one in five physicians and two and five nurses intend to leave their current practice within the next two years and then I read a different AMA study recently that said the expense to replace just one physician could [inaudible 00:08:54] almost $250,000 in recruiting costs and that they estimate the cumulative cost of turnover and reduced clinical hours due to physician burnout is estimated at 4.6 billion dollars of annual expense. So how do hospital executives deal with this? What can they do to make healthcare more attractive, deal with some of the stress? Like, what do you do if you're running a hospital?

Tim Bosse:
Well, the first thing is, those numbers are staggering and continue and I think it's probably even much greater than that. I think the first thing, there's multiple things that hospital executives and administrators can do and one of the first things that I would recommend is do everything you possibly can to retain the staff that you have. That's the first thing. There's so much discussion about the resignation, as you've said. We see consistently with our clients throughout the United States is, can we have support? Can you help us recruit here? Can we have additional resources? We're doing this project, we're having these gaps and the first thing that I would say is look at the resources and staff that you have and do everything you possibly can to retain them and bear hug them and make sure they don't leave.

Tim Bosse:
That's one of the first things. Now, the other things which are just things that we have seen over the time, even the phrase of the healthcare heroes, that's starting to fade away and I've seen some negative articles and information out there about just how, were we heroes or were we just doing our job now? Now we're considered an enemy and sometimes and it's just a very interesting dynamic going on but the first thing that I would say to administration executives is retain the staff that you have and absolutely look at every aspect of the benefits, the compensation, the workforce, the work setting that they're working in and the different types of roles and responsibilities that they have, that they've been really looking at over the last few years and then experience.

Justin Steinman:
When you look at those sort of strategies, have you seen sort of the increase in compensation starting to sort of rear its head as we've gotten deeper and deeper into the pandemic now looking for any strategy whatsoever to try to sort of, like you said, bear hug those employees and keep them. I would imagine that the compensation piece is probably something that is coming to the forefront quite a bit. Have you seen that?

Tim Bosse:
It is. I think compensation is always in any of the sectors quite frankly, across System One and all the areas that we work across with our a thousand plus clients but compensation is usually in the top three and when someone's looking at a job, it's looking to potentially move and as we're talking about retaining the staff, so most healthcare workers, if you went into a hospital today and you pulled them all into the auditorium and you asked them how many got into the healthcare and the medical profession because of compensation and money and most would not raise their hand. It is important, you want to be paid fairly. So we are seeing facilities become more flexible, what I think is good because what we see, is when we provide candidates to facilities and to hospitals and health systems, we provide a profile and that profile outlines and it's their story. It's the candidate's story around their personal, professional and financial drivers of why they're interested in this position.

Tim Bosse:
So we tell that story and one of the things that they want to know is, is there growth there? And we are starting to see compensation in particular areas begin to increase, which I think is very helpful and never hurts but the other thing just to follow up on that, Todd, is the fact that there have been a lot of bonuses that have been paid out with the different government relief funds and different monies that have been available and now that's going away so that was temporary reward for what they were doing and I think what facilities need to do is really look at their current compensation, all the benefits involved by position with the roles and responsibilities.

Justin Steinman:
Are you seeing any geographic variations? Are people moving to certain regions away from others? Are they going rural, urban, north, south, east, west?

Tim Bosse:
Well, we are seeing more of a movement from some of the hardest hit areas and with COVID so in the northeast, in some of the eastern states and some of the states in the west, we are seeing more of a migration. I don't think that there is, I can't pinpoint and say, okay, everyone is moving to Florida or everyone is moving to Texas. There is a lot of movement and I think one of the things that we're seeing as candidates, and it's a very good point, because if you're looking to move for a full time position and you're in New York City, are you going to move to Denver, Colorado? Are you going to move to Boise? Why would you consider moving when you have opportunities in the region maybe where you lived, or you went to school where you have family?

Tim Bosse:
So we are seeing movement. We are seeing [inaudible 00:14:36] to some of the areas that were the hardest hit, but it really is geographically critical, whether it's north, south, east, west across the facilities and then we haven't even talked about the rural areas yet, which have been incredibly impacted.

Justin Steinman:
Yeah. I got one stat here that kind of really hits that which is that the health resources services administration released a report recently that said rural regions make it more than 60% of the healthcare workforce shortage in the country. So how do you help address that from your seat?

