Site Guide: Roy Vera, R.T., MBA Publisher, Author and Consultant for the medical staffing industry.
VISMEDICAL.COM
Resource For The Medical Staffing Industry
 | |  | |  | |  | |  | |  |
| Top Links |
 | |  | |  | |  | |  | |  |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
 |
 |
www.vismedical.com Volume 1, Issue 9
The Roy Vera Newsletter
*******************************************************************
From:
“Are We Doomed To Repeat The Past”
Dear Friend
Wow! The economy has really taken a hit. I had a visit with my financial broker today
and it seems that 2007 was a good year for my stocks, mainly because he advised me
to drop any stock I may have in Real Estate. I actually listened to him and did exactly
what he told me to do. You see, Doug (my broker) is my friend, I met Doug while we
both were completing our Graduate studies. Doug really knows his business. He
always brings these neat spreadsheets filled with color and fancy letterheads. But
more than that, he brings his knowledge with him.
I realize that everybody has an expertise, but if we try to become experts in every topic,
we become fools. Thomas Edison never finished school, he had no formal degree yet
he was able to power the world. But, did he do it himself? No!, He had what I call a
mastermind. A group of people with expertise in a field he lacked knowledge in. He
used that expertise to mold and build his vision.
What does this have to do with the title of the Newsletter?. “Are We Doomed To Repeat
The Past” It has a lot to do with the title. The past often reveals to us a 20/20 vision.
Listening to the past often provides to us a glimpse into the future. The problem is
many refuse to listen to the past by ignoring the experts in any particular field and
ignoring the warning signs.
What past or future am I talking about and how does this relate to Medical Staffing?
It really gets interesting from here, just hang on!
I read this article published back in 2003 by Knight-Ridder/Tribune Business News
“Jun. 1--BOCA RATON, Fla.--Amid the depressed economy and bear market, one of
the hottest bets on Wall Street last summer was temporary nurse staffing companies.
Two of the biggest in the industry -- Cross Country Inc. and Medical Staffing Network
Holdings Inc. -- recently had gone public with stock offerings during one of the worst
nationwide nursing shortages in decades.
Hospitals were desperate for nurses and the two staffing companies headquartered in
Boca Raton could barely keep up with demand for their nurses. For every nurse they
had looking for an assignment, they often had 10 jobs waiting. With this seemingly
insatiable demand for nurses, the firms could virtually name their price.
Investors pushed up the price of both stocks, thinking there was little downside risk,
given the nursing shortage. Many believed the Boca nurse staffing firms offered the
best of two fast-growing trends: the booming demand for health services and the
increasing move to temporary employment.
But as any experienced investor soon realizes, Wall Street really is subject to gravity.
Shares of Cross Country and Medical Staffing came plummeting back to Earth during
the past eight months, not because the nursing shortage eased, but because
increasingly cost-conscious hospitals have decided to do everything they can to avoid
paying the higher costs to hire temporary staff. Hospitals are requiring their own nurses
to work overtime, increasing nurse-patient ratios and offering $10,000 bonuses to
attract and retain nurses.
Boca Raton Community Hospital noted the use of contract nurses in its 2001-2002
budget year as one reason it lost money. In response, the hospital has hired more staff
and built up its own pool of temporary staff to reduce dependence on staffing agencies,
which can charge at least $10 an hour more than a full-time nurse.
When Martin Memorial Medical Center in Stuart noticed admissions were down this
winter, the first thing it did was cancel its order for temporary nurses.
Phil Robinson, chief executive officer of JFK Medical Center in Atlantis, is blunt when
talking about temporary staff. "We are using less contract labor, and would like to use
even less," he said.
As a result of hospitals' change in attitude, Cross Country and Medical Staffing have
seen reduced demand for their nurses. That's kept billing rates flat and led the
companies to cut or withdraw quarterly profit forecasts. “
So!, that was in 2003!
Yes it was, and that is what we need to be aware of today in 2008. The federal reserve
chairman Ben Bernanke cut 75 basis points that came to a surprise even after the huge
global financial markets sold off in dramatic fashion at the beginning of Jan. Ben
Bernanke, the way I see it understands the premise of not repeating the past. His fast
actions in my opinion are meant to stop the U.S. economy from moving into a recession
based on the experience and foresight he has and the fact that this has happened
before. The last time the feds cut such a huge rate was back in the 80’s, but what
people don’t remember is how High the interest rates were. In 1982 a typical Mortgage
Index rate was approximately 15.53. Today it is almost 1/3 of that.
What does this have to do with staffing?
