Banking on KC – John Nolan of Next Move Healthcare
Listen Now, or read the transcript below:
Kelly Scanlon:
Welcome to Banking on KC. I'm your host, Kelly Scanlon. Thank you for joining us. With us on this episode is John Nolan, the co-founder and CEO of Next Move Healthcare, a healthcare staffing agency that specializes in travel nurses and allied healthcare content. Welcome John.
John Nolan:
Thanks, Kelly. Glad to be here.
Kelly Scanlon:
What sets Next Move Healthcare apart from other staffing agencies?
John Nolan:
Next Move Healthcare is focused on delivering to the clinicians first as opposed to the hospitals or the delivery organizations first. My co-founder is a nurse, a healthcare provider, and our whole philosophy is deliver a raving fan experience to the healthcare providers that we serve. I think the other big piece is that your people set you apart. Just like any great business, it's first and last about the people and we try and deliver that raving fan experience to our internal staff too. We're ultimately focused on delivering an undeniable best career experience in healthcare, and we do that through our people.
Kelly Scanlon:
When you say clinicians first, how do you put that into action on a day-to-day basis with them? Just walk us through that relationship.
John Nolan:
So the clinicians that work for Next Move Healthcare, they are W2 employees of our company. We entice them on a career experience that isn't your traditional the hospital is your employer, nine to five, it's more gig economy focused and a lot more flexibility around your schedule, where you're working, pay is a little bit better. At being W2 employees of our company, we can shower them with benefits, all of the same benefits that you would expect from working for any employer or hospital, matching 401k and things like that. We deliver that raving fan experience by focusing on them first. Whenever I say that it's what do they need? How can we best support them in the opportunities they want to create, the career experience they want to have, the support they need, the mental health resources they need. If we're first focused on them, we believe that that will bring client demand and that they will be able to deliver exceptional patient care. So the first focus is a raving fan experience for the clinicians.
Kelly Scanlon:
And then that will carry upstream to the medical facility and then ultimately to the patient. So when you talk about having these clinicians as W2 employees, how many clinicians do you work with on average at any given time?
John Nolan:
I think this week we've probably got nearly 300 clinicians that are working full-time hours for Next Move or Prime Surgical Associates and yeah, they're all W2 and that's in addition to the internal staff, the recruiters and the payroll team and our account managers and things like that.
Kelly Scanlon:
Yeah, all the support services folks. Tell us about how you do the placements. Do you work with any medical facility? Are they a second kind of set of customers that you have? How does that all work?
John Nolan:
Well, it works differently with different facilities, with different healthcare delivery organizations. Most of our customers we contract through group purchasing organizations or in our industry they're called vendor manager services or managed service providers, MSPs. So we partner with these group workforce management companies that contract with hospitals and that technology that is that middleman is able to aggregate the needs that hospitals have for supplemental staff and then we go out and hire exceptional clinicians and credential them, onboard them and then match them with these open, and most of it is contract work. So the hospitals need somebody to take a assignment on a specific unit with a specific type of schedule for three months at a time.
That hospital will enter that order into some technology. We partner with the technology companies often and then can solicit those assignments to our clinicians to take. The clinicians get to travel around. We staff across the country, we're certainly very heavy and focused in the Midwest. Kansas City's by far the biggest city that we staff in. We also partner directly with facilities, so we prefer that a lot of the time because we get information faster, we can better understand the type of clinician that will be successful at that facility and ultimately having more information, faster information, provides a better experience for the healthcare providers.
Kelly Scanlon:
So theoretically the clinicians could be working for one group for a three-month period and then the next three month or two month period, whatever the contract is for, they could be working at a different place.
John Nolan:
That's very normal.
Kelly Scanlon:
How do you develop a relationship with the healthcare facilities, the hospitals, the doctor's offices, wherever it is that you're doing these placements, so that they have that trust and that confidence that the people that you are placing with them meet the same standards and so forth as the personnel that their HR departments would bring into them?
