Looking Abroad for Solutions to the Nursing Shortage in the US: Bhavdeep Singh, Founder and CEO of Global MedTeam

Michael Carrese: Hi, everybody. I’m Michael Carrese, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare. 

Today, we add another voice to our ongoing conversation about how to improve the nurse

staffing crisis faced by the US healthcare system. That voice belongs to Bhavdeep Singh, founder and CEO of Global MedTeam, a startup focused on bringing foreign-born nurses to the US to fill staff shortages. 

Mr. Singh is an accomplished international executive with a strong background in retail, health care, logistics, and HR, leading private and public companies on three continents, including Fortis Healthcare, which is one of the largest providers of healthcare in Asia. He's also the founder of WHA Partners and Whitehawk Associates, an advisory platform launched in 2021, serving clients in retail, supply chain, and health care. 

When we first spoke to him three years ago, he was CEO of Health Quarters, which was partnering with the Mount Sinai Health System on an innovative delivery model focused on wellness. So, welcome back to Raise the Line, Bhavdeep. I’m glad you could join us again. 

Bhavdeep Singh: Thank you very much. It's good to be here. You know, it was only about two or three years ago that I was here, but quite honestly, based on everything that's happening around us, it feels like it was a long, long, long time ago, but glad to be here. Thank you.

I appreciate the opportunity to be able to share a little bit about what's happening in our side of the world. 

Michael: Absolutely. We're looking forward to it. So, for those who did not happen to hear the

show three years ago, let's start by having you tell us a bit about your background and what led you to get started in retail?

Bhavdeep: Well, you know, I was like most teenage kids, high school kids kind of figuring out what to do in life. I grew up in White Plains, New York and one day I was -- this is in the early 80s -- quite honestly, you know, as a minority, where diversity wasn't yet a term -- so a young man with a turban on his head looking for a job, the red carpet was certainly not being rolled out. In fact, no carpet at all. And so, you know, the question sounds like such a provocative one…what got me started in retail? Well, that was the guy that hired me. I would have started anywhere. I walked into a grocery store, there was a sign outside that said “Help Wanted” and I was nervous. And the store manager asked me three questions, “ How old was I? Could I speak English?” and “When can I start?” It was a fantastic interview. I apparently did well, because forty seconds later, I was hired. 

There aren't too many teenagers walking around saying, “You know, when I grow up, I’m going to be a grocery store manager.” But I started working there. My mother was horrified that her son was going to work in a grocery store and I assured my mother, no, no, this is just temporary. It would be just a few weeks, and maybe a couple of months, and then I'd get a real job.

Well, I ended up staying with the company, and with hard work, lots of good mentors, and a whole lot of luck and the grace of God, eventually, I became president of the company. So I started sweeping floors, stocking shelves and as I said, some twenty odd years later, I became president. I had the good fortune of being able to learn along the way. As I said, many, many good mentors, people who believed in me more than I did, gave me the opportunity to do something different. I came up through the system, continued to work hard, learn, and did eventually become president. 

Michael: Well, there's a ton of lessons to learn on that kind of journey. And as I was mentioning in the intro, you went on to run a very large healthcare system in Asia. What was the jump from retail to healthcare? 

Bhavdeep: Well, you know, I was born in India but I lived most of my life here in the USSo India was just as foreign to me as it would have been to you. It was just a remote land that I'd visited once and I came back thinking, “That was fine. Let's go back to work and let's get back to life here.” 

But around the late 90s, early 2000s, things started to change. There was a big, big buzz in the market around BRIC, everybody was talking about BRIC -- Brazil, Russia, India, China -- and the fact that these countries had a promising future. I thought to myself, “Good Lord. For once in my life, it's good to be from India.” Because it really hadn't been much of an asset. You know, again, we were still an evolving nation in terms of understanding other cultures, understanding other people, how people live their lives, and really being able to develop respect and insight in terms of how other people have lived their lives. 