EVERYTHING!!!!!
You cannot ignore the facts, because the facts are what should guide you in how you
need to approach a facility to try to secure more accounts. It is also how you need to
approach new recruits as well as gauge investments or understand the need for
diversification. I know! I Know! How can I be talking about diversification and at the
same time talk about being careful with spending.?
Listen, diversification is the foundation of keeping your staffing agency from dying a
horrible death in today’s economy. Take heed to the example above talking about the
outcome in 2003. Placing all your marbles in one basket may contribute to your
eventual demise.
I hope I am using correct saying!
Cross Country Inc. and Medical Staffing Network Holdings Inc. are two power players in
the staffing industry. But as you read the article above in 2003 they still manage to
create a loss while the industry was hurting for qualified nurses to fill shifts. As the
article pointed out that for every shift covered, these companies were unable to fill 10.
Why did that happen?
Can it happen to you?
Sure it can! I had a client that started staffing initially X-ray techs. She quickly realized
that she needed to move into Ultrasound and CT as well as Mammography. But soon
the pool of available shifts and seasonal peeks and valleys alerted her to a more
drastic move. She decided that in order to survive the huge peeks and valleys that are
often associated with the staffing industry, she opened a small imaging center. Nothing
too fancy, but enough to allow her to make revenue and fund her staffing agency in the
slow months.
Why did she have to do that?
Listen, it will depend on many factors, in her case she was dealing with.
1. Competition
2. Pricing wars
3. Not enough techs.
4. Facilities cutting back.
Beginning to sound familiar?
Many factors play a pivotal role as to why facilities slow down the use of registries.
Even though the need is huge, a facility will begin to cut staff and do with less if
1. Census is down
2. Concerns of overspending
3. Government funding diminishes
4. Reimbursements change
The need to staff a facility versus the desire to cut registry is a constant battle.
Facilities realize they need registries to be able to meet state or federal standards. At
the same time they will do without whenever they can.
As a staffing agency you will always be needed. But don’t let that go to your head.
Why? Look at what happened to Cross Country Inc. and Medical Staffing Network
Holdings Inc. 2003 needs to be a warning to us all.
Listen, when I was in my graduate school to earn my MBA I took a finance class that
proved to be challenging. My research project in this class was based on the impact a
recession has on the medical industry. What I discovered was that time and time again,
the medical industry is inversely proportional to the rest of the country.
What does that mean Roy?
It means that I discovered that when businesses other than the medical industry are
experiencing loss, the medical industry is not. Does the name “countrywide” ring a bell,
you bet it does. They were considered the largest privately held mortgage company in
the country, and guess what? They are selling to BofA. Wow!
OK, so if it is inversely proportional, why did Cross Country Inc. and Medical Staffing
Network Holdings Inc. experience losses in 2003. That is a testament of what I call “The
Squire Syndrome” You know! A squire! What do squires do best? They hide food for
future use. The problem is that squires are so good at hiding food, that sometimes
they forget where they hid their food and never, ever find it again.
Hospitals in my opinion are not different, no I am not saying a Hospital is a squire!, what
I am saying is that a hospital will quickly try to save money, cut expenses and save as
much money as possible, especially if the rest of the economy is doing badly. This will
occur often even when a facility is doing fairly well. The first directly affected by cuts is,
you guest it “REGISTRIES”. Hospitals begin to do cuts in a rush to save money, but the
funny thing is that soon after they realize that they need registries. It is a vicious cycle.
You cannot fight this syndrome, all you can do is be prepared for immediate action and
process immediately your backup plan.
What backup plan you may ask?
You have to be prepared to let some of your staff go. You have to be prepared to
begin staffing other industries. You have to be prepared to be more aggressive. You
have to be prepared to cut your own expenses.
What I am going to tell you next is not a recommendation, it is not something that I tell
my clients to do and I think companies that do this are bordering on unethical behavior.
A company I new did the following and probably continues to do so, I cannot use there
name but believe me when I tell you, they are doing this for a fact.
They hire people initially for full time status offering the employee full time benefits, but
those benefits will not kick in until the probationary period. They place that employee at
a site, then before the three months are over, they let the employee know that they
cannot continue offering benefits but can have them continue on at a higher rate
without benefits. This is a dirty trick that may seem beneficial to the employee, but the
tactics prove to have a cascade affect across the industry.
How?
Perspective employees are attracted to this company with the promise of benefits.
They offer lower pay but seems to be justified by the fact that they are getting benefits.