Tim Bosse:
It's a challenge. So if you're a physician or you're a nurse and, or you're a nurse leader, or you're a department or an operational leader in management, what are the benefits of going to a rural area or a smaller community base or a critical access facility? And there are benefits that you have in those locations versus being in larger metropolitan cities. And some of that has to do with more of, and I hear this frequently, and when I ask, why would someone want to go to ABC hospital in this rural community? And one of the first things the administrators, the executives tell me is it's the environment, it is the culture. It's the family, it's the family atmosphere and setting and in healthcare compared to our other sectors that we recruit for, so in IT, or legal or in financial services and engineering, you hear culture a lot more than you do in healthcare.

Tim Bosse:
So I think that when you're trying to go to a smaller 25-bed hospital in a particular state, one of the biggest benefits of going rural is the cost of living, the size of the communities, the real estate and maybe just getting back to a simpler lifestyle, and still being able to provide care as a nurse or a leader or a physician.

Justin Steinman:
When you talk about the sort of the culture, and when moving to maybe a smaller hospital and that sort of thing, it always makes me think of the age split in the current healthcare market. There's a lot of older physicians and I say older, maybe say 40 and up in terms of who is out there that might be thinking of moving around. I think maybe some of the younger cohorts of either physicians or ancillary services, whether they be therapists slash even PAs and NPs, I would think that they have more opportunity to move away, but the culture piece makes me think that it's, as you age into your profession, maybe that becomes more of a consideration. Some of the older healthcare professionals are more likely to move to a more rural space, maybe creating more opportunity in urban studies or in the big cities.

Tim Bosse:
That's fair so more experienced healthcare professionals, I think when you don't have possibly as many personal commitments that you have more flexibility to move, but on the flip side of that, it is, it's still, when someone moves from a metro city into the rural area, then you're going to have that vacancy but why was someone in a particular area? Maybe they like the school system better, maybe they like the cultural activities that they had. Maybe they wanted a big city from maybe a sports opportunities and culture and arts and things like that but when you go to the rural area, we are seeing more experienced healthcare professionals considerate than ones that have maybe than 10 years or less experience.

Justin Steinman:
Do you feel that's going to feed more into that cycle of a shortage of physicians. So for the New York cities and the larger metro areas, as we see more of the seasoned professionals move, maybe more of them move into a smaller areas because we're not backfilling those at a rate in which we would have enough to cover the spots that are leaving. Do you see this as a sort of cycle where we're going to end up in a spot or exacerbates the dearth of new healthcare professionals coming into the market?

Tim Bosse:
Well, the first thing is, I think one of the data points here you have 122,000 physicians that we'll be short in by 2032. Now we have that getting even more impacted by the fact that as the over 65 population continues to grow, that's going to continue to grow at 48% going up to 2032 so you have a lot of physicians that will be retiring. So when one person leaves, there's another opening and there's not enough across the physician and the nursing recruitment and from the pipelines and the education side that are filling these openings and I think the other thing to add on that, Todd, is if you take away just COVID in the last 24 months, which we can't, this crisis pandemic, we've never seen this before, these challenges were there in 2020. It is you hear phrases, the war for talent, that's been out there for long and the other thing that was going to add to that is when we talk about candidates, it's a candidate's market. They have choices, they'll have choices for the next 10, 15, 20 years, in my opinion.

Justin Steinman:
Yeah. From 2020 to 2021, I got some pretty alarming data. According to some of the research in our database, we saw family practice went down by net 1800 providers this year. Surgery went down by almost a thousand providers year over year. These are people leaving the industry and no longer filing claims. Internal medicine down by 850 providers. General Practice down by 800 providers, OB GYN down by 600 providers. These are folks leaving the workforce and not getting backfilled and so I think we have a supply demand problem now, I mean, 2032, yes, that's a huge problem but even today, I think it has rattled off three, 4000 providers leaving the nation or leaving the practice, excuse me, as more and more people are getting sick and now we're getting into the delays of care as we start to get out of the COVID crisis, fingers crossed, knock on wood, everything else and people start to resume the care that they may have pushed off during the pandemic. What do we do here?

