Middle-Market CEO Interview: Shari Sandifer of Avant Healthcare Professionals

While the steep cost of U.S. healthcare no doubt captures the majority of healthcare-related headlines these days, the sector also continues to attract attention when it comes to jobs. In all, 5.6 million healthcare jobs were expected to be added within the United States between 2010 and 2020. Shari Sandifer, CEO of Avant Healthcare Professionals, a fast-growing staffing firm based in Casselberry, Fla., recently spoke to Middle-Market Executive about how her firm grew despite constant jabs of “regulatory flux.”

MME: The healthcare landscape continues to quickly evolve here in the Unites States. How has your business model needed to adapt?

Sandifer: We are a healthcare professionals staffing resource, and our specific niche is offering an international solution. We recruit internationally and place folks in the U.S. Now, over time, our business model has been impacted by different regulatory changes. The visa backlog in particular has impacted us. In fact, at one point we were moving healthcare professionals around the world, but the bulk of our business has been recruiting internationally for shortage professions in the U.S. Our model has been to place people on long-term 20-to 24-month assignments, with about 85 percent of our healthcare professionals eventually joining the staff of the client. This really gives our clients the opportunity to build their critical core staffs in these shortage areas. When a client comes to us, they are really looking to make a long-term commitment because they have a critical vacancy.

MME: How did you respond to the visa backlog? Did you in some way pivot?

Sandifer: Well, we initially started out dedicated to placing nursing staff and working with hospitals, but the backlog made us look for other ways. We did place some people into different countries, but ultimately we established a business offering to recruit physical and occupational therapists, while working with home care, nursing homes, and rehab facilities. Today, we provide nurses — the bulk of whom had their visas petitioned 6 years ago — and we provide physical occupational therapists. We staff hospitals and skilled nursing facilities, home care and some outpatient areas as well.

MME: How else does your model differ from traditional recruiting models?

Sandifer: In a typical staffing company, you have recruitment — the folks working with the candidates — and you have people who sell — who work with the accounts or clients. In our company, we have a licensure department, an immigration department, and a clinical department, which helps people to fill the gap between practices overseas and practices inside the U.S. We have a transitions department, which deals with just that sociocultural piece — for instance, how to get a credit card or how to get an automobile. 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 in which we close the gap.

MME: How large an organization are you today?

Sandifer: We are roughly 260 employees today. We have about 210 healthcare professionals on assignment, and this number grows and changes as they go on and off assignments. We place them in 36 states inside the Unites States. We began in a space that probably had 1,100 square feet. Today, we’re at about 12,000 square feet, but we’ve added a skills lab and large classroom.

MME: There must be a lot of red tape when it comes to dealing with immigration issues. Have you been able to simplify the process?

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. Recruiting internationally only gets more complex. We deal not only with immigration agencies, but also with departments of state and embassies around the world. I’ve spent a lot of time suggesting to lawmakers that we have to make this effort easier. As part of the journey of growing Avant, back in 2007, we were a founding member of a trade association known as the American Association of International Healthcare Recruitment. I’ve been on the board of this association since it was started, and I head up the regulatory affairs committee. We are definitely out there talking to lawmakers about the unique needs of healthcare professionals. It’s interesting: We find that there is some familiarity with the IT side of the visa issue, but there are people in the Senate and House who oppose the use of visas. Part of this is a perception that we are bringing people over using H1Vs and then sending them back to their own countries and paying them less to do the same work, but clearly this is not something that happens in healthcare.