Locum physicians (also called locum tenens physicians) are qualified doctors who work on a temporary basis to fill staffing gaps, typically as independent contractors. The U.S. is facing a physician shortage that's expected to accelerate, driven by a shrinking supply of practitioners coupled with the increasing care needs of an aging population. By 2036, studies estimate a national shortage of up to 86,000 physicians. Given these constraints, locum doctors are key team members who can provide relief to overworked staff, help departments meet patient demands, or even keep entire clinics up and running — particularly in rural areas.
We'll discuss the meaning of locum tenens, provide an overview of how they fit into medical staffing models, and answer your questions about working with this type of provider. We'll also share three best practices that you can use to help your team collaborate with locums to provide high-quality patient care.
Locum Tenens: Definition and Example
Locum tenens is Latin for "holding a position." It can be used for any worker who fills a position in the place of another worker (such as a substitute teacher), but it's frequently associated with healthcare. Locum tenens positions are most often held by physicians and advanced practice providers (APPs), such as:
- Locum physician assistants (PAs)
- Locum nurse practitioners (NPs)
- Locum certified registered nurse anesthetists (CRNAs)
Example: A hospital hires a locum tenens neurosurgeon for six months to fill a staffing gap created by a neurosurgeon on sabbatical. The locum neurosurgeon helps the hospital continue to offer spinal and cranial surgeries despite the permanent surgeon's absence.
Working With Locum Medical Doctors: FAQ
The healthcare industry is seeing sustained use of locum tenens, meaning hiring facilities are utilizing this workforce on an ongoing, predictable basis. One report found that 80% of the healthcare organizations using locum staffing strategies plan to continue or increase their use of this workforce. Here are some common questions about the position and how it fits into staffing strategies and care delivery.
What is a locum physician responsible for?
Locum tenens physicians are board-certified doctors who have completed medical school and residency. Because of this, they have a professional and ethical duty to meet the same standards as permanent staff physicians. Locum medical doctors are responsible for providing seamless coverage, requiring a rapid orientation to a new and unfamiliar environment.
What is a locum tenens career path like?
Physicians providing locum tenens coverage must go through the same schooling and residency training as other doctors. They are credentialed, licensed practitioners. Sometimes, temporary assignments supplement their permanent job, providing extra income or an opportunity to travel and practice medicine in a new way.
The career path varies according to the physician's motivation for taking assignments. For example, new physicians sometimes engage in locum work before committing to a permanent position. This allows them to test different environments and roles, trying to find the right fit. For experienced physicians, locum assignments may provide variety, expand clinical skills, or help with the transition to retirement.
What is the history of locum work?
This staffing niche emerged in the 1970s as a result of grant-funded research into meeting healthcare staffing demands in rural areas. Those involved in the research recognized the need for a mobilized, temporary physician workforce. Today, many hospitals and healthcare facilities rely on locums, and many doctors and APPs work within the model.
What are some reasons to bring in locum doctors?
While the position was once considered a short-term fix for urgent coverage needs, it's now also used more proactively and strategically. Facilities may onboard locums to:
- Prevent revenue loss related to a staffing gap (for example, lost revenue from missed and delayed surgeries when a surgeon takes vacation).
- Ensure permanent staff physicians can use PTO and attend career development and continuing medical education events.
- Secure coverage for undesirable on-call shifts (such as nights, weekends, and holidays), thereby preventing burnout of permanent staff.
- Temporarily fill a position while a more lengthy and robust permanent-staff hiring process unfolds.
- Meet patient surges (e.g., "snowbird season" in Florida).
- Test new service offerings before committing to permanent expansion.
- Provide relief to understaffed departments.
- Secure coverage in underserved/rural areas that struggle to attract permanent hires.
- Deliver virtual care in emergency departments to help staff meet the demands of an influx of patients (e.g., a locum doctor may be called in to support permanent ED staff after a natural disaster).
What should be considered when onboarding a locum healthcare worker?
These workers are typically adaptable and versatile, ready to do what it takes to learn the ropes at a new facility as quickly as possible. Facility leaders can provide support by establishing strong onboarding practices. Here are some critical onboarding tasks to consider.
- Prompt assignment of login credentials: While many freelancers are familiar with the leading EHR systems, they'll be stopped in their tracks if they can't log in. Support their swift integration into your healthcare system by providing role-based access on Day One.
- Connection to a clinical point-person: Assign a short-term clinical mentor that the locums can go to with practical questions, such as the location of clinical supplies.
- Support rapid orientation: Your temporary workforce can contribute to high-quality patient care only after they've been oriented to local workflows. Establish a systematic process to efficiently communicate the aspects of care delivery that are unique to your organization.
Best Practices for Working With Locum Tenens Doctors
When working with locum doctors, it's important to consider how the arrangement will impact core, permanent staff and contribute to the patient experience. Here are three best practices that will help you integrate locum help in a way that supports team dynamics and patient satisfaction.
1. Highlight the Benefits of Collaboration With Freelance Providers
Locum tenens healthcare workers typically earn higher pay rates than permanent staff, which can become a point of contention if the proper groundwork isn't set. Define locum tenens positions to permanent staff in a way that emphasizes potential positives.
Locum providers are capable of bringing advanced skills and a wealth of experience and knowledge to healthcare teams. One survey of the locum tenens physician workforce found that 65% had at least 21 years of experience practicing medicine. Even if your hire is relatively new to the profession, their interest in temporary work may have exposed them to diverse clinical techniques and methods. Setting the stage for your coverage in this way will help to prevent social friction, and encourage other providers to turn to the locum as a resource rather than competitor.
2. Think Outside of the Box When Creating Locum Physician Jobs
The meaning of locum tenens has changed over the years, shifting from an "emergency fix" to a sustained staffing strategy. Expand your usage of this flexible workforce by researching the job market. For example, small, rural facilities may share providers with other rural facilities by creating a rotating schedule of three to four days per site. Virtual care is increasingly offered in hospital-at-home and remote monitoring delivery models, opening up the potential for virtual locum positions.
3. Build Rapport With Temporary Team Members
Physicians choose temporary work for many different reasons, from a desire to travel to seeking relief from burnout. As you work with these professionals, discover the unique reason they've chosen the path. Getting to know each provider will help you discover the ways they can contribute to your organizational objectives. Developing a positive rapport may also help your facility recruit top performing providers for the next opening, or a permanent spot on your staff.
Get More Support as You Build Your Healthcare Team
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