With demand moderating for travel staff, flexibility emerges as the new imperative for healthcare systems
A Three-Part Series (Part One)
With the COVID-19 pandemic’s intensity subsiding, noticeable shifts in healthcare staffing are evident: One standout trend is a decreasing use of agency travelers as healthcare systems increasingly favor full-time employment, bonuses, and competitive pay. However, amid the growing gig economy, many healthcare professionals remain drawn to the flexibility and freedom staffing agencies offer. “While traveler contracts trend downward, flexibility is becoming the new currency,” observes Robert Crowe, EVP, per diem and local workforce strategies at Medical Solutions and founder of Matchwell.
In this conversation, Crowe discusses evolving traveler trends, emphasizing the vital role of flexibility and autonomy in modern healthcare. He advocates for organizations to incorporate both elements, even in local contracts, to remain competitive and retain top-tier talent.
Q: What trend are you noticing regarding agency traveler numbers?
Crowe: We are quickly approaching a new normal of post-pandemic traveler activity. According to data from Staffing Industry Analysts (SIA), pre-pandemic, about 1.5% of RNs in the U.S. worked as travelers through an agency. At the pandemic’s peak, this number surged to almost 6% of RNs. Now, also based on SIA data, we're seeing a 30% reduction in open travel positions in 2023, indicating that the percentage of RNs working as travelers is stabilizing and will likely settle around 3%. There is a common feeling that healthcare systems moved quickly in 2023 to reduce agency utilization and, in that process, overcorrected. While many systems commendably increased wages for full-time employees during the pandemic, a balanced approach is crucial as healthcare is still recovering from burnout and other challenges.
Q: In terms of traveler utilization, do you think it will ever return to pre-pandemic numbers? If not, why?
Crowe: I don't think the industry will return to the lower pre-pandemic numbers because of the growing appeal of the freelance nation over the last decade. This macro trend significantly influenced our clinical workforce and is here to stay. Many clinicians now prefer flexible work patterns, such as working three months on and one month off or two days a week instead of the traditional three days and two weekends. Yet, the real evolution lies in whether clinicians need to go to an agency to access this flexibility, which is the more exciting part of the industry’s current pivot.
Q: What are more sustainable options for healthcare organizations looking to reassess their traveler workforce?
Crowe: Organizations should establish infrastructures that empower clinicians to balance work demands with personal life. We see systems migrating from traditional scheduling to dynamic models, like shorter eight-hour and six-hour shifts five days a week instead of three, allowing for family time. We are seeing weekends-only shifts and Uber-like float pools where people move around. Our clients are focused on optimizing internal workforces to their fullest, including how best to integrate these different scheduling components, which is a great first step. Furthermore, many healthcare systems are developing internal agencies for their local workforces, enabling clinicians to float between departments for a few weeks up to three months. This move signifies an acceptance of the inherent need for flexibility and a willingness to invest in it.
Q: What underlying motivators of travel nursing can healthcare organizations replicate for their non-traveler workforce?
Crowe: Flexibility stands at the forefront of modern work demands. For organizations to stay competitive, they must also offer attractive compensation packages. However, continually increasing wages to outdo agencies isn’t sustainable. Beyond flexibility and competitive pay, clinicians also yearn to be part of a team and supportive environment. They seek more than transactional employment—they aspire to be part of a mission. Successfully blending flexibility, fair compensation, and a shared purpose will naturally attract and retain staff. Some healthcare systems are even exploring collaborative ventures to pool clinical resources, a testimony to the evolving landscape.
Crowe concludes by emphasizing the critical, nuanced role agency travelers will play in the future of healthcare staffing. “When local supply is lacking, a good use of agency is to import travelers to provide quality patient care,” he says. However, as the reliance on travelers finds its equilibrium, the strategy must evolve. “Travelers are an ideal workforce solution when local supply doesn’t exist, but if someone lives within driving distance of your facility, they should be your primary workforce. Innovative internal staffing programs and technology platforms are pioneering new ways to engage those living close by, ensuring a balance between flexibility and stability.”
Part two of our Q+A series explores the rise of direct staffing platforms.