E2E: From Entry Level to Executive
Sep 1, 2026 · 29 min · 10 segments
More than $1.7 billion was invested into building the “Amazon of healthcare staffing.” So what happened? In this episode, Bob Livonius takes a clear-eyed look at the venture capital-backed platforms…
So it's interesting that COVID, while there was a huge spike in demand in the healthcare sector as a consequence, it sort of worked against the platforms in a way.
I think the way you characterized it in your article was a sort of an ironic outcome because it pulled them away from the client relationship aspect of staffing, which was so critical.
How then does a staffing operator tell the difference between, you know, what's legitimate real market demand and reacting to temporary spikes like COVID? How do you know? How do you make that decision?
I think most of these folks that are in this industry from that new sector of venture capital may not have realized that this was a one-time event.
I mean, we all kind of hoped it was a one-time event, right? But the volumes went up so fast and so good that most of us that have been around the industry knew that this was going to come crashing down.
But if you hadn't been in the industry before, you might have thought, okay, this is the new trend.
But it not only wasn't twice as good, it didn't not only keep going, it just dropped out, bottomed out completely.
And that's because both the clients, we became the necessary evil meter was very, very high.
People thought of us very, very negatively because they thought that we... gouged them on pricing.
As soon as they started paying the nurses more, the need for contract labor went down.
And even people who wanted to do contract labor and travel nurse anymore, the number of people who wanted to do it went down.
But It's been three or four years now since COVID, and that has been what we've seen.
And unfortunately, with too much capacity in the industry, now you had all these new companies coming in, and then you had everybody else building their platforms even bigger to handle COVID.
The focus of the platforms, obviously, because of the heart of it is technology driven.
Are you saying, should we conclude that the platform innately, inherently is fundamentally mismatched with this type of business, with the healthcare business? Or is there a version of tech plus hands-on and relationship that works at scale?
So it's interesting that COVID, while there was a huge spike in demand in the healthcare sector as a consequence, it sort of worked against the platforms in a way.
I think the way you characterized it in your article was a sort of an ironic outcome because it pulled them away from the client relationship aspect of staffing, which was so critical.
How then does a staffing operator tell the difference between, you know, what's legitimate real market demand and reacting to temporary spikes like COVID? How do you know? How do you make that decision?
I think most of these folks that are in this industry from that new sector of venture capital may not have realized that this was a one-time event.
I mean, we all kind of hoped it was a one-time event, right? But the volumes went up so fast and so good that most of us that have been around the industry knew that this was going to come crashing down.
But if you hadn't been in the industry before, you might have thought, okay, this is the new trend.
But it not only wasn't twice as good, it didn't not only keep going, it just dropped out, bottomed out completely.
And that's because both the clients, we became the necessary evil meter was very, very high.
People thought of us very, very negatively because they thought that we... gouged them on pricing.
As soon as they started paying the nurses more, the need for contract labor went down.
And even people who wanted to do contract labor and travel nurse anymore, the number of people who wanted to do it went down.
But It's been three or four years now since COVID, and that has been what we've seen.
And unfortunately, with too much capacity in the industry, now you had all these new companies coming in, and then you had everybody else building their platforms even bigger to handle COVID.
The focus of the platforms, obviously, because of the heart of it is technology driven.
Are you saying, should we conclude that the platform innately, inherently is fundamentally mismatched with this type of business, with the healthcare business? Or is there a version of tech plus hands-on and relationship that works at scale?
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