Tim Bosse:
Well, the... We could spend hours talking about the numbers and I think, and we've talked about the physicians, we've talked about the nurses, but if you think of the... If you take, there'll be a gap of over 400,000 home help aids. So even as you shift care into more other healthcare settings or home settings, that's 400,000 home healthcare aids, you have 29,000 nurse practitioners and this is in the next three years, not even going up to 2032. You have 200,000 nurses that are needed every year from now until 2026 so that's over a million nurses. So what can be done is it gets complex. I think that facilities, I think governments, I think the states, the federal level, that there needs to be strategy today and there needs to be strategy over the next 18-36 months as well.

Tim Bosse:
We have to build these pipelines of talent. We have to look how to retool, retrain, rebuild this healthcare workforce and as I said earlier, 30 years, and I got into this industry in 1992 pre-internet and the amount of opportunities, it's great to be a candidate because there's a lot of opportunities. There's no question, the speed, the access to opportunities has never been seen before, but what are we going to do right now? And I think there has to be a strategy on the local front and there has to be a progression around the education. There has to be different programs. We have to, we just have to start earlier and attract. It doesn't mean that you have to be a physician. Work your way through the healthcare worker ecosystem.

Justin Steinman:
It feels like it almost has to have the same mindset, as you said, with employers, trying to retain their employees. It has to be that find ways to make it attractive to people so that goes from the cost of training, so universities, how much they're charging for a medical degree down to the time it takes and again, getting more people to get in the front door so it's a filter, right? The number of people who come in through the universities to go to med school down to who actually makes it end up being a doctor, that has to be opened up a little bit and so maybe part of the way to have the top of the funnel wider is to reduce some of those costs.

Justin Steinman:
And again, that strategy has to be similar to, like you said, for employers, we have to look at all avenues, whether it's money, it's the attractiveness of the job, it's the ability to get in, all those things have to be on the table from a governmental, from a university, from a society level because if people are starting to feel now, like you said in the beginning, that sort of mind shift change of they were the heroes and now they're in between somewhere with some parts of our community, that has to change too, because who would want to go into a position where they're seeing the debt that you can go into as well as the environment in the public as well.

Tim Bosse:
Let me add a couple points and some suggestions recommendations. So one of the things is that I do think that you need to address, as we said, retain your staff today. Do everything you possibly can and through the crisis and through the pandemic, facilities and leaders have done a great job at re-shifting staff, looking at roles and responsibilities that can be done remotely, moving staff especially when there weren't as many surgeries, having people do different roles within the facility and got creative with that but that was crisis and strategy type decisions.

Tim Bosse:
What I would do once you do everything you possibly can to focus on retaining staff, then I would put this short term and long term strategy in place around talent attraction. And what I would do there is I'd have a playbook and I'd have a formula of what you're doing, whether you're working in a small community based hospital or large metro facility and build a plan at all levels. So there has been a challenge of even getting volunteers in the last two years because of just COVID and the protocols so there's a lot of money that is calls that have reduced because you have volunteers.

Tim Bosse:
Now you take volunteers all into admitting into the ancillary services, into environmental services, housekeeping, all the way up to physicians. So I'd have a short term plan of retaining, I would make talent acquisition, I'd have a seat at the senior executive level, just like you have a chief financial officer, not that you don't have a chief human resources officer, but you have a chief talent officer or whatever name you want to call it, because you hear about talent is our most important asset and people are our most important asset. The things that you do in leadership of appreciating and thanking and listening to your staff at all levels.

Tim Bosse:
Now we're two years into the pandemic and those things continue and they get a little bit more, they don't have as much impact. So they're the things that I would do immediately and what I would say about, which I think adds to a lot more complexities, is how do you get people interested in the industry? How do you have a LPN now want to become an RN or an RN to a nurse practitioner when you're going to have those 20,000 29,000 openings for nurse practitioners in three years, where is that coming from? So what you had just addressed is around the programs, around the training, around the education and something that just was released in the last two weeks is what the state of New York has done. Their program that they just announced, they're going to invest $10 billion and this is for the state of New York.

