Who Exactly is doing Locum Tenens?
There is a shortage of physicians in this country, although sometimes it doesn’t feel that way. If you look at the number of hospitals in New York City you would think everyone should have their own concierge medical doctor. However, the demand for certain specialties and certain locations continues to rise as our population increases. Hospitals and medical practices are constantly looking to fill in gaps in coverage and therein lies the opportunity. Many of us know a friend from residency who is dabbling in locum tenens work, or are familiar with that ER doctor who spent the summer helping out in our short staffed community, but who are the good folks making a career out of this? Well, sit back and let us introduce ourselves.
First let’s start with why you are in demand. Medical facilities around the country are constantly in flux, with changes in healthcare laws, staffing is a full-time job for recruitment agencies. Critical staffing needs happen when doctors get sick or leave on short notice. These unexpected absences put hospitals and practices in a precarious position. Often times a hospital is left with little notice that they will need to permanently or temporarily replace a doctor and turn to locum tenens physicians for help. In addition, smaller hospitals with a single practitioner in a specialty may have to cover short vacations or leave of absences while their employed provider hikes to Manchu Pichu or cares for a newborn. These coverage opportunities tend to be short to medium in term, ranging from a weekend to 1-3 weeks of coverage. These positions come up fast and many doctors first entertaining the idea of locums work will try one or two of these before taking a bigger plunge into full time locum tenens work.
Longer duration positions may be created when a health system is starting a new service line, a new program, or growing an existing program to provide a new procedure or operation at an existing or new location. Imagine that small community hospital just outside Omaha that wants to start doing interventional radiology for the first time. However, the most common reason a long-term locum tenens doctor will be needed is when coverage is needed while the hospital recruits a permanent provider or augments their existing staff during a jump in volume associated with seasonal or unexpected conditions. Lastly, some geographic locations are dealing with long term, chronic shortages in staffing and may have ongoing need for locums doctors.
Over the past few years, the demand for locum tenens physicians has risen dramatically. In 2016, over 90% of healthcare facility managers reported using locum tenens doctors in the prior 12 months, up from just over 70% in 2012. In addition, at any point, almost 50% of the same managers report actively seeking a locums provider to fill a need in their institution and 75% reporting using at least one locum tenens physician in a typical month. Who are the looking for? The specialties most in demand are primary care (family medicine, internal medicine and pediatrics), hospitalists, emergency medicine, and anesthesia. However, the demand for all specialties exists. Surgery, radiology, neurology, and oncology are next in line, with a noticeable growing need for telemedicine providers and behavioral health. With the physician deficit expected to triple by 2025, the demand will continue to grow and opportunities are expected to increase.
A question that always is asked from physicians considering locum tenens relates to the perception of their quality. Will I be respected and treated fair? Over 80% of health care managers report that they are satisfied with the quality of the locum tenens doctors care and think they are justify the extra cost. Locum tenens allows hospitals to avoid lapses in patient care coverage, prevent revenue loss, decrease existing staff burnout and ensure quality and costs. At the same time, drawbacks to health systems include cost, training, credentialing and billing issues. These issues are often avoided by using a trusted locum tenens staffing agency. When selecting a physician, health systems and practices turn to staffing agencies with specific demands. Quality, availability, experience, flexibility, and customer service are top of the list for what agencies are asked to provide. When it comes to the bottom line, a good locum tenens primary care doctor can generate up to $100,000 for a hospital in a month and a general surgeon $200,000.
So what does the average locum tenens doctor look like? While there are several subtypes of doctors doing locums work, there isn’t a definable protype. Locums doctors are as unique and varied as the positions. In 2008, 7% of practicing physician at some point in their career utilized locums work, that number increased to 11.5% in 2016. With just under 1 million doctors practicing in the USA, that equates to just under 100,000 physicians. Of this group, 20% are primary care doctors, 16% are in behavioral health, 8% are anesthesia and another 8% are emergency medicine. In total, 64% are specialists. Over 46% are 60 years old or older, 41% are between 40 and 60 years old, and around 10% are under 40 years old. Interestingly, over 85% of locums doctors have at least 10 years of practice under their belt. When asked at what stage of your career did you try locums, 15% started right after residency, 50% were mid career, and 35% were after retiring from permanent practice.
Of doctors practicing exclusive locum tenens work, 80% report improved satisfaction when compared to permanent practice with only 20% reporting they would consider going back.The top reasons locums doctors cited for the satisfaction were freedom and flexibility, pay, reduced politics, and travel.
What next? Time to dive into choosing a locum tenens to work with!