The employee is then offered a higher pay for the removal of the benefits. The
problem is that the employees initial pay structure is lower than the standard. The pay
increases using a 1099 instead of a W2. This places that employee in equal pay
standards to other staffing agencies. A classic bait and switch technique, leaving the
other staffing agencies unable to compete.
The reason I tell you the above story is to isolate the fact that we are in business and
we are in the business of making money. But it should never be sacrificed to unethical
and immoral behavior directly affecting the lively hood of your employees. Your
employees are important and should be treated as such. Having to downsize and layoff
employees because of unforeseen events outside of your control is different than
creating a false need and placing your employees in jeopardy as the example above.
Anyway, enough of the dread and doom!
I think you get the gist of what I am trying to say for the most part. The cyclical nature
of the medical staffing industry can be ridden until an upward spike allows to once
again be in “black”.
Recently I sent an email alerting all my readers that I was working on a new book. It is
exactly what all of you have been asking me to write about. Apparently there is a huge
need for a book written specifically for the medical staffing industry on basically “How
To Find Clients” I thought I would be done with the book by the end of January, but it is
taking me longer than I had expected. As soon as I am done with the book I will let you
know.
Thank you for your patience and I hope to be done with the book by the end of
February. As always I offer all my readers a discount before the book goes live on my
website.
So, how can you benefit from this Newsletter?
If you have not taken the time to visit any of my free topics then I encourage you to do
so at http://vismedical.com/Topics/topics.html
You can also use my FREE resources that can provide you will hundred of sources of
information you can use for your staffing agency. http://vismedical.
com/Resources/resource.html
If you need help in starting a staffing agency from the ground up then I highly
encourage you to visit me at: http://vismedical.com/SpecialOffer.html
Sincerely,
Roy Vera, R.T., MBA
Roy Vera, R.T., MBA
VISMedical was created by Roy Vera, R.T., MBA: His website deals directly with issues related to the
medical staffing industry. Roy is an accomplished publisher, author and consultant for the medical
staffing industry: http://www.vismedical.com/
If You have not taken advantage of our most popular ebook, Click Here
Medical Staffing Resources
How To Start A Medical Staffing Agency
Recruiting For Medical Staffing Agencies
Medical Staffing Business Plan
Employee Background Checks
Incorporate Your Business
The Roy Vera Newsletter
*******************************************************************
From:
“Are We Doomed To Repeat The Past”
Dear Friend
Wow! The economy has really taken a hit. I had a visit with my financial broker today
and it seems that 2007 was a good year for my stocks, mainly because he advised me
to drop any stock I may have in Real Estate. I actually listened to him and did exactly
what he told me to do. You see, Doug (my broker) is my friend, I met Doug while we
both were completing our Graduate studies. Doug really knows his business. He
always brings these neat spreadsheets filled with color and fancy letterheads. But
more than that, he brings his knowledge with him.
I realize that everybody has an expertise, but if we try to become experts in every topic,
we become fools. Thomas Edison never finished school, he had no formal degree yet
he was able to power the world. But, did he do it himself? No!, He had what I call a
mastermind. A group of people with expertise in a field he lacked knowledge in. He
used that expertise to mold and build his vision.
What does this have to do with the title of the Newsletter?. “Are We Doomed To Repeat
The Past” It has a lot to do with the title. The past often reveals to us a 20/20 vision.
Listening to the past often provides to us a glimpse into the future. The problem is
many refuse to listen to the past by ignoring the experts in any particular field and
ignoring the warning signs.
What past or future am I talking about and how does this relate to Medical Staffing?
It really gets interesting from here, just hang on!
I read this article published back in 2003 by Knight-Ridder/Tribune Business News
“Jun. 1--BOCA RATON, Fla.--Amid the depressed economy and bear market, one of
the hottest bets on Wall Street last summer was temporary nurse staffing companies.
Two of the biggest in the industry -- Cross Country Inc. and Medical Staffing Network
Holdings Inc. -- recently had gone public with stock offerings during one of the worst
nationwide nursing shortages in decades.
Hospitals were desperate for nurses and the two staffing companies headquartered in
Boca Raton could barely keep up with demand for their nurses. For every nurse they
had looking for an assignment, they often had 10 jobs waiting. With this seemingly
insatiable demand for nurses, the firms could virtually name their price.
Investors pushed up the price of both stocks, thinking there was little downside risk,
given the nursing shortage. Many believed the Boca nurse staffing firms offered the
best of two fast-growing trends: the booming demand for health services and the
increasing move to temporary employment.
But as any experienced investor soon realizes, Wall Street really is subject to gravity.