So at that point, you know, as India started to evolve, as India started to grow, as India started to change, I became very curious. What would it be like to work somewhere else? What would it be like to work in India. So I started waking up early every morning and started reading Indian newspapers to find out what was happening in India. I had this urge to go to India and my family actually made fun of me. They said what are you going to do in India? You don't know how to do anything. The Indian ecosystem and the professional environment in India is all academic-based.

You have hundreds of millions of people walking around with MBAs, some of them working menial secretarial jobs, but everybody has an MBA. So many people have PhDs and doctorates, and here I am with an undergrad degree running a grocery store. So what am I going to do in India? I said, “Well, I'll have to figure something out, but I’m going, I want to be in India.”

Fortunately for me, right around the same time, organized retail started to take a hold in India and that was new because until then everything was independent grocer, independent corner stores, you know, kind of like what we're used to, the nickel-dime kind of store in the US, small stores like that. But organized retail started to take hold. 

So in 2006, with my family, I sold my house, put everything in a container, and moved to India. I had the fortune of working with Reliance Retail, one of the largest companies in the world, one of the largest retailers. When we joined Reliance Retail, we were just getting started. And just, you know, the ownership and the leadership at Reliance, just had tremendous vision, tremendous appetite for growth and being able to invest in that kind of a plan. 

We opened seven hundred brand new stores in less than two years. And at the end of three years, I was running a thousand stores for Reliance Retail, which very quickly became one of the largest retailers in the world. The only challenge for me then was that I was working in retail, things were good. I'd been promoted a few times over and was running most of the business now. The challenge became that when I'd moved to India, I'd convinced my family that, oh, it's going to be great. We're going to go to India and we're going to spend time together. We're going to have quality time. We're going to walk the streets. We're going to go to the markets. We're going to go to the temples. And the reality was I was leaving every Monday morning at 6 a.m. on a flight to Mumbai and coming back on a Friday night. 

So the family challenges became quite significant and I started thinking about how do I come back to Delhi, Gurgaon, which is where my family was living. Right around the same time, I got a call one day from a recruiter asking me about a healthcare opportunity, and I hung up on the recruiter. I said, “You got the wrong Singh.” You know, Singh in India is a bit like Jones in New York. I said, “I sell rice and beans for a living.” And the recruiter said, no, no, hold on. The board is looking for somebody who understands brand, who understands customer experience, who understands process. I actually didn't know a thing about healthcare. 

What I didn't realize was that the company talking to me, Fortis Health Care, was one of the largest private healthcare providers in the world. They were insistent that we want somebody who understands scale, who can help us build this brand and so after about four or five months, I became the CEO for Fortis Healthcare. And I was like, I’m going to do this. 

It was quite interesting… when I joined Fortis Healthcare, the company had about three thousand beds, which still makes it a very large health system. Twenty-five hospitals. I was completely clueless. I had no idea what was going on. Didn't know difference between an OR and a cath lab. Completely confused. And I just thought to myself, this is not going to go well. But I worked hard. I started waking up every morning to start reading about healthcare, start reading about orthopedics, oncology, cardiology, and started educating myself. 

I ran into a friend of mine right around that time, about a month or two after I was there. He said, “Hey, I heard you joined Fortis. How's it going?” I said, “It's terrible. I have no idea what's going on. I’m so confused.” I said, “These guys, they're going to chuck me out of here.” And he said, “Well, you know, give it a shot. What's the worst that could happen to you?” But I did give it a shot. I kept working at it, kept reading, kept educating myself, read more and more about healthcare as time went on and started spending a lot of time with doctors, with nurses, to really start building my understanding of what happens inside the four walls of the hospital. 

About three or four months later, I ran into the same friend again and he said, “How's it going with the new job?” And I said, “Well, things are better. He says, “Well, that's great. So you understand healthcare now?” And I told him, “No, but I’m not sure if anybody else does either.” My understanding and my learning has been that -- and this happens not just at Fortis, I’ve seen this in the US and everywhere -- when we talk about healthcare, we make it sound like a commodity. We make it sound like we're selling widgets. The reality is that when a patient goes to see a doctor, when a patient comes inside a hospital in a really fragile position, it doesn't matter who you are. It doesn't matter how big you are. It doesn't matter how much money you have. It doesn't matter what stature you have. When you don't feel well, and you go to see a doctor, that's you and I at our most delicate moment. Right? 

