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November 2007
Rx for Hospitals
By Ellison Clary

     You think your job is hard? It’s probably not as difficult as Greg Allen’s. He’s president of Cirrus Medical Staffing, a Charlotte company that places traveling health care professionals at hospitals in all 50 states.

      Allen lists a few of the hats he wears during his typical 12-hour work day: “You have to be a Realtor, a psychologist, a salesperson, a customer service representative—and it’s very difficult,” he says. “This is not easy to do and if you can do it consistently and do it well, you know you’ve done something with yourself and your career.”

     He flashes his quick smile and adds: “It’s very fulfilling. Sometimes I have to be on the verge of a nosebleed to be happy. This definitely takes me there.”

     After 20 years in recruiting, Allen was working with DBS Systems in Charlotte when longtime friend and mentor David Cline broached the idea of starting a medical staffing firm. Allen took the challenge along with Cline and Cline’s wife Leslie and several other investors.

     The result was Cirrus Medical Staffing, which places roaming medical professionals with hospitals that need their services. Cirrus started with just Allen and two others in May 2002; today, Cirrus has 38 internal employees operating in 10,000 square feet in an office park near Billy Graham Parkway. It keeps more than 200 professionals working at hospitals across the country.

     With $20 million in annual revenues, Cirrus ranks far behind industry giants such as San Diego’s AMN Healthcare Services with north of $1 billion in 2006 sales. Yet Cirrus already is larger than most firms that specialize in placing medical professionals and Allen plans to grow annual revenue to $50 million in five years.

     He likes the size of Cirrus because the firm can provide individual attention to its clients, which includes both health care professionals and hospitals. A downside is that, positioned between the big boys and the small-timers, Cirrus wrestles with the investment it takes for the kind of consistent marketing campaign it needs on a national basis.

 

Medical Match-ups

     Still, Allen exudes happiness as he describes the details of his business in his fourth floor corner office. The 48-year-old Salisbury native who studied pre-med at the College of Charleston says he’s glad he paid his dues in various recruiting functions. It has helped him amass a wealth of savvy for situational solutions.

     “I like the analysis involved,” he says. “You have a certain issue, you get creative with it and you analyze it. Then you come up with a resolution.”

     Solutions usually involve matching an itinerant health professional with a hospital that needs that person’s services. Cirrus works with physician’s assistants, respiratory therapists and nurse practitioners, as well as technicians in surgery, radiology and magnetic resonance imaging applications. But, because of a severe shortage in America, Cirrus most often places registered nurses.

     Knowing they are in demand, nurses who desire to see the country travel to various spots and use placement firms such as Cirrus to find work. Probably 10,000-plus nurses are employed through placement firms at any given time.

     “We consistently keep 200 nurses on our payroll,” says Allen. “We may employ anywhere from 300 to 350 in a year.”

     At a typical hospital in the Charlotte region, about 5 percent of the nurses might be “travelers,” the name given to those professionals who move from hospital to hospital. But a patient wouldn’t be able to pick one out. A study by the International Journal of Nursing Studies showed there is no difference in the quality of care given by a traveler or a full-time nurse, Allen says. That study also showed travelers, on average, are as educated or better.

     “Both hospitals and travelers are our clients,” Allen explains. “You are trying to satisfy and work with the traveler, but the hospital has to be satisfied with what you’re doing, too.”

     Typically, nurses who move about the country work a 13-week contract with a hospital and that can be renewed for another 13 weeks. The nurses and other traveling professionals remain employees of Cirrus. The hospital where they work pays Cirrus and Cirrus, in turn, pays them.

     Cirrus finds housing for its travelers and provides them with fully-paid benefits, including major medical, dental, vision, prescription discounts and a life insurance policy. Other options are plentiful. There’s supplemental life insurance, accident insurance, cancer insurance and long-term care insurance. Further, Cirrus provides financial analysts to assist with investments.

     The average traveler with Cirrus is in his or her mid-40s, Allen says, and a number of them move around with their spouses. Often a traveler has at least 10 years of experience and has been a clinician in more than one specialty area such as intensive care, emergency room, pediatrics or medical surgical nursing.

     They tend to shy from institutional politics, Allen adds, and they usually are very quality-oriented. Also, they enjoy moving from hospital to hospital and learning new ways of practicing health care.

 

Traveling Aid

     “Moving really does enhance their career,” Allen says. “They practice health care in many different modes. A small hospital would do something one way while a large hospital would do it a different way. But there’s the same outcome. The patient gets well and the traveler learns different ways of healing the patient. It makes them more well-rounded professionals.”

     Traveling nurses often earn between $70,000 and $90,000 and can bring in as much as $5 more per hour than their stay-put counterparts, according to Allen.