Shares of Cross Country and Medical Staffing came plummeting back to Earth during
the past eight months, not because the nursing shortage eased, but because
increasingly cost-conscious hospitals have decided to do everything they can to avoid
paying the higher costs to hire temporary staff. Hospitals are requiring their own nurses
to work overtime, increasing nurse-patient ratios and offering $10,000 bonuses to
attract and retain nurses.
Boca Raton Community Hospital noted the use of contract nurses in its 2001-2002
budget year as one reason it lost money. In response, the hospital has hired more staff
and built up its own pool of temporary staff to reduce dependence on staffing agencies,
which can charge at least $10 an hour more than a full-time nurse.
When Martin Memorial Medical Center in Stuart noticed admissions were down this
winter, the first thing it did was cancel its order for temporary nurses.
Phil Robinson, chief executive officer of JFK Medical Center in Atlantis, is blunt when
talking about temporary staff. "We are using less contract labor, and would like to use
even less," he said.
As a result of hospitals' change in attitude, Cross Country and Medical Staffing have
seen reduced demand for their nurses. That's kept billing rates flat and led the
companies to cut or withdraw quarterly profit forecasts. “
So!, that was in 2003!
Yes it was, and that is what we need to be aware of today in 2008. The federal reserve
chairman Ben Bernanke cut 75 basis points that came to a surprise even after the huge
global financial markets sold off in dramatic fashion at the beginning of Jan. Ben
Bernanke, the way I see it understands the premise of not repeating the past. His fast
actions in my opinion are meant to stop the U.S. economy from moving into a recession
based on the experience and foresight he has and the fact that this has happened
before. The last time the feds cut such a huge rate was back in the 80’s, but what
people don’t remember is how High the interest rates were. In 1982 a typical Mortgage
Index rate was approximately 15.53. Today it is almost 1/3 of that.
What does this have to do with staffing?
EVERYTHING!!!!!
You cannot ignore the facts, because the facts are what should guide you in how you
need to approach a facility to try to secure more accounts. It is also how you need to
approach new recruits as well as gauge investments or understand the need for
diversification. I know! I Know! How can I be talking about diversification and at the
same time talk about being careful with spending.?
Listen, diversification is the foundation of keeping your staffing agency from dying a
horrible death in today’s economy. Take heed to the example above talking about the
outcome in 2003. Placing all your marbles in one basket may contribute to your
eventual demise.
I hope I am using correct saying!
Cross Country Inc. and Medical Staffing Network Holdings Inc. are two power players in
the staffing industry. But as you read the article above in 2003 they still manage to
create a loss while the industry was hurting for qualified nurses to fill shifts. As the
article pointed out that for every shift covered, these companies were unable to fill 10.
Why did that happen?
Can it happen to you?
Sure it can! I had a client that started staffing initially X-ray techs. She quickly realized
that she needed to move into Ultrasound and CT as well as Mammography. But soon
the pool of available shifts and seasonal peeks and valleys alerted her to a more
drastic move. She decided that in order to survive the huge peeks and valleys that are
often associated with the staffing industry, she opened a small imaging center. Nothing
too fancy, but enough to allow her to make revenue and fund her staffing agency in the
slow months.
Why did she have to do that?
Listen, it will depend on many factors, in her case she was dealing with.
1. Competition
2. Pricing wars
3. Not enough techs.
4. Facilities cutting back.
Beginning to sound familiar?
Many factors play a pivotal role as to why facilities slow down the use of registries.
Even though the need is huge, a facility will begin to cut staff and do with less if
1. Census is down
2. Concerns of overspending
3. Government funding diminishes
4. Reimbursements change
The need to staff a facility versus the desire to cut registry is a constant battle.
Facilities realize they need registries to be able to meet state or federal standards. At
the same time they will do without whenever they can.
As a staffing agency you will always be needed. But don’t let that go to your head.
Why? Look at what happened to Cross Country Inc. and Medical Staffing Network
Holdings Inc. 2003 needs to be a warning to us all.
Listen, when I was in my graduate school to earn my MBA I took a finance class that
proved to be challenging. My research project in this class was based on the impact a
recession has on the medical industry. What I discovered was that time and time again,
the medical industry is inversely proportional to the rest of the country.
What does that mean Roy?
It means that I discovered that when businesses other than the medical industry are
experiencing loss, the medical industry is not. Does the name “countrywide” ring a bell,
you bet it does. They were considered the largest privately held mortgage company in
the country, and guess what? They are selling to BofA. Wow!
