Miami’s Jackson Health System faces another threat: headhunters trying to poach its staff
In between the crush of intense shifts as a respiratory therapist at Miami’s public hospital, Micheline Plantada said she often checks her phone to find several missed calls and texts from staffing agencies seeking to lure her away from Miami.
Though Jackson Health System has yet to be inundated with COVID-19 patients like hospitals in the New York City metro area and elsewhere, Jackson officials say they don’t feel they’re out of the woods yet, with looming threats of a delayed surge or an outbreak in the healthcare system itself.
But staffing agencies have mounted attempts to poach the public hospital’s most crucial workers, even as the novel coronavirus upends operations and mashes its bottom line, with estimated losses of $25 million per month going forward under the status quo.
Plantada, who helps manage ventilators for critically ill COVID-19 patients, said the offers — as high as $7,000 per week plus room and board — are both aggressive and enticing. But she has no plans for leaving.
“We want to support our community,” Plantada said. “Most of the therapists down here, that is our priority: sticking by and being here for everybody else.”
The mechanisms of hospital staffing agencies are not unique to the pandemic. Most South Florida healthcare systems rely on the brokers to surface employees capable of meeting ever-changing and highly specified workforce needs.
But the uncertainty of the novel virus has raised the stakes for a public hospital trying to cling to its critical-care workers while also facing the possibility of layoffs, furloughs and pay cuts for others.
In a memo on Jackson’s second-quarter finances sent Friday, CEO Carlos Migoya said the coronavirus has already reared its head in the budget in the form of a $7.5 million shortfall at the end of March. At the beginning of March, he said, the hospital had been $5.4 million ahead of its budget projections.
That was before the cancellation of elective procedures — business the hospital had been trying to cultivate to shore up its bottom line — drained the hospital’s revenues.
“That was an unprecedented swing, despite the fact that elective procedures were not fully canceled until the middle of March,” Migoya said in the letter to lawmakers.
In the letter, Migoya pleaded with lawmakers to deliver on promises of federal funding, saying “Jackson cannot afford any delay — unlike many private health systems in our region, we do not have the cushion of massive cash reserves or investment-grade profit margins.”
Though the taxpayer-funded hospital network had recently built some financial momentum, that has since evaporated. Plans for furloughs and pay cuts, however, were deferred earlier this month after Miami-Dade commissioners said Jackson could draw on a $150 million line of credit for operating capital.
Meanwhile, the public hospital system has maintained a relatively stable level of inpatients, ranging between 150 and 170 in the past week or more. Hospitals throughout Miami-Dade County have avoided the worst-case scenario of a New York City-style surge, but are united in predicting that things could still get worse before they get better.
Plantada said that, while challenging, she has been surprised that the number of patients never quite overwhelmed the public hospital as many expected.
The respiratory therapist said her advanced degree likely increases her attractiveness on the job market, but added that many nurses at Jackson will be targeted because of their experience with trauma injuries, airborne disease, high patient volume and people who have comorbidities such as asthma and chronic obstructive pulmonary disease.
“We have a very wide knowledge of respiratory disease,” she said. “We have protocols in place where we think outside the box, and can pretty much be physician-extenders and help giving recommendations on the course of therapy.”
Dr. Jeff Scott, an emergency medicine physician at Jackson, said there were national shortages of critical-care health workers before the pandemic. That’s because, unlike in Europe, the field is fragmented, with workers entering from diverse backgrounds such as trauma, anesthesia and pediatrics, Scott said.
“The critical-care market is what we call multidisciplinary,” Scott said. “Not everyone is best suited for every job, but this is a crisis.”
Staffing agencies have targeted just about anyone who can fit that “critical care” mold, Scott said. This has led to a ripple effect in the healthcare workforce. The average salary of an ER doctor in Miami is $175 an hour, Scott added, and critical care is about the same.
“The offers I’ve gotten are up to $350 an hour in the last few weeks,” he said. “You do the math.”
Scott did draw a distinction: Some of the recruiting is coming direct from hospitals without deep pockets, seeking volunteers they desperately need. But other recruiting efforts come from profit-driven staffing companies.
“The concept of poaching through brokers is very real,” he said. “They don’t care if they take from New York where they’re dying for people.”
Though Scott and Plantada both said they had adequate staffing and protection at Jackson, Scott worried that an outbreak among healthcare workers could destabilize that quickly.
“I’m in a public health system,” he said. “If you poach my doctors, what do we do to take care of our mission of treating those who can’t afford treatment?”