     David Erskine is a traveling respiratory therapist who used Cirrus to hook on at Lincoln Medical Center in Lincolnton, N.C. Originally from Columbia, S.C., Erskine had been working at hospitals in and around Houston, Texas. He’s been at Lincoln Medical for almost three months and thinks he’ll sign up for another two or three.

     “I thought about six or seven different agencies before I went with Cirrus,” Erskine says. “The people at Cirrus were real straight up for me and worked hard for me to get a job and make everything happen.”

     Many hospitals see an advantage in taking on traveling professionals, Allen says, and hospital executive Rawle Barker agrees. Barker is director of employment services for Novant Health’s South Piedmont Region and he’s based at Charlotte’s Presbyterian Hospital.

     Presbyterian has used Cirrus for at least four years, Barker says, to find nurses for 13-week periods. This works better with scheduling than repeatedly trying to fit in a nurse on a one- or two-day basis.

     “Travelers help us fill out our schedules,” Barker says. “We’ve not had any problems with Cirrus. They serve our programs very well.”

     Sandra Curry, director of education and development at Northeast Medical Center in Concord, echoes those sentiments. “Cirrus has sent us the type of staff nurse that we have asked for as far as competency,” Curry says. “They know what kind of nurses we need and the different units we have them in.”

     “The needs of a hospital change quickly,” Allen explains. “It gets cold, and there’s a ton of heart attacks, and they don’t have enough intensive care nurses. With one call, you can get some more without having to close beds in your unit (due to nurse to patient care ratios).”

     Medical problems often occur in cycles, he adds. There’s a flu season and more emergency room visits happen in the summer as well. Elective surgery spikes around holidays, as does operating room demand, and birth rates rise in the early spring.

     The cost of a traveler versus a full-timer usually is a wash. “If you calculate compensation and efforts to recruit a full-time employee, you’re ending up paying about the same thing,” Allen says. “So nobody’s getting gouged.”

      Cirrus has more than 1,200 contracts with hospitals in all 50 states. “We’ve never had a hospital contract cancelled,” he brags.

      Indeed, Cirrus is the first medical staffing firm in North Carolina to win Healthcare Staffing Firm certification from the Joint Commission of Hospital Accreditation, says Allen, who sits on the commission’s staffing advisory council.

     “Accreditation is very beneficial because it helps you organize your business better,” Allen says. “You know you’re meeting the same criteria the hospitals are held accountable for.”

 

Versatility and Reliability

     Along with keeping hospitals happy, Allen takes pride in the loyalty of the medical professionals Cirrus helps. “Our retention rate for travelers is above 70 percent,” he says.      
     “That’s one of the highest industry averages, if not the highest. It’s because we treat people right, we do what we say we’re going to do. We don’t leave things unattended. We take what we do very seriously.”

     Taking care of the travelers involves more than most would imagine, such as handling personal problems. “Just like in a full-time job, there are times when a traveler has a family emergency or a medical emergency,” Allen says, “that may take them away from an assignment.”

     Sometimes a traveler can return soon and make up the time lost. In other cases, Cirrus has to cancel the contract and find a replacement for the hospital.

     Regardless, a Cirrus staffer is available to handle unforeseen situations 24 hours a day, seven days a week.

    That brings Allen to a detailing of the various tasks that his internal employees handle. There are recruiters who find jobs for travelers and they work closely with hospital coordinators who make sure Cirrus is complying with the needs of the medical institutions. Account managers develop new contracts with hospitals. Quality control folks collect required medical and professional information and handle referencing, credentialing and continuing education. They interact with each hospital human resource department. And there’s a controller and an accounting department.

     Allen’s staff of 38 handles all this. “We’re lean and mean,” he laughs, then takes a more serious tone. “We have some exceptional talent and I wouldn’t trade this group of people for anything.”

     One of the hardest parts of his job, Allen says, is maintaining balance. “There are times when our cubicle area is like the New York Stock Exchange,” he says with a head shake. “You’re juggling multiple issues with multiple people. You’re trying to get situations resolved on both ends of the spectrum—with the hospital and with a traveler.”

     But that produces what Allen calls the best part of his job: variety.

     “I’m not stuck doing one thing all day,” he says. “I get exposed to a lot of different things, whether it’s the hospital, whether it’s the traveler, whether it’s our internal employee. I get variety and I like that. It feels like I’m still growing.”

     Growth continues for Cirrus, as well. A recent Charlotte Business Journal ranking of area staffing offices by size placed Cirrus in a tie for ninth. Additionally, Cirrus just made Entrepreneur magazine’s list of top 500 fastest growing small businesses in the United States, coming in at 42.

     Allen doesn’t rule out acquiring other firms, although he adds that there are no purchase targets currently. He might also entertain a merger.

     He sums up growth options simply: “We’re going to keep an open mind to what’s going to grow the company and what’s necessary to secure the talent we have long term.”

Ellison Clary is a Charlotte-based freelance writer.
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