Casselberry, FL — For Shari Sandifer, business opportunities are really just gaps — spaces between demand and supply — and nowhere does Sandifer see a larger opportunity than inside the realm of healthcare professional talent.
Of course, Sandifer first identified the opportunity back in the 1990s, which has perhaps given her 10-year-old firm, Avant Healthcare Professionals, a running start inside a sector that is expected to have added 5.6 million healthcare jobs between 2010 and 2020.
Even more relevant to Sandifer’s business is the fact that nearly 22 percent of healthcare workers in the United States are foreign-born, compared to 13 percent of all workers nationally, according to a Georgetown University study. Avant deserves some of the credit. The 260-employee firm is a staffing company that specializes in placing foreign nationals in American healthcare organizations.
“Our clients don’t have to worry about doing immigration work or sponsoring visas. We do all of that, as well as the clinical transitioning wherein we close the gap between professional practices overseas and practices here in the U.S.,” explains Sandifer, who attributes Avant’s success to its approach of placing healthcare professionals on long-term (20- to 24-month) assignments rather than relying on renewable “travel assignments” running in 13-week increments — the preferred offering of many U.S. staffing industry firms.
As the underlying healthcare reimbursement system becomes more derivative of outcomes, Sandifer says, long-term assignments offer healthcare providers greater consistency that later translates into better outcomes. On average, she adds, it takes Avant 12 to 18 months to place someone from overseas with an American client.
“When a client comes to us, they are really looking to make a long-term commitment because they have a critical vacancy,” says Sandifer, who estimates that 85 percent of Avant’s staffing placements convert into permanent hires. It’s a formula that has put the firm on a rapid growth trajectory. Avant grew by 305 percent between 2008 and 2011, reaching $17.9 million in sales, according to Inc. magazine. Today, the firm is estimated to be near $30 million in annual sales.
However, not all has gone smoothly. Back in 2007, Avant fell victim to a U.S government dictum putting a hold on visas for nurses entering the U.S. Sandifer wisely skirted difficulties by maneuvering her firm into new recruiting veins, including occupational and physical therapists. Meanwhile, the firm’s ties to the ever changing healthcare climate have routinely added some uncertainty to an otherwise seemingly boundless opportunity.
“Last October marked the fourth consecutive fiscal year of Medicare reimbursement cuts for rehabilitation, and we’re feeling a softening in the market and margin pressure. So you’re always balancing the support that we offer and the costs for that,” explains Sandifer, who along the way helped to establish a trade association, The American Association of Healthcare Recruitment, to better amplify the industry’s critical needs.
Says Sandifer: “It is very difficult to come into this country as a healthcare professional, and a lot of the things that we do are to make certain that the people who do enter have the right level of education, experience, and English fluency.”
The task of recruiting talent from overseas has led Avant to develop a number of specialized departments tasked with helping recruits to address immigration and licensure issues, as well as a transitional unit that deals with everyday social issues such as how to get a credit card or buy an automobile.
“Recruiting internationally only gets more complex. We deal not only with the immigration services, but also with departments of state and embassies around the world,” says Sandifer, whose attention was first drawn to the opportunity when she was a practicing nurse.
She adds: “That’s when I first saw the gap that exists between people who practice overseas and people who practice in the U.S. It varies on a lot of levels, so the question became: How can we better prepare these people to go out and work in the U.S.?”
Or, to put it another way: Mind the gap.