Disrupter creates 'Uber for nurses' to fight staffing challenges

Over the past decade, thanks to platforms such as Uber, PostMates, Instacart and DoorDash, the gig economy has fundamentally changed the way tens of millions of people of work. According to Pew Research Center data from last year, 16% of all American adults have earned income from sort of online gig work.

For Tampa entrepreneur Tony Braswell, the gig economy is nothing new. He pioneered on-demand employment for nurses and caregivers in the 1990s, when he created Per Diem Medical Staffing Inc. The service allowed nurses to pick up extra shifts at understaffed facilities and get paid the same day or the following morning.

Per Diem, the 57-year-old Braswell says, was a godsend for single parents who struggled with the cost of food and child care and couldn’t stretch a single paycheck over the span of two weeks.

“Sometimes it made the difference between whether their kids could eat or not,” he says. “I hear it all the time. People say, ‘I’ve just started a job, but I don’t get paid for three, four weeks. How stupid is that? We’re making driverless cars, but still paying people every two weeks” — or more.

In 2016, Braswell transitioned the Per Diem concept into a new company called Gale Healthcare Solutions. The company's signature product is a mobile app called Gale — the name is a tribute to Florence Nightingale, the British nurse who’s widely considered the progenitor of modern nursing — that’s “Uber for nurses,” he says.

Today, Gale has signed up more than 50,000 nurses and caregivers, while health care facilities — mostly nursing homes and other long-term care facilities — in 39 states use the service. Every day, it helps 3,000-4,000 nurses land gigs and earn extra income, and just like Per Diem, it pays them immediately following the end of their shift.

“We hire a lot of nurses every day,” Braswell says, adding that Gale users are classified as W-2 employees, not 1099 contractors, and receive benefits from the firm. “That’s all we’re doing.”  

But is Gale Healthcare Solutions’ rapid growth sustainable? Its revenue (Braswell, citing intense competition in the sector, declines to disclose specific numbers) shot up 197% from 2020 to 2021, after doubling every year since 2016, and it now has more than 500 administration and back-office employees. It's running out of room at its nondescript office behind a 7-Eleven on West Hillsborough Avenue in Tampa.

The company's business model allows it to pay nurses a competitive hourly wage and then turn a profit on what it charges its customers — the health care facilities that need extra staff. 

"I'll pay somebody 20 bucks an hour and then bill $25," Braswell says. "I'll make a couple points on the difference, but I take the risk. I pay the nurse today but I bill the client and they pay me within 30 to 60 days."

That means Gale frequently has to float funds. But the formula works — so much so Braswell has sky-high expectations to meet: In late June, Ernst & Young LLP named him its Florida Entrepreneur of the Year, and in August the company was named to the Inc. 5000 list of the nation's fastest-growing privately owned companies. 

 “I was floored” by the win, says Braswell, who survived a cancer scare at age 26, an experience that continues to drive his intense interest in improving the health care industry. “They came and interviewed and videotaped me.”

After watching the recording of his EY interview, Braswell thought he came across as too “scary passionate” to win the award. “I was like, ‘I’m so, so sorry,’ and they said, ‘No, no, you’re fine. Entrepreneurs have to be a little crazy.’”

Crazy or not, Braswell has taken steps to ensure Gale is ready for the hyper-growth stage on the horizon. He embarked on a Series A funding round last year that netted $60 million from FTV Capital, although Braswell remains the firm’s majority owner. He also signed a lease for a larger headquarters, near Raymond James Stadium in Tampa — a significant step up from the 7-Eleven.

The move, Braswell says, “gives me the chance to go and hire 1,000 new people.”

Despite Gale’s rapid ascent to prominence in the healthtech space, Braswell is unsatisfied. Big-screen TVs in his office display real-time information about usage of the app, and he bemoans the fact that thousands of open nursing shifts remain unfilled. “That means thousands of people are not going to get care today,” he says.

But Gale can only do so much when there’s a shortage of 1.5 million nurses nationwide and, in an ironic twist, qualified nursing school applicants are not being admitted to schools because of lack of clinical space and instructors to teach them. 

“Last year, we turned away 91,000 [potential] nursing students,” he says. “Nursing students have to train for six months to a year, but how can you train somebody when you’re short-staffed? You see the problem here?”

Braswell believes he can be a big part of the solution to that problem, and he aims to have at least 200,000 nurses on the Gale platform within the next 18 months.

“We’re a mission-driven company,” he says. “Making money is a byproduct. If we don’t do our job, people die.”