John Nolan:
One way is we are accredited by the Joint Commission. The Joint Commission is a healthcare quality assurance body that certifies hospitals and staffing agencies and other type of vendors that work within the healthcare space that certifies that the way in which you go about your business, and it's different for every type of business, meets quality standards that they have deemed as best practices to avoid bad things happening. So some of the things that we do to ensure those standards are high as part of that accreditation is background checks, reference checks, not just any reference checks. It must be from a manager, a charge level individual. It's certain types of certifications for different units. It's a certain number of years of experience in that setting. It also helps us identify how many negative interactions or negative feedbacks from the facilities is too many to where we draw the line. It helps to keep us accountable to make sure that a Joint Commission certified agency is staffing into a hospital, that hospital should have confidence that we are doing what a lot of other people have determined as the right level of credentialing.
Kelly Scanlon:
One of your responsibilities as CEO of Next Move is overseeing and actually driving your growth strategy and your acquisitions, and earlier this year you did make an acquisition of Prime Surgical Associate, which will be your entry point into a whole new area, surgical staffing. Why is that a good expansion for Next Move?
John Nolan:
We want to be able to understand how to actually change healthcare for the better. So long-term thinking, one of the things that we need to do is we need to be able to be in the conversation more. And so that means working directly with the facilities. And the surgical, the perioperative space is the main revenue driver, the profit driver for a lot of these hospitals. There's also a giant backlog of surgery volume that didn't happen during the pandemic when elective surgeries got paused. The idea about the investment and the acquisition of Prime Surgical Associates is we get to work directly with healthcare systems in their biggest profit driving area. We get to expand our services a little bit.
We also got to partner with the founder of Prime Surgical. His name's Ty Taylor. He's an incredible human being. And like I've mentioned, it's all about your people. It starts with your people and ends with your people. So the deals don't happen for us unless we feel really confident that the leader of that matches the values and vision for what we have of the future. And so Ty is just a fantastic individual and his passion and work ethic for creating an incredible healthcare experience really fit our organization. And I just think that we want to capitalize on the increased surgery volume. We want to help hospitals be able to staff as many operating rooms as they have demand for. It just made a lot of sense.
Kelly Scanlon:
I mentioned your growth through acquisition. We talked about that just a little bit, but even before that Next Move was growing tremendously. You launched in 2019 with two employees, you've since expanded well beyond that, you've in fact, you have expanded your headquarters, you've tripled it nearly. So what's driven that growth and importantly, how have you managed it?
John Nolan:
We obviously just were in a fantastic position having started a healthcare staffing business a year before the pandemic hit. Jim Collins is one of my favorite authors and he talks about the idea of return on luck being really important in businesses that last. So we were just in a good market at a good time and we made the right investments. We saw what was happening and wanted to really make sure that we had the internal staff capacity to deliver care and provide an incredible experience to the clinicians. And so we made big investments early on at the pandemic to be able to capture as much growth as possible.
Kelly Scanlon:
Really ramp up.
John Nolan:
Really ramp up. I mean, we were even hiring when... The pandemic didn't hit the Midwest for four or five, six months from when it hit the coasts. So everything was kind of on lockdown, shut down here and during that time, our business, what little growth we had in our first year in 2019 pretty much went to zero because everything stopped. So during that time we said, well, if we're going to create the most satisfying career experience in healthcare, we're going to have to invest. We need to be able to capture this demand and take care of our clinicians and the health systems when the demand does pick up. We hired, we trained and made the investments that we did, and ultimately we had the capacity to fill needs and to work with clinicians when a lot of other agencies just had not done that. So we grew a lot just by, I mean I referenced this earlier, our people. People, people, people.
We just really built a culture of A players that were giving Olympic level effort, that were really committed to our mission and made it a fun place to work. And while everybody else was working remote during the pandemic, we were not. Long hours in there just trying to keep our heads above water. I mean, just like the clinicians were and the healthcare systems were. We were just focused on it. And it was a lot of fun and managing that I think has been challenging. We built our business essentially all during the pandemic. We're now post pandemic. There's a lot of changes there that occurred I think in our business especially that just even how we go about going to market, how we go about providing the experience that these clinicians want is a little bit different now than it was during the pandemic.
So being flexible I think is really important as you're scaling a business but also not losing focus on your core, and that's if you deliver a raving fan experience to your internal team, they will deliver a raving fan experience to your clinicians who will deliver the best patient care and get great outcomes and the hospitals are asking them to come back.
