Ninety percent of organizations use temporary physicians and other clinical staff, a figure one temporary staffing executive calls "incredible." And the profile of locum tenens physicians has changed: Seven in ten have two decades of experience and half are mid-career professionals, survey results show.
Hospitals and healthcare facilities have increased their use of temporary physicians significantly over last year, a new survey shows. Bonnie Britton, senior VP of Staff Care, an Irving, TX-based provider of temporary healthcare clinicians, says her firm's study results show 90% of healthcare organizations using locum tenens providers.
That's a 22% increase over the previous year, when use of locum tenens doctors was at 73.6%.
"To have 9 out 10 organizations using locum tenens—that's incredible," says Britton. "We've been doing this survey for 11 years, and we've never had these results before."
Britton attributes the growth, in part, to a "constrained" supply of physicians, and that supply is expected to continue to decline. The Association of American Medical Colleges estimates the physician shortage will be 131,000 by 2025, though there are already federally designated health professional shortage areas (HPSAs) across the country.
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As of January, the federal Health Resources and Services Administration reported 6,000 primary care HPSAs and nearly 4,000 mental health HPSAs. These two categories of providers are the same ones that hospitals use locum tenens for the most.
To accommodate its need for more PCPs, Britton says healthcare organizations are increasingly turning to nurse practitioners. Last year's survey showed organizations' use of NPs at 7.8%; this year that jumped to 15.38%—a 97% increase. NPs are viewed by many to be an answer to physician shortages, but others, such as the American Academy of Family Practitioners, believe improving reimbursement is key to slowing down the looming doc shortage
Samuel Williams, MD |
A Financial and Professional Boost
The profile of a locum tenens physician may be surprising. It's not the newly minted doctor who isn't sure where to put down roots. Instead, Britton says her research shows that half of all locum tenens physicians are mid-career professionals.
"We see that 90% of locum tenens physicians have 11 or more years of experience; 70% have more than 20 years of experience," she says.
Samuel Williams, MD, a general surgeon who retired from Carilion Roanoke Memorial Hospital in 2001 is an example of the latter. He's been practicing as a locum tenens provider for hospitals for five years.
"It's a boost, both financially and professionally," he told me while on his way to vacation with his family—something Britton points out as a perk of being a locum tenens doctor, particularly now because more physicians are looking for a work life balance rather than 100-hour work weeks.
"Anecdotally, locum tenens physicians are driven by three key factors: flexibility; travel; no office politics," says Britton.
Williams represents a smaller proportion of the type of provider hospitals hire temporarily (general surgery), but Williams says over the years he's noticed more turnover at rural hospitals.
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"It's harder to attract a high quality general surgeon and keep them there," he says. "A lot of times I hear about pretty good places [to practice], but a year later they're advertising. In rural areas and smaller hospitals, it's a revolving door and there seems to be a lack of commitment on behalf of surgeons."
When that "lack of commitment" happens, Williams is happy to step in because practicing in a rural setting is what he prefers.
"I strive to be a complete surgeon, not just a warm body," he says. "I liked the slower pace and the bread and butter type general surgery."
A Place Holder
While the use of locum tenens physicians has its roots in rural medicine, the survey results show that it has moved into metro areas that are facing pressure with the transformation of healthcare delivery.
Analyzing the survey's results from 2009, one year before the Patient Protection and Affordable Care Act was signed into law, is eye-opening. For example, back then, the main reason hospitals used locum tenens physicians was to fill in for staff who were vacationing or on leave for continuing education.
That is now the number three reason hospitals use a locum tenens physician. Back in 2009, the third most popular reason for hiring a locum tenens doc was to test market a new service. That reason has all but disappeared today.
Today the main reason for using locum tenens is to fill in for staff who have left an organization or to fill in until permanent doctor is found.
Stefan Trocme, MD, a 58-year old cornea specialist who retired as a tenured professor from Case Western Reserve University, has been filling in as a locum tenens for about a year, says the instability in healthcare is driving not only the need for more locum tenens, but also filling a pipeline with experienced physicians who still want to contribute to medicine.
"I have something I never had in my professional career—control over my time," says Trocme. "You were very limited in the amount of time you could spend away from work. And, having worked in academics, office politics took way too much time. As a free agent and entrepreneur, you are not so embroiled in all that.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.