Michael: Right. 

Bhavdeep: Whenwe're actually concerned. And so the idea of healthcare as a 

commodity was just so foreign to me. I started talking to doctors about what does good patient care look like? You know, how much time do you spend with a patient? The doctors educated me on how they handled it. So I ended up staying at Fortis for about two years. It was a great experience. I spent a lot of time with doctors, nurses, etc. A family tragedy, unfortunately, brought me back to the US. At that point, I spent four or five more years in retail. I ran Ahold USA. I was the head of the operations for Ahold, which is a twenty-six billion dollar retailer. 

Michael: Yeah. 

Bhavdeep: About 800 stores and 100,000 employees. I ran that for about five years. And then healthcare came knocking at my door again. Fortis reached out again saying, “Look, you always said you'd come back one day. We'd love to have you come back.” And so I went back to India. I ran Fortis again for four years between 2015 and 2019. And then again, there were some family issues and the organization had gone through a transition as well, so I thought it was a good time for a change. 

I came back to the US, and more recently, you know, I launched a startup with Redesign Venture Studio, launched a partnership with Mount Sinai. We launched an aggregate healthcare platform where we brought wellness and clinical under one roof and that was just a great learning experience as well, because that helped me understand just the way people think about health care. 

If somebody has knee pain, or if they have a stomach issue, they're not just going to the primary care doctor. They're going to the primary care doctor but they are going to go see a nutritionist. They may go see any sort of a doctor who's done some expert work. I’ve heard about people with stomach disorders who go to chiropractors. 

Michael: Yeah. 

Bhavdeep: If you have a problem, you're going to go to an orthopedist, you're going to go to a chiropractor, you might go to an acupuncturist. And so what we built at Health Quarters at Mount Sinai was, we brought all of healthcare under one roof. It was an aggregate health care platform at Mount Sinai with a series of clinical disciplines in the same building. We also had, dental, orthodontal, chiropractor, mental health…the idea being that give a patient the opportunity to get everything they might want in healthcare under one roof. So, that was a great experience. 

Michael: Makes a lot of sense.

Bhavdeep: More recently, last two or three years, I started focusing on consulting. And what I’m really excited to talk about, what we've been working on here in the US now, has been really starting to look at the challenges that US healthcare is having with medical staffing. 

Michael: Right, which is the bulk of our conversation today. And as I said, we've been talking to other folks about this, and we're really interested to get your perspective, partly because of that broad sweep of experience that you just talked about, but also that you do have a global

perspective on health care. Most of the folks we talk about have only worked in the U.S., and so that obviously limits what they bring to the table. So I guess a good place to start is just to get your take on what's happening with nurse staffing and then how Global MedTeam is approaching it. What are you bringing to the space?

Bhavdeep: Well, the journey on healthcare staffing started for me with a conversation that I had with a senior healthcare executive at a very, very large New Jersey health system. I was just having a conversation about, you know, what are some of the key things that we're working on as a consultant. I was talking about the usual things…revenue cycle management, process improvement, patient experience, et cetera. And this executive turned to me and said, “Look, you really want to help me? Go get me some nurses.” And I said, “Okay. I'll bite. Tell me, what does that mean? How big is your problem? And he asked me a question. He said “What do you think is my annualized cost for one travel nurse over the course of a year?” I said, “Okay, one nurse over the course of a year…” and I just kind of played it out of my head. I thought to myself, typical RN on the East Coast, Northeast, $85-90,000 salary. I thought about, you know, what does a nurse practitioner make? What does a PA make? What does a nurse make? So I just kind of thought in my head and guessed $130-140,000. He said, “Higher.” 

Michael: Yeah.

Bhavdeep: $170,000? $180,000? I’m thinking now I’m at the top. He told me that his annualized cost for one travel nurse was over $350,000. 

Michael: Oh my gosh.

