How to Employ Locum Tenens Clinicians to Fill Workforce Gaps

Locum tenens clinicians are hired for various lengths of time, Sturdivant says. They can fill in for a week during the holidays, for a couple of months to cover maternity or paternity leave, or for several months while a healthcare organization recruits a permanent clinician.

In the longer term, Anderson says, it’s more beneficial to have physicians who remain with a health system, hospital, or physician practice for long periods of time.

“Locum tenens physicians tend to come and go, and there is less opportunity for them to get to know the staff, get to know a facility, and get to know the community,” he says.

Anderson says permanent clinicians are superior in the long term because they become familiar with their clinical colleagues, their institution, and the community they serve.

Financial perspective

There is a financial challenge associated with employing locum tenens clinicians, Anderson says.

“They tend to be more expensive than employed clinicians,” he says. “So, in the long run financially, locum tenens is not the best model for us. It is important to fill gaps and make sure we can operate our business fully staffed. However, the incremental salary a locum tenens clinician typically demands is a cost burden.”

Typically, locum tenens clinicians earn 25% to 40% more in monetary compensation than permanent clinicians, Sturdivant says. However, they are not given a benefits package as part of their compensation, which can account for one-third of the compensation that permanent clinicians have as part of their employment, he says.

“You must look at why organizations look at hiring locum tenens physicians,” he says. “There might be a surge in patients and an organization’s current staffing model cannot handle that level of patient care efficiently. Those inefficiencies can suck away the margin that serving a larger patient population can produce.”

In addition, Sturdivant says, locum tenens clinicians can help to reduce doctor turnover as well as boost retention and provider satisfaction because permanent clinicians are overworked when there are openings in the permanent staff.

“If you are not meeting your staffing goals, your physicians are going to burn out and leave, which has a financial cost,” he says. “When you talk about the financial bonus that locum tenens physicians receive, that cost is offset by improvements in patient care, permanent physician satisfaction, and margin that is generated from being fully staffed.”

Having a pipeline to recruit permanent clinicians is an alternative to using locum tenens clinicians, Anderson says.

“In today’s market, you will have a need to fill gaps here and there, but having a physician pipeline is the best solution,” he says. “At RWJBarnabas, we have established a physician pipeline in partnership with Rutgers University. We are hiring physicians from Rutgers and retaining them in our communities.”

Ensuring locum tenens assignments are successful

A successful locum tenens assignment, Studivant says, begins with teamwork.

“In my experience working in a locum tenens capacity, the facilities where I have struggled in my assignments are those that treated me not as a member of the team but as an expendable commodity,” he says. “When I have worked as a medical director, I have had the most success with locum tenens clinicians when they are brought on as full members of the team.”

“You want a locum tenens physician to get to know a facility and get to know the team they are working with,” he says. “It is important to establish connectivity and relationships early on, so the locum tenens doctor can work as a team member with the other staff in the facility.”

The onboarding process should include creating familiarity with an organization’s culture, mission, vision, and values.

“They need to understand the strategic priorities of the organization,” Anderson says.

That includes the quality and patient safety requirements of an organization.

“There needs to be transparency around the areas where you are focused in terms of quality and patient safety,” he says. “You need to make sure that a locum tenens clinician sees the metrics that are being tracked. They need to understand the areas that are being prioritized. They also need to know how they can contribute to the outcomes that a facility is seeking.”

Sturdivant says several studies have shown that locum tenens physicians compared to permanent providers are statistically indistinguishable in terms of quality care.

“[They] are not bouncing around from job to job because they are not doing a good job,” he says. “They are highly educated and highly motivated professionals who have chosen to work locum tenens assignments with a skillset comparable to permanent physicians.”

Sturdivant says physicians are attracted to locum tenens jobs because they can have a freedom of movement and the ability to set a working schedule.

“I personally have viewed my locum tenens work as an opportunity to put my toe in the water and test-drive different organizations and different practice patterns,” he says. “Then you get the benefit of being in control. As a locum tenens clinician, you get to declare your availability in terms of scheduling.”