Tim Bosse:
So if you think about New York that was hit the, and impacted, unbelievably through COVID, they've just announced that they were going to invest 10 billion dollars over the next five years and try to increase their healthcare professionals and that workforce by 20% and that's being done, they're retaining, rebuilding, and growing their healthcare workforce. They're going to add four billion dollars for wages and two billion dollars to pursue retention bonuses but what you just hit upon is what are they going to do? How do you retrain, retool? They're going to have $3,000 in full time workers' bonuses. They're going to get 500 million dollars for cost of living adjustments and one of the most important things is there's going to be free, opportunities for free tuition.

Tim Bosse:
There's going to attract students into there, start in middle school all the way through, make it easier for a healthcare professionals to come into your state. So, and I bring up this with New York because if we did that state by state, or we did it on a federal level, and take this healthcare crisis, this healthcare professional crisis that we're in and exasperated by COVID, we could really start to make this a profession where people want to go in and then continue and evolve through it.

Justin Steinman:
Right. It sounds like really a model to start with and I, if you think about the difficulties maybe to cross license across states and things like that, if we try to reduce that too, it, again, it allows for that maybe increased competition for sure between states, but also again, it allows a little more freedom and again, makes it more attractive as a profession.

Tim Bosse:
Correct. And that is one of those suggestions about making sure, I mean, you have reciprocity between states on the nurse licensure side and parts of the physician. Why wouldn't you make it in all 50 states? Why do you have to have a crisis to have physicians go over border or go over the line and different state lines? The other thing that I thought was an interesting fact that New York is suggesting and recommending with this investment is to build workforce development, partnerships and talent pipelines. And if they can do that on a state the size of New York, some of that goes back to what we were talking about earlier and that is to move some of the talent out to the rural areas inside of the state of New York so you open up those opportunities to move your talent where the greatest need is, and to make it attractive for someone to leave New York City to go upstate New York or to some other areas.

Justin Steinman:
You know, Tim, as I'm listening to you talk, these are some really good ideas and I think what the City of New York is doing is absolutely fascinating. I find myself wondering if there's any way that, like we can use technology to make up for some of these shortages, right? More moves to virtual care, more remote patient monitoring, chronic condition management. I mean, obviously healthcare is a full contact sport, you really got to be able to actually touch the patient and see the patient, but do you think we can use technology to address any of these shortages?

Tim Bosse:
I definitely do. And you're seeing it now in facilities that have used technology, let's just use it from a standpoint of the admitting patients. So they're using technology and they're using the workers that have shifted to being remote so they do not have to come in to admit the patient. So you're using the tech, you're using your EMR system, you're using some type of technology and you're using a remote, one of your remote colleagues that's going to admit so you could use technology for that.

Tim Bosse:
If we had a button that we could push that could create a physician or a nurse that would be spectacular, but technology has played, has provided benefits from what I've seen with this crisis staffing models that these hospitals have talked about over the last 24 months, how that goes into the future, anything that's efficient, anything that will save time and money, if you can do it with the technology and remote staff I think there's a benefit there. Plus you talk a lot about working from home and remote workers and changing workforce, changing hours and schedules, that's the experience. That's how you're also going to retain staff. Listen to physicians, the doctors, the nurses, the PTs, OT, speech, you still have to be in the hospital, but the Teladoc, certain professions, certain specialties, absolutely the telemedicine took off and I think that is not going away at all.

Justin Steinman:
Are you seeing doctors leave the "physical workforce", quote, unquote and move to the virtual care delivery organizations like Teladoc, like American Well, all these other companies that are out there hiring doctors to talk to people solely from their home offices?

Tim Bosse:
Yes we are and we have actually physicians and nurses are going on the case management side that continuously contact us and say, could we have, or do you have opportunities to do telemedicine? Do we have opportunities that we can work? There's different programs out there especially in the government side where they have large case management teams all over the United States and you work remotely. That is... I think if these caregivers and these frontline workers want to leave the industry or leave the setting that they're in the hospital setting, provide opportunities where they can take that experience and still contribute and the telemedicine is absolutely going to continue to grow.

Tim Bosse:
The numbers have been staggering, but use workforce, have a flexible workforce that wants to do that and that's usually with more experience in seasoned physicians. Take nurses and doctors that want to only work part-time, instead of leaving, if you can only work full-time and that's what the hospitals are telling you that's what they want, why are you going to get, why are you not going to utilize someone that used two part-timers? So I just think flexibility in the staffing models, because there's such a supply constraint, let's look at flexible ways to provide the care.