Bhavdeep: Three hundred and fifty thousand dollars. I actually thought to myself, you know, we're just having a conversation. So perhaps he's being a bit dramatic and maybe he's rounding up in a big way. A month or two later, I was talking with an executive at a health system in New York City and I had the same conversation. I just casually said, “I heard this number. Is that possible? Could it actually be that high? And this individual turned to me and said, “No, no, no, no. That number's not right. It's actually higher. It's probably $400,000-450,000 for us in New York City, just because the cost of living is more, rentals are more. Transportation is more.” 

I was stunned. I was thinking to myself, how is it possible that for an otherwise fully funded role -- in other words, with benefits, vacation, if you put everything in -- it probably cost about $110,000 at best. How is it that a $110,000 replacement in any scenario is three x that much? Maybe four x? 

Michael: Yeah.  And we should point out that the money's not going in the nurse's pocket. A lot of that difference… 

Bhavdeep: Absolutely. Right. I mean, you have the actual cost to get a nurse there. Number one. Number two, the related costs of travel, et cetera, whatever it might be. But then there is a premium that's paid to the nurse and then there's the agency who's actually providing that service. And so you're right. The nurse may -- instead of making $95,000 or $100,000 -- might be making $130,000 to $150,000 but they're not making $300,000 obviously.

But I heard number and I was stunned. I was just flabbergasted. And so I started looking into the space. I started thinking about, okay, I’ve been a CEO, I’ve run companies before. And when you think about the nurse, which is a lion's share of your workforce in any health system, how can anybody possibly afford to pay that? That's when I started to realize that, you know, the US today is short half a million nurses. Now, you can look at different sources and I’ve seen numbers as high as 600,000 or 700,000. I’ve seen numbers as low as 380,000 or 400,000. But it's not ten thousand. 

Michael: Right. 

Bhavdeep: We're several hundred thousand nurses short. The other thing that's interesting is that the number of nurses that left the workforce after COVID…the number of nurses that are licensed nurses, but they're not working as nurses today. That number is also several hundred thousand because they've just said that's not the life they want to live, right? And the even scarier part is the number of nurses that are planning on leaving. Again, depending on what data you look at over the next three to five years, there's potentially another three, four, five hundred thousand nurses that are going to be leaving. Now you combine that with the fact that the demand for nurses is going up -- the most obvious reason being that we have an aging population -- and the supply is actually going down. 

Our chief executive officer, Dennis Kogod has actually said -- and I love the way he phrases this -- he says, “COVID was here for a while before we actually realized COVID was here.” Everybody talks about March of 2020 as when COVID started. COVID was here for a good seven, eight months before that. We just didn't recognize and acknowledge it. The way he describes it is that the second phase of the pandemic is here. It's the healthcare workers shortage, specifically the nursing shortage. It's here. We just don't realize how big a challenge it is.

We've heard about doctor's offices that decided to run four days a week instead of five because they don't have the staff. They just take the nurses and run them ten hours a day for four days instead of five days of eight hours a day. Or you have ICU and CCU areas that can't be fully staffed. So it's frightening. It's frightening. 

We did a full detailed inventory on what kind of solutions are being implemented. There's some wonderful work being done in this space, you know, whether it's process improvement, whether it's optimization from a staffing perspective, software to make sure that we have the right kind of scheduling. We've looked at remote monitoring as a time-saver. Instead of somebody having to go take the temperature, it's remote monitoring and it's done automatically. So all these things are very helpful, but the numbers are indicative of a problem that's getting worse. And so everything that we're doing today certainly helps. Technology helps. I read an article two weeks ago about you know, maybe AI would produce technology that would be equivalent to a nurse at a nine dollar an hour rate. 

Michael: Hmm. What parts of a nurse's job are they talking about, though?

Bhavdeep: Remote monitoring. Being able to do a diagnosis. You can put technology behind all of it. I tell this story very often. When I was running Fortis Healthcare, I got a letter from a patient one day. For three quarters of the letter, tis individual talked about the nurse and the wonderful care the nurse gave. Most of it was about the fact that the nurse came in every day whenever it looked like, you know, the patient wasn't feeling great and would offer a play gin rummy with them. 

