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Locum Tenens: A Staffing Solution When Physician Supply Does Not Meet Demand
Jan. - Feb. 2000
Source: “Demand for Specialists Reshapes the Locum Tenens Market,” Group Practice Journal, September 1999; “Docs on the Go,” Unique Opportunities, May/June 1999
Group Practice Journal and Unique Opportunities
In times when demand is high and supply is low for a particular specialty, many medical groups and hospitals have turned to the locum tenens market to fill open positions.“Locum tenens” is Latin for “to hold the place of, to substitute for” and is used to describe physicians who accept temporary assignments in various medical group practices. Consumer demand for access to specialists has contributed to the growing popularity of locum tenens firms, as the increased need for certain specialties can make it difficult to recruit full-time physicians. In fact, in 1987, only 4% of physicians in non-academic settings practiced as locum tenens compared to 15% of physicians who accept temporary assignments today.
Common Uses for Locum Tenens
Medical practices hire locum tenens for more reasons than to just fill a spot temporarily. Medical groups or hospitals in underserved or rural areas use locum tenens because it is often difficult to recruit permanent full-time staff. Coverage during physicians’ vacations and peak periods during the year are also among the top reasons medical groups will hire an independent physician or contract with an agency that specializes in locum tenens assignments.
Medical group managers and administrators find locum tenens help keep revenues and referrals steady during times when the absence of a physician or two could prove detrimental to the practice’s bottom line. And lastly, having enough staff on hand helps with patient satisfaction and patient migration, as people often complain about the length of time it takes to get an appointment as well as the amount of time spent in the waiting room waiting to actually see the doctor.
What to Look for in Hiring a Locum Tenens Agency
Contracting for a locum tenens through an agency is the most common approach, although it is not unheard of to contract directly with an independent physician. Working with an agency that pays strong attention to detail can make the process go smoothly for you and the locum tenens physician. Providing information about housing, car rentals, and basic information on the community and its surrounding area are a few of the details a good agency should give to a new, temporary physician. Licensing and hospital credentialing should also be taken care of by the staffing firm. This will allow you to concentrate on familiarizing the locum tenens with your practice, procedures, and policies, thus enabling him or her to focus on clinical affairs as soon as possible.
Characteristics of Physicians Who Will Succeed As a Locum Tenens
There are several characteristics that make for a good locum tenens, so when working with an agency or interviewing the candidates yourself, you may want to keep the following in mind. Doctors who tend to be entrepreneurial, adventurous, and independent in nature usually make good locum tenens candidates. It is also helpful if they have an interest in traveling and meeting new people, and can develop a rapport quickly with new colleagues and new patients. Physicians who are interested in enhancing their medical skills and working in different practice settings and geographic locations also fare well as temporary physicians.
Physicians in locum tenens positions should also be somewhat business-minded and detail-oriented as they must function as their own accountant and financial planner. Locum tenens must be prepared to pay federal, state, and Social Security taxes on their own, since they won’t be automatically withheld. There is also no paid sick time, so physicians may want to ask the agency for assistance in making arrangements for life, health, and disability insurance, as well as retirement planning, to protect themselves in case of illness, injury or, some other debilitating factor that prevents them from having a regular income.
Reasons Physicians Accept Locum Tenens Assignments and What It Will Cost You to Hire Them
Dan Groth, President, LOCUM Medical Group listed four major reasons why physicians seek locum tenens positions: 1) residents who have recently completed training and are still trying to decide on a permanent position; 2) those who are in mid-career and have accumulated several weeks of vacation time that they are looking to fill; 3) those who are between positions due to unavoidable circumstances such as hospital bankruptcy or downsizing; and 4) those who are at the mature end of their careers and are looking to cut back and do something a little different.
Physicians in locum tenens positions can expect to make approximately 10% to 30% less than they would in a permanent position. Call, weekends, and extended shifts are scheduled and negotiated in advance. Daily fees vary depending on the specialty and the current demand for it. According to Staff Care, Inc., a national locum tenens staffing firm, a primary care physician’s average daily fee is $638, which represents a 3% increase from early 1998. Other specialties such as anesthesiology, cardiology, and radiology currently make over $1,100, representing a 16% to 31% increase from last year, depending on specialty.
In 1997, primary care physicians accounted for 65% of the locum tenens industry, but have dropped to 45% in the first half of 1999. The IM subspecialties rose from 8% to 14%, while specialties such as radiology and anesthesiology went from 2% and 3% in 1997 to 11% and 9%, respectively, in early 1999.
The need for locum tenens will continue to fluctuate depending on the supply and demand of physicians, as well as market factors, which make some specialties more in demand than others. The pace of education affects staffing supply as residency programs attempt to respond to market demands as quickly as possible. However, it takes a few years to turn out a supply of residents depending on the specialty and the length of the program associated with it. In the meantime, locum tenens provide an excellent, temporary solution to help group practices at times when they are understaffed. The key to successfully using locum tenens is to hire agencies that provide licensed, credentialed physicians who possess the appropriate mix of clinical skills and adventurous spirit needed to thrive in new and unfamiliar environments.
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