We also brought in, I have a really strong board of directors. This is not my first rodeo in entrepreneurship, and one of the things I've learned before is that surround yourself with people who are looking at different things than you're looking at. It's really easy to get tunnel vision or to not see the writing on the wall when you're in it every day. So I built a really strong advisory board, board of directors for our company and they advised me in summer of 2021, we had grown a lot already. They said, "Hey, we need to bring in an operator who has some industry experience", and we did a search. We brought in a COO from a publicly traded company in our space. His name's Clint Clevenger, he's also a Kansas City native, and he has really helped us, helped me kind of as the wind in the sails, the energy kind of guy, he has helped me build an organization, train leaders and managers, develop them into strong capable folks who are able to deal with adversity and have difficult conversations and show grit and all of those things.
Kelly Scanlon:
Yeah, I think a key thing that you are alluding to is you can have success, but you can't get complacent about it. You've got to constantly reassess. You said that the way you do things now is differently than you did during the pandemic. What worked then doesn't necessarily work now. And I think that sometimes entrepreneurs fall into that mindset that you just keep doing what made you successful rather than taking a step back or maybe 30,000 feet up and saying, "Is this still working?"
John Nolan:
Yeah, it's a delicate dichotomy of stick to the plan, stay focused, don't lose track of the thing that makes your business run, the thing that makes you different or best in the world. For us, that is this raving fan experience. It's the most satisfying career experience in healthcare. It's clinicians first. You can't ever lose track of that, but also you have to be able to pivot how you do that and look at it from... The objective is deliver that, the way in which you do it though, there's a million mechanisms to do that. So.
Kelly Scanlon:
You've spent your entire career as an entrepreneur. Have you always known you were going to be an entrepreneur from a young age? Did the path start by chance? Why is it that you're a serial entrepreneur and you've never known anything but entrepreneurship?
John Nolan:
I dislike that notion of serial entrepreneur because I feel like my whole thing is when I'm in it, I'm all the way in it. So my uncle was a entrepreneur and had a pretty big exit from a technology enabled company in the dot-com era. And as I was growing up, I saw the lifestyle he was living and what his day looked like, the things he talked about, how he was carrying himself, and I looked at that, how he was spending his time. I looked at that against the other people I had in my life and immediate family and folks that I knew and I thought, I want my life to look like that. I want my life to look like his. I don't want to be working when I'm 60 years old or 50 years old, whatever. I now can tell you that I can never not work because I just love it so much.
But the idea was, well, I need to be an entrepreneur. I need to own my own business. I need to be a creator if I'm going to be able to achieve that, just from the very limited data set that I had. And then from there, it was in college, I started a landscaping company and I think ever since then I just fell in love with the idea of creating, creating opportunities for myself, for other people. I'm very passionate about inspiring people, that's I feel like what my personal mission statement is, it's what I was put on the Earth to do, so I get to do a lot of that as an entrepreneur. I fell in love with creating. I just don't really feel like there's another place that I can do that as impactfully or as much as I can being an entrepreneur.
I've also learned a bunch of lessons, like if you're going to have to lay people off, you don't want to do it twice. You really want to make sure that you go a little bit further than you think you need. I've learned the lesson of if you can use debt, you should use debt. In a lot of cases, that's a lot better scenario for you than using the cash. Obviously banks have a really good idea of how to tell you should you or should you not leverage yourself to this, but that's a really effective tool and oftentimes even better than cash because cash flow is everything in business. I've also learned that without a really strong conviction, I talk a lot in our business about this idea of a hundred percent intention is night and day from 99%. When you are a hundred percent intent on something, it will happen. If it can happen, it will happen. And when you're 99%, it almost will never happen.
Kelly Scanlon:
Yeah, it's that whole difference between the temperature where water boils, that one degree makes all the difference. It creates steam that can drive locomotives. It's a difference of one degree.
John Nolan:
There's only one intention, fully intent, and there's a million mechanisms. So there's always a way to get something done or to accomplish what you're wanting. There's so many different ways to accomplish whatever your dream is, but there's only one commitment on the outcome. And so I've really learned to be honest with myself about how intent I am on that outcome, how committed I am to something, and I believe that integrity is doing what you say you're going to do. And so trying to get command over myself around not feeling bad about if I am not getting all the things on my to-do list done, just being really clear about what is my intention with this and being okay if it doesn't get done, if I'm not intent, but on the things that I am intent on accomplishing, making sure that I understand what that commitment means. It means I'm going to do whatever it takes to get it done.