Michael: Yeah.

Bhavdeep: I thought to myself, we don't teach our nurses to play gin rummy with the patients. In fact, that's not their job. We don't tell a nurse that if you see a patient who looks stressed, hold their hand. Just hold their hand and sit. Sing a song. Right? I don't think we've found technology that can do that yet. You know, when you have a really bad headache, we can't function because it's such a bad headache. That headache, my headache, your headache is the biggest problem in the world. Global peace comes a distant second, right? Because that's all you can think about. So having a nurse who can help you, who can make you feel better, who can give you some comfort…we're decades away, maybe centuries away, from figuring out technology that's going to be able to do that. 

So we started scoping out and thinking about a way to help. We've been talking about what are the solutions that are available because we have such a big problem. And that's where we came upon internationally educated nurses, and that's what GMT is about. GMT is building a platform where we're looking at countries outside of the US where we can bring nurses from to the US. Our primary focus area till now has been the Philippines. And we're now looking at Mexico, we're looking at the whole Latin-Am region where we think there's a big, big opportunity. 

The Philippines has a very rich history with respect to nursing. I mean, the Philippines has been sending nurses to the United States since World War II. Some of the best nurses in the country that we have today are Filipino nurses. If you talk to any doctor or any healthcare worker, even other nurses, they'll tell you that the Filipino nurses are the ones that are amongst the hardest working, just do a fantastic job, and just are a huge value. And we think there's a big, big opportunity.

We’ve visited the Philippines now six, seven times in the last year, year and a half. The ecosystem in the Philippines is built to send nurses to the USA. The predominant number of nurses that become a nurse in the Philippines do so for one reason, which is to come to the United States. It's a huge market to bring nurses here and so our focus is that. 

Michael: That does beg the question, sorry to interrupt, about what happens to the folks back in the Philippines who need care. I mean, this idea of taking too many nurses away from any particular country or area…

Bhavdeep: Well, you know, it's funny. I think that's a good point and we looked at that point as well and what we found was that there are approximately one million nurses in the Philippines today. Of the one million nurses, a little over a half are working in healthcare as nurses. Forty to 50% of them are working outside of healthcare because a Filipino nurse makes about five hundred to six hundred a month but if they work in a call center, they can make eight hundred, nine hundred a month. If they work in a restaurant, they can make more money. And by the way, in a country with a million nurses where half a million, six hundred thousand are working as nurses, the U.S., taking five, ten, fifteen thousand nurses, is not material, number one.

Number two, there's a compensation issue that they're working on fixing there in terms of getting that right. So, I think there are lots and lots of nurses that are available in the Philippines. I think it's more an internal issue and I’m sure they are working on it. I think the government's focused on it. The private healthcare employers are working on it. So I don't think that the number of nurses we might take -- even if that number was fifteen, twenty, fifty thousand -- it's not going to materially impact what's happening there and their demand and their challenge. Because you're right, they do have a challenge but the challenge is more driven by their comp structure versus, you know, GMT taking out some nurses from there.

Michael: What do you do about the credentialing question? I mean, whatever the educational infrastructure is in the Philippines and what they consider to be a registered nurse versus what we would consider it to be here in the States. Is there any big difference there? 

Bhavdeep: There are differences. There are differences. However, there's a couple of things that's happening. Number one, the nursing ecosystem in the Philippines is very, very strong. For a nurse to be a registered nurse, you have to pass the NCLEX examination. They have to pass the NCLEX and then they have to be certified by state nursing, to get your nursing license, you are certified by state, like many professions in the US. The way the system is set up today in the Philippines is that a nurse can take the and pass the NCLEX examination in the Philippines. The state certification can be done in the Philippines. 

Theoretically, a nurse could work on a Saturday night at a hospital in the Philippines, hop on a plane, land at JFK on a Sunday evening, and Monday morning start seeing patients at a New York hospital. So all the registration, certification, everything is done in the Philippines. And when the nurse shows up here, I mean, they would have to certainly get onboarded just like any new employee would be in any company, everything from, you know, what's the uniform, who's in charge, where are the bathrooms, what documentation do we use? But it's done completely there.

