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More hospitals reaching out to locum tenens doctors
■ The number of physician jobs has probably increased, but difficulty in filling them fuels an uptick.
By Victoria Stagg Elliott — Posted March 7, 2011
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The need for locum tenens doctors is increasing, according to a survey by a physician staffing company.
According to the "2011 Survey of Temporary Physician Staffing Trends," issued Feb. 16 by Staff Care, 85% of the 105 health care executives queried had hired locum tenens physicians in 2010 to supplement staff. Only 72% did so in 2009, down from 77% in 2007. Staff Care of Irving, Texas, is a locum tenens agency within AMN Healthcare, a health staffing firm.
Experts said the upward trend was in part a sign of an economic recovery, but a lack of enough physicians to fill a growing number of permanent slots was the far bigger factor. People who work in physician recruitment have noted that the number of staff jobs for MDs and DOs has been rising in the wake of health system reform. An expanding interest on the part of hospitals and large health systems for greater alignment with physicians is one reason cited.
"The physician shortage, especially in primary care, is not getting any better," said Tim Boes, president of AMN Healthcare's locum tenens division. "And more and more facilities, as they are looking for permanent staff, are filling in some gaps with locum tenens."
For example, Staff Care's survey found that about 63% of health care executives hired locum tenens physicians in 2010 to fill open positions until a permanent replacement was hired. Only 34% said the same in 2009.
About 53% brought in locums to cover vacations or absences due to continuing medical education courses in 2010 compared with 37% in 2009.
Marc Powell, manager of physician recruitment with Stanly Regional Medical Center in Albemarle, N.C., said his health system used locum tenens doctors frequently in the past year before finding physicians who could fill open positions permanently. Some of the physicians were in the military and working a few days a month for extra money. Others were in the middle of a fellowship or not interested in a permanent position.
Powell said using locum tenens doctors was expensive, relative to an employed physician. But it was a necessary expense. "We usually end up breaking even at best, but we didn't lose revenue. We didn't lose patients. We could keep everything going."
The Staff Care report found that facilities using locum tenens physicians tended to use more of them, more often, than in 2009. The number of facilities hiring one to three locum tenens physicians per month was 53% in 2007 but dipped to 20% in 2009. This went back up to 55% in 2010.
Demand was greatest for behavioral health physicians, with 22% of locum tenens days requested from Staff Care in 2010. Primary care was second, with 20% of requested days.
Locum tenens physicians tend to be older doctors. In 2005, 54% of locums tenens physicians had been in medicine for 21 years or more. The number grew to 68% in 2010, based on a survey of 626 locums tenens doctors. Physicians with less than a year of experience comprised 5% of locums physicians in 2005, but this number declined to 2% in 2010.
"Young physicians may not have made a decision about what kind of care site they want to practice in, and they are testing out a couple of alternatives," Boes said.
"More mature physicians are finding that running their own practice with the administrative burden may be too much for them," he added. "They want to cut back and spend more time with their families."