OK, so if it is inversely proportional, why did Cross Country Inc. and Medical Staffing
Network Holdings Inc. experience losses in 2003. That is a testament of what I call “The
Squire Syndrome” You know! A squire! What do squires do best? They hide food for
future use. The problem is that squires are so good at hiding food, that sometimes
they forget where they hid their food and never, ever find it again.
Hospitals in my opinion are not different, no I am not saying a Hospital is a squire!, what
I am saying is that a hospital will quickly try to save money, cut expenses and save as
much money as possible, especially if the rest of the economy is doing badly. This will
occur often even when a facility is doing fairly well. The first directly affected by cuts is,
you guest it “REGISTRIES”. Hospitals begin to do cuts in a rush to save money, but the
funny thing is that soon after they realize that they need registries. It is a vicious cycle.
You cannot fight this syndrome, all you can do is be prepared for immediate action and
process immediately your backup plan.
What backup plan you may ask?
You have to be prepared to let some of your staff go. You have to be prepared to
begin staffing other industries. You have to be prepared to be more aggressive. You
have to be prepared to cut your own expenses.
What I am going to tell you next is not a recommendation, it is not something that I tell
my clients to do and I think companies that do this are bordering on unethical behavior.
A company I new did the following and probably continues to do so, I cannot use there
name but believe me when I tell you, they are doing this for a fact.
They hire people initially for full time status offering the employee full time benefits, but
those benefits will not kick in until the probationary period. They place that employee at
a site, then before the three months are over, they let the employee know that they
cannot continue offering benefits but can have them continue on at a higher rate
without benefits. This is a dirty trick that may seem beneficial to the employee, but the
tactics prove to have a cascade affect across the industry.
How?
Perspective employees are attracted to this company with the promise of benefits.
They offer lower pay but seems to be justified by the fact that they are getting benefits.
The employee is then offered a higher pay for the removal of the benefits. The
problem is that the employees initial pay structure is lower than the standard. The pay
increases using a 1099 instead of a W2. This places that employee in equal pay
standards to other staffing agencies. A classic bait and switch technique, leaving the
other staffing agencies unable to compete.
The reason I tell you the above story is to isolate the fact that we are in business and
we are in the business of making money. But it should never be sacrificed to unethical
and immoral behavior directly affecting the lively hood of your employees. Your
employees are important and should be treated as such. Having to downsize and layoff
employees because of unforeseen events outside of your control is different than
creating a false need and placing your employees in jeopardy as the example above.
Anyway, enough of the dread and doom!
I think you get the gist of what I am trying to say for the most part. The cyclical nature
of the medical staffing industry can be ridden until an upward spike allows to once
again be in “black”.
Recently I sent an email alerting all my readers that I was working on a new book. It is
exactly what all of you have been asking me to write about. Apparently there is a huge
need for a book written specifically for the medical staffing industry on basically “How
To Find Clients” I thought I would be done with the book by the end of January, but it is
taking me longer than I had expected. As soon as I am done with the book I will let you
know.
Thank you for your patience and I hope to be done with the book by the end of
February. As always I offer all my readers a discount before the book goes live on my
website.
So, how can you benefit from this Newsletter?
If you have not taken the time to visit any of my free topics then I encourage you to do
so at http://vismedical.com/Topics/topics.html
You can also use my FREE resources that can provide you will hundred of sources of
information you can use for your staffing agency. http://vismedical.
com/Resources/resource.html
If you need help in starting a staffing agency from the ground up then I highly
encourage you to visit me at: http://vismedical.com/SpecialOffer.html
Sincerely,
Roy Vera, R.T., MBA
Roy Vera, R.T., MBA
VISMedical was created by Roy Vera, R.T., MBA: His website deals directly with issues related to the
medical staffing industry. Roy is an accomplished publisher, author and consultant for the medical
staffing industry: http://www.vismedical.com/
If You have not taken advantage of our most popular ebook, Click Here
Medical Staffing Resources
How To Start A Medical Staffing Agency
Recruiting For Medical Staffing Agencies
Medical Staffing Business Plan
Employee Background Checks
Incorporate Your Business
| Medical Staffing Newsletter |
| Subscribe FREE Click Here |
VISToday Newsletter is
published by Roy Vera of
VISMedical.com
(More about Roy)
If you are not yet a
subscriber, get on the list
right now! Click Here
published by Roy Vera of
VISMedical.com
(More about Roy)
If you are not yet a
subscriber, get on the list
right now! Click Here
Thanks for reading our op-in only publishing
Advertising Info.
Advertising Info.