Justin Steinman:
So look, Tim, this has been a fascinating conversation. To kind of put it in macro terms here, I think we've had it really a classic conversation about supply and demand. Healthcare is a recession proof industry, right? There's always going to be demand for healthcare, in fact, I think we've said demand's going to continue to increase and at the same point in time, you have got supply constricting as medical providers are leaving the field in droves. So in the old classic supply and demand, I'm going back to business school here and I hope I don't screw this up, but I think if you have increasing demand and decreasing supply, your price goes up and we already know that healthcare is a massively expensive proposition in the United States driving nearly 20% of its GDP. So if I were to name you suddenly President of the United States or Head of the US Economy, how do we solve this massive supply and demand problem? Really unfair question.

Tim Bosse:
We're at a, beyond a critical state now and it's hard to even think, I know from speaking to these healthcare executives and the hospital executives to even think two, three years down the road. I am suggesting okay, put a chief town officer at the board table, okay, that's one thing that, but you have to look at the talent, you have to look at what brings the revenue in. The chances of OR and surgeries being closed like they did early in the first year of the pandemic, that's going to be very difficult to ever be sustainable again. So what do you do? How do you improve your financials? How do you improve the revenue growth? And then how do you maintain your cost? And the cost have skyrocketed. For contract healthcare labor, it was, for a travel nurse it was a thousand dollars two years' ago, now they're making a week now they're making over 2500 average where some of them making up to 5000.

Tim Bosse:
So you've escalating cost. You have a supply challenge and you have people leaving like over the 500,000 that have left since last year, just in healthcare. So you have a lot of things colliding here. I think that you just focus on the short term, retaining, putting a program in place, building talent pipelines, and then long term, make sure that the education, the programs, tuition, flexibility in staff, use technology and take care of the patients the best that you can.

Justin Steinman:
So let's give them some free advice. If I was a healthcare senior executive talking to you about how I should think about hiring in the midst of, [inaudible 00:37:05] we're still in the midst of the pandemic here, why not? What advice would you give me?

Tim Bosse:
Well, first of all, take a breath. You're open 24 hours, seven days a week, 365 days. There's no other sector like it. I would look at recruitment partners, companies like System One and others, and have a hybrid approach, build up a world class talent acquisition team, like if I was a hospital executive listening to this, one of the things I'd say is get talent acquisition at the seat of your table, separate it from human resources and make sure that you get the speed to hire faster because you have facilities that are still taking the same approach to looking at talent. If Todd is a physician and Todd all of a sudden has three or four more opportunities, there's two hospitals that are going to hire much faster, and you have to do that. And you're talking hundreds and hundreds of openings times thousands of hospitals so we just, you have to change. Let COVID be the foundation of changing how you source, screen and select candidates.

Justin Steinman:
Right. It's a multifaceted problem with a multifaceted, so there really is no single silver bullet here and my take away way today, Tim, is that you are sitting on the front lines of all of it, and what a fascinating place to be. Your hours must be long. Your days must be long so we're not going to take any more of your time today, but we are going to thank you for not only joining us on the podcast today but also helping to make sure that those healthcare professionals are where they need on the front lines, delivering the care to the people who need it most. So, Todd, thank you, Tim, thank you.

Todd Bellemare:
Yeah. Thanks Tim.

Tim Bosse:
Thank you. I appreciate the time.

Justin Steinman:
Thanks for listening to Definitively Speaking and the definitive healthcare podcast. Please join me next time for an afterwards episode where Brittany, Todd and I will break down today's podcast and offer our own thoughts on the future of staffing in the healthcare industry.

Justin Steinman:
Then join me in two weeks for a conversation with Cara McNulty, president of behavioral health and resources for living at CVS Health. As many of you know, May is mental health awareness month and Cara, and I will have a common around the importance of mental health and wellbeing and how CVS Health is making mental health treatment as easy to get as treatment before a sprained ankle.

Justin Steinman:
If you like what you've heard today, please remember to rate, review and subscribe to the show on Apple, Google, Spotify, or wherever you get your podcasts. To learn more about how healthcare commercial intelligence can support your business, please follow us on Twitter @definitivehc or visit us at definitivehc.com.

Justin Steinman:
Until next time, take care and please, stay healthy.