How COVID Shaped the Future of Healthcare Staffing -- For Better and Worse

An interview with Jim Chandler, senior vice president of Health Carousel Locum Network

The following is a transcript from an episode of The Workforce Solution, an interview series about the most pressing topics in healthcare staffing and workforce management.

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Jim Chandler founded Onyx MD, an elite physician staffing solution, with his physician friend Dr. Robert Moghin, after the two met serendipitously at the University of Colorado.

Onyx is now part of Health Carousel Locum Network, where Jim serves as a senior vice president.

Jim talked with us about how COVID-19 shaped the healthcare staffing industry and what he believes is the key to the future of the industry.


My business partner and I, we co founded onyx MD in 2005. And it was all locum. Like 99%, anestesia. He was an anesthesiologist resident in the University of Colorado, and through just, you know, social network, we're able to connect, and, you know, he kind of had this idea because, you know, what he was doing out with his own practice in California, when he got out of residency was sort of a microcosm of, you know, the industry, and being, you know, the entrepreneurial spirit that he was, you know, he kind of, he started doing his own diligence, and our, our paths crossed, and, you know, the stars aligned, and, you know, here we are 15 years later, and now part of Health Carousel.

Onyx MD as an organization, before becoming a part of Health Carousel, we realized that we needed to hitch our wagon to something bigger and you know, we needed to figure out a way like, how are we going to add value separate from competition and be able to differentiate ourselves in a way that it's going to bring additional value and enhances our presence within a marketplace.


The COVID-19 pandemic has affected every aspect of healthcare irrevocably, and the locums industry is no exception.

From telemedicine to elective surgeries, chronic conditions and capacity issues — the impact of the pandemic will continue to be felt throughout this complex industry for months and even years.


One of the things that, ultimately, I think will impact the staffing industry is just the lack of patients with either known or unknown chronic conditions that could be developing, that are just kicking the can down the road, because for fear or there's some comorbidity going on, or they're in a demographic that's more exposed to getting the virus. And those underlying conditions are not getting treated. And I think that the long-term burden on the industry, is a result of that is going to be more than it is today. And it's going to really strain the already existing strain system as it is.

It presents some challenges, but I also think it presents some opportunities. The demand with where the locums business has gone over the past year, it's gone in crazy directions.

There was a lot of red tape that used to exist with telemedicine. And I think a lot of that, when you really dig in, had to do with what the reimbursement environment looked like. And, you know, I hate to say it sometimes, but you gotta follow the money. And I think that that was there was some clearly there were some lobbying efforts behind it,

I think easing some of the restrictions with respect to that was big, because very intuitively and practically, it makes a lot of sense. You don't have to see a patient physically, all the time for every condition. So I think leveraging that type of technology and where we are, I think is a really good thing.


At Health Carousel, Jim and the other senior leadership team members believe passionately in higher acuity specialties. Recruiters are organized by speciality and trained with a deep knowledge of their specific specialty.

The mission is to speak the language and understand the nuances better than anyone, so that patients end up with the best possible provider.

Jim believes that staying focused on specialization is the key to the long-term success of the healthcare staffing industry.


There was an article I read a long time ago, I think Bill Gates hosted a, a dinner for, you know, a lot of prominent industry folks —Warren Buffett being one of them. And I'm paraphrasing here, but there's one question that got asked of both of them, in terms of “what made you become successful in what you do over your career” and they basically said the same thing, and responded with the same word, which is focus.

The industry, especially in locums, it's really, it's an industry of niches.

Historically, our approach has been that we're an inch deep and a mile wide. Meaning, like, we're the jack of all trades, but the master of none. And I think that’s where the focus comes in is, instead of being an inch deep and a mile wide, now, we're an inch wide and a mile deep. And I think that technical subject matter expertise is really what gets the flywheel moving with respect to becoming the known industry experts and just the simple concept of, like, sales, networking on the client customer side, as well as on the provider side. They're like, “Hey that's the brand I'm going to, because they're the ones that do this well”.

And, you know, sometimes it's important to say no, and really be proactive in explaining what you're good at and what you're not. And I think setting those expectations, ultimately, is what leads to lasting relationships and in the human capital business, I mean, it's paramount. It’s critical to long-term success.

Another example within the industry itself is, you remember when they shut off the government shut down elective cases? Elective cases are, you know, where hospitals make the money that they do to keep the lights on. And that was a big deal. And the way that impacted the locum market was the anesthesiologists and CRNAs — that whole specialty shut down for, I'd say, the better part of about call it six to eight weeks. And then as elective cases came back online, there's clearly a backlog, I mean, it's not like the surgeries just go away, right?

So there's a backlog, and then it came back, like with a lot of momentum. So as the pendulum swung back, the companies that had that focus that really stayed disciplined, and continued to work their networks of providers and staying in touch with them, were ready for that demand in those cases to come back, and we're poised really well to capitalize.

Our industry is very real time, and things go stale after after a while, including all the goodwill that you build up, and you start to lose contact with both your customers and your providers pretty quickly if you're focused elsewhere.


As vaccinations continue to be distributed across the country and the number of vaccinated Americans increase, the discomfort associated with travel and other locum related factors that were considered high-risk will start to dissipate.

What does the future hold for locums? No one knows for sure. But, one thing is for certain: every physician in America is looking for an opportunity to make a difference in the lives of their patients — no matter where they serve or how long the impact of the pandemic lasts.


We are a very tight knit group of professionals who are relentless and wanting to do a great job and deliver quality service to our clients and providers. And we don't give up. And I think where we are today is a testament to the team and just as importantly, the leadership throughout the organization and staying dedicated to the mission despite a lot of challenges along the way — financial and otherwise. I think having that support from the top down really garnered and instilled confidence in the team to not give up and just know this industry isn't going anywhere. This is a blip on the radar, it's big blip, but the things that we're doing are going to make us stronger in the end.

I think for all those reasons, we’re going to be better for it.

This episode of The Workforce Solution has been an interview with Jim Chandler from Health Carousel.

The Workforce Solution is a storytelling series brought to you by Health Carousel,  a world-class healthcare staffing and workforce solutions company designed to improve lives and make healthcare work better.