Healthcare’s Wild Ride: How Locum Tenens Can See You Through

By Tim Boes, president of Staff Care, an AMN Healthcare company

June 16, 2010 - No one knows exactly what healthcare reform will look like when it gets to the level of individual sites of care; we do know that pressure is building on many fronts and that life, as we know it, is going to change. Already faced with a short supply of qualified clinicians, healthcare employers are anticipating a bit of a rollercoaster ride in the coming months.

Despite the uncertainties, there are some proactive steps that administrators can take to plan ahead, smooth out the bumps and stay in control.

Factors at work

Many healthcare leaders believe that the thousands of patients who are about to join the ranks of the newly-insured will have greater-than-average health problems, due to previous neglect, and will need a higher level of care. At the same time, the population will continue growing – and aging – bringing more diseases and chronic conditions into the mix, all while the issues of quality and patient satisfaction are receiving even greater emphasis and scrutiny.

Today’s physicians are working fewer hours, according to a February JAMA study (“Trends in the Work Hours of Physicians in the United States,” by Staiger, Auerbach, and Buerhaus), the large baby boomer population is beginning to retire, and the nation’s supply of new physicians is expected to remain fairly flat – all of which are contributing to a growing shortage. And as the economy improves, hospitals are expected to start putting building plans and new service offerings back on track, increasing the demand for clinicians.

In this push-and-pull, up-and-down environment, your staffing plans must be flexible enough to cover every base, and provide excellent care to every patient. The strategic use of locum tenens is the ideal way to address these challenges.

Why locum tenens?

Locum tenens (Latin for “holding a place”) is the term commonly used to refer to physicians, dentists and advanced practice healthcare professionals who work temporary assignments. Healthcare facilities and practices are finding that locum tenens personnel are an important part of a diversified staffing mix.

Locum tenens can be used in a variety of situations: to fill vacancies ranging from a few days to a few months or longer; to provide on-call coverage; to test the need for a new specialty or service; or to help implement new initiatives, scheduling plans and delivery models. As their skills are matched to a facility’s needs, these professionals are able to provide continuity of care, sustain patient loyalty, maintain revenue streams, reduce stress and turnover in permanent staff, and help their employer deal with the unexpected.

Two recent surveys – one by Merritt Hawkins (a division of AMN Healthcare) and the other by the Medical Group Management Association – demonstrate that the opportunity cost related to a physician vacancy is sizable. With daily billings ranging from approximately $1,400 to over $7,000 per day, and one-month revenues ranging from $107,000 to nearly $180,000, depending on specialties, the income losses add up quickly when a position remains unfilled (request Staff Care’s recent white paper, The Growing Use of Locum Tenens Providers as a Supplement to Permanent Medical Staff, for full details).

Added to these numbers is the patient business that might be lost if a facility were to operate understaffed, and the potential decrease in the quality of care.

The risks associated with staffing shortages should encourage more administrators to adopt multi-layered staffing strategies. These strategies can include full- and part-time physicians and other advanced healthcare professionals in traditional private practice, direct employment, remote medicine/telemedicine, hospital medicine (hospitalists) and locum tenens. This variation of employment choices also helps meet the differing needs of today’s clinicians.

By employing the flexibility of locum tenens and a variety of practice models, facilities can ensure patients continue to receive high quality healthcare, team members remain satisfied and revenue keeps flowing.

A quality solution

Staff Care’s 2009 Survey of Temporary Physician Staffing Trends found that hospitals and medical groups value locum tenens personnel; four out of five administrators indicated that they were worth the investment, and the vast majority of those surveyed were positive about their level of quality.

That shouldn’t come as any surprise. Locum tenens candidates are rigorously screened, and as the employment model has become more and more popular it has attracted experienced, well-trained clinicians who are motivated to provide quality patient care.

One of the best examples of this is Staff Care’s own Abraham Scheer, M.D., who was chosen as our Locum Tenens of the Year for LocumLife (see separate story). Dr. Scheer was in private practice for several years before beginning his current locum work, and has a wealth of varied experience. Since filling an urgent need last fall, he has made an immeasurable impact at his current facility: stabilizing the neurology department, earning the American Heart Association’s highest award and getting the facility on track for certification in stroke care by the Joint Commission.

Advantages of planning ahead

Given the short supply of clinicians and the mounting pressures on facilities and practices, administrators will benefit from building a relationship with a reputable staffing agency that excels in locum tenens and has the resources to fill their needs quickly, with the highest quality care providers. A staffing professional can help you develop a forecast, find the right mix of permanent and temporary personnel and provide qualified candidates who match your criteria.

The future of healthcare may not be crystal clear, but it promises to be an interesting ride. Adding locum tenens to your staffing plans can help you through the ups and downs.


Staff Care, an AMN Healthcare company, is the nation’s leader in locum tenens recruitment and staffing, matching qualified physicians, dentists, CRNAs, nurse practitioners and physician assistants with healthcare organizations’ needs. For more information, visit Staff Care or request a copy of the new white paper, The Growing Use of Locum Tenens Providers as a Supplement to Permanent Medical Staff, by contacting Phillip Miller, vice president of communications, by email or phone, 469-524-1420.