The other thing that we're doing at GMT is that, in principle, we have a partnership with one of the largest health systems in the Philippines and so every nurse that we bring to the US not only would have passed the NCLEX examination, not only would have English proficiency, not only would they be state certified, they would also go through a US nursing protocol training regimen. Our chief nursing officer, Michael Moorhead, has developed a full training program. And so every nurse that GMT Global MedTeam would bring over would actually have gone through, again, A, NCLEX examination, B, English certification, C, state. In addition, a Global MedTeam certified US nursing protocol program confirming that exactly the theoretical example I gave you, where they could actually leave here on a Saturday, Monday morning start seeing patients in the US to enable them to do that. 

So we think the gap is not significant. And one of the things that helps, quite honestly,

is the loyalty and the dedication of Filipino nurses. I'll share a statistic with you which is quite humbling. During COVID, we all know that, very sadly and unfortunately, many healthcare workers even got COVID and some of them passed away. The Filipino nursing fraternity makes up for something less than 10% of all the nurses in the USA today, right? So if you take all the Filipino nurses in the US, they make up for less than 10%. However, almost one-third of all the nursing deaths in the US as a result of COVID were Filipino nurses. 

Michael: Oh, my goodness.

Bhavdeep: That is very surprising, yeah. That's a function of the fact that these were the nurses who signed up for the late-night shifts. They were the ones who signed up for ICU. They were the nurses who signed up for trauma, urgent care, where some of the highest infection incidents were. And so that statistic, you know… every once in a while, you hear something that you say, okay, I don't think I’m ever going to forget this data point. That's one of those data points that I don't think I’m ever going to forget. And that's a function of their dedication. It's a function of their commitment. The fact that they do what it takes. And by the way, we have great nurses in this country. So that's not to take away from any nurse. 

Michael: Sure. 

Bhavdeep: It's just a function of the fact that these nurses are, I think on most levels, just as good as anybody else and I think they can be a big help. Every time we think about what's happening in nursing, we ask ourselves, what's the best way to think about it? And the reality is, you know, we can try all sorts of solutions. We can try all sorts of things and say, will this work? Will that work? And we should. Every one of them, whether it's a process improvement, whether it's infrastructure change, whether it's some technological enhancement,

whether it's some machine learning, remote, we should do all of those things because we need all of them. But that's not going to get us to where we need to. We still have a huge, huge shortage. 

The worst thing about this is it is actually getting worse.  I guess one last thing I would say about this, just specifically this topic, is that while we're talking about nurses, when you start talking about home healthcare workers, phlebotomists, nursing assistants, that number is about a million short today. So nurses by itself is a half a million, five, six hundred thousand. But in addition to that, we have a million other healthcare workers that we're short right now.

Look, God forbid we have anything that even remotely resembles COVID. Even a bad flu season.

Michael: Yeah, we're really not prepared in a lot of ways. 

Bhavdeep: We're not prepared. Our view at Global MedTeam is that we've put together a process where we can do it. We've made it turnkey. We handle everything for a client. From the time that they say, okay, get us twenty nurses, we get that client forty, fifty nurses to interview. They pick the twenty they want. We train those twenty. We handle everything on immigration from start to finish. From start to finish, we handle everything and we've made it as easy, as simple as possible. 

We're working on one of the top immigration law firms in the country. So we have our approaches. Don't make it difficult. Don't make it hard. Don't make it challenging. When people say, this is too confusing and I have enough to do,, then we say tell us what you need and we'll take care of the rest. And that's why we think this is a viable solution and something that, quite honestly, I think we need to have in this country. 

Michael: So, I don't have a sense of how long you've been working on this. I'm just curious how it's going. What kind of reception are you getting? What kind of traction are you getting? What kind of questions are you getting from the healthcare systems that you're trying to work with?