Kelly Scanlon:
What is the next move then for Next Move?
John Nolan:
It has always been, and at this point I believe always will be, delivering the most incredible, undeniable, most satisfying career experience for healthcare providers. I'm incredibly passionate about this and I believe that one of the large problems in healthcare, there's several, but is this giant supply gap between the supply and demand disparity of the number of healthcare providers that are available, quality, qualified, engaged healthcare providers, and the amount that we need, and it's only going to continue to increase. We do not see that that gap is going to shrink. At least there's no indications right now. There's a lot of things that could be done to help it that just don't seem really likely. Bringing in international nurses, that's a government regulation thing. There was a lot of changes a decade ago with that to the detriment of foreign nurses coming to the US that we don't really see changing.
So what's next? It's probably technology and creating service offerings that don't exist or are not widely used that directly make a healthcare provider's job better. Some thoughts that we have on that are we think that there's an opportunity to expand the use of shift work and fractional shift work within the acute care. This is something that is fairly common in post-acute, so home health, long-term care, rehab facilities, nursing home, hospice, things like that. But we think in acute care, technology is going to allow us, and it'll be further adopted for hospitals to use a clinician to come in just today and maybe they don't come back for two weeks as opposed to what Next Move does, mostly now is contract work. They're there full-time for this many weeks and then they can either renew their contract or they go somewhere else. So the shift to shift work, that's called per diem in our space, we think that'll expand in healthcare, that is, or in acute care, that's starting to happen.
I also believe that there's an opportunity for fractional shift. You've got an incredible part, a incredible piece of the population of nurses that likely have young children. So when you think about what would improve their lives, one of the things would be, "I need to be off at four o'clock today so that I can go to a recital or the soccer game. I need to take the kids to the soccer game." That is something that there is no option for right now. They have to work this, it's this very strict 12 hour shift. There's report from the nurse that you're getting the handoff of the patients from at 7:00 AM and you are then doing handoff at 7:00 PM. And because staffing is so tight and they're like, the census demand is so tough, in the interim there, it's really challenging. I mean, you'd have to get the nurse that's coming in late to come in an hour early or two hours early.
We think why isn't there the ability to have a clinician come in and work a three-hour gap there at the end of the shift so that healthcare provider can do the things that they should be able to do, like go to their kids' recital without having to leave the hospital short-staffed for that whole shift? Technology can do that. There's a lot of challenges to it, like credentialing and making sure that the clinician that's coming in knows how to work that unit, knows where they go, and being able to do that on short notice, but we're looking at that. I also think that there's ways that we can promote this idea of the best clinicians. Just like in any profession, there are clinicians that they do love their job, they are passionate about it. They geek out about better outcomes and understanding things. Well, there isn't really a good way right now to let those clinicians that are in that premium tier, like they're incredible at their job, to feel the satisfaction of, I am the best at what I do.
Hospitals aren't compensated differently for them. It's just the clinician doesn't get compensated nor the hospital if that clinician takes four patients as opposed to two or delivers a better outcome necessarily, it's not tracked to them. So we think that there's an opportunity for us to create a premium model kind of that really puts extra investment in and leverages these clinicians that love what they do, and we think through that, being able to compensate them a little bit better and also just support them in expanding their profession, pursuing mastery within their career, that that will help other people see that that's possible. It's something to work towards because that doesn't really exist right now.
Kelly Scanlon:
John, thank you so much for what you're doing. Really appreciate you taking the time to come and share your vision for healthcare staffing, the disruption that you're creating, how that can impact all of our lives through better healthcare, ultimately.
John Nolan:
My pleasure. Thanks Kelly.
Joe Close:
This is Joe Close, president of Country Club Bank. Thank you to John Nolan for being our guest on this episode of Banking on KC. Many times when we think about innovation, science and technology come to mind, but in a field that depends on both for medical breakthroughs and accurate diagnoses and treatments, Next Move Healthcare is disrupting the industry in a more basic way by focusing on people, the people who provide the care, and the people who receive the care. The company's premise is that when providers are well taken care of, the health outcomes for patients will be better too. Putting people at the center of healthcare may seem more intuitive than disruptive, yet in practice, it's an approach that's often overlooked. Sometimes innovation simply means getting back to basics. Thanks for tuning in this week. We're banking on you, Kansas City. Country Club Bank, member FDIC.