85% of Health Care Facilities Used Temporary Doctors in 2019

RPT_CoverPDFThe use of temporary physicians, known as “locum tenens,” to fill staffing shortages continues to be widespread, according to a new survey from Staff Care, a leading national physician staffing firm and a company of AMN Healthcare (NYSE: AMN).   

Staff Care’s 2019 Survey of Temporary Physician Staffing Trends indicates that 85% of hospitals, medical groups, and other healthcare facilities used locum tenens doctors in 2019, primarily to maintain services until permanent physicians are found and to fill gaps caused by turnover.   

“Virtually every hospital in the United States now uses locum tenens doctors,” said Jeff Decker, president of Staff Care. “They have emerged as a key part of the medical workforce in an era of physician shortages and evolving delivery models.”  

According to Decker, locum tenens physicians are filling openings that last from a few days to over a year while healthcare facilities seek difficult-to-find primary care physicians and specialists. They also can be used to fill-in when healthcare facilities experience turnover on their medical staffs, an event made more likely by the growing employment of physicians by hospitals and other healthcare facilities.As healthcare facilities respond to Covid-19, some are using locum tenens physicians, particularly emergency medicine physicians and primary care physicians, to supplement their staffs (though this trend was not noted in the report).

As the employed physician model replaces physician practice ownership, physicians have more latitude to change jobs, according to Decker, creating more temporary openings and hence more demand for locum tenens physicians. Employed physicians commonly enjoy a month of vacation and continuing education time off each year, which also creates demand for locum tenens doctors, Decker said.

Specialists in rising demand as “temps”

Primary care physicians, including family physicians, general internists, and pediatricians, are the most in-demand type of locum tenens doctors, according to the survey. 30% of healthcare facility managers surveyed indicated they used locum tenens primary care doctors in 2019, higher than any other type of physician. However, this is down from 44% in 2016, the last time Staff Care conducted the survey.  

By contrast, the use of locum tenens specialists has accelerated. For example, 21% of healthcare facilities managers reported using locum tenens surgeons in 2019, up from 11% in 2016, 17% reported using locum tenens internal medicine subspecialists, up from 9%, and 22% reported using locum tenens anesthesiologists, up from 11%.

The need for specialists is being driven by an aging population and by an aging physician workforce, with many specialists entering retirement age. In its April 2019 report, the Association of American Colleges projected a shortage of up to 122,000 physicians by 2032, including up to 55,000 primary care doctors but an even larger shortage of up to 67,000 specialists.

“Older patients need specialists to care for ailing organs and body systems,” said Decker, “and we simply don’t have enough of them to go around.”

A growing need for surgeons, internal medicine subspecialists, and radiologists

In 2014, 14.7% of facilities surveyed by Staff Care reported that they had used locum tenens surgical specialists sometime in the last 12 months. That number declined to 10.8% in 2016, but grew to 21% in the 2020 survey. In addition to the growing demand for surgical services referenced above it should be noted that surgical specialists are relatively old compared to primary care physicians. For example, 57% of orthopedic surgeons are 55 and older compared to 44% of family medicine physicians. Attrition due to retirement may be another reason for the rise in demand for locum tenens surgical specialists.

Similarly, in 2014, 8% of facilities surveyed by Staff Care indicated they had used locum tenens internal medicine subspecialists in the previous 12 months. That number rose to 9.7% in 2016 and to 17% in the 2020 survey, further signaling a rise in demand for specialists, who are particularly needed to care for the declining organ systems of older people.

The use of locum tenens radiologists also is increasing for similar reasons. In 2014, 4.5% of facilities surveyed by Staff Care indicated they had used locum tenens radiologists in the previous 12 months. That number rose to 7% in 2016 and to 12% in the 2020 survey.

Continued need for behavioral health professionals and hospitalists
In March 2017, the National Council of Behavioral Health (NCBH) release a report indicating that