Bhavdeep: So we started GMT about eight, nine months ago. It took us this long to get our processes right. We have an office in the Philippines now. We're the team in the Philippines. We're setting up an office in Mexico as well. So we're the infrastructure piece, getting our processes. You heard me reference a US Nursing Protocol training program, so we’re developing all of those things. We've written a white paper on the state of nursing in the Philippines.

Not too many startups are writing white papers. We thought we needed to do that to educate people in terms of what's happening. We've written a white paper on the state of nursing in the US and what's happening there as well. Again, because we think we have to educate people and to help them understand what's happening. So with that said, we're just starting now to engage with clients. We've just received our first two or three placement orders this week and so we're excited about the fact that people are starting. 

I think the questions people are asking -- one of them is the question you asked earlier -- how do the Philippines feel about this? How does it affect their on-ground nursing situation? We thought that was a really good question and that's why we researched it that's why the data points I’ve shared with you is something we happen to know quite well.

People ask about the English language… is there going to be any language barrier?  You know, all of us call whether it's Marriot Hotel or Mastercard or Amazon…we call these call centers all day long. A good chunk of them are from the Philippines and very often you can't tell because the language proficiency is actually quite good. I think those two things have come up quite a bit and then the whole immigration piece has come up and we actually can, handle it from start to finish .

So we see traction building now. We just attended the conference in Florida about three weeks ago. We attended a rural Texas hospital summit last week, so the interest is building quite nicely. There are a lot of people who are interested. There's a significant need out there and so we see this as becoming a significant enabler as we go forward in terms of nurses and 

other healthcare workers as well. 

Michael: And by that you mean the allied health professions you were talking of before? 

Bhavdeep: Yes, because very often the problem is that when you don't have a phlebotomist, when you don't have health aids, when you don't have nursing aids what ends up happening is you actually further exasperate the nursing shortage because now nurses end up doing these things. So now you have nurses that are placing bedpans, nurses that are cleaning up because you're short some other position. So it's a bit of a vicious cycle, and so all of a sudden, a health system that might be short twenty nurses it feels like you're short 30 nurses because nurses are doing non-nursing things. So, yes, as I said, we started with nursing but we're very quickly pivoting and jumping and looking at other roles here because we think that's that is a big crying need. It just hasn't gotten the attention. It's on page three. The nursing shortage is on page one, so it's a little bit behind the scenes but it's coming. It's going to be page one news very, very soon. 

Michael: I agree. I mean, I heard numbers that just for the state of California of needing I think it was a hundred thousand allied healthcare professionals by 2030 or one of these numbers that just makes you wonder how are we going to keep functioning as a healthcare system?

Bhavdeep: The reality is, as Dennis has said, we have a problem we just don't know it yet. So that's why we brought  together a team that I’m very, very pleased with. The folks that are here are seasoned, mature healthcare professionals who run big businesses in healthcare who understand healthcare and we all have one thing in common: we all believe, and we're working day and night, that if we don't help solve this problem it is going to be something that's going to impact every one of us and how we live our lives. God forbid if one of us gets sick. The challenge is going to be how do we get out of this? We're going to have in a health system that quite honestly is not going to be able to handle the kind of disease burden, the kind of incidents that take place or I keep saying this you, god forbid we have another pandemic or anything that remotely looks like that. We're going to have a big problem and so hence we're hopefully working to at least in some way, shape or form mitigate that and help our health system do a better job.

Michael: Well, I would say you're not overstating the nature of the problem that's for sure based on what we hear from so many of our guests. And I would also say that the framework that it's going to take lots of different kinds of solutions to really get this into a manageable place is also true. So we're happy to learn about the approach you're taking and we wish you guys a lot of luck and hope you can take a big bite out of the problem.

Bhavdeep: Thank you. Thank you very much. We're under no illusion that this is a cure all. We just we think we can be a part of the solution, but we all need to do a lot more as we go forward. So thank you for the opportunity. I appreciate being able to share some of our thoughts with you.

Michael: We appreciate having you. Thanks very much for your time, and with that I’m Michael Carrese. Thanks for checking out today's show and remember to do your part to raise the line and strengthen the healthcare system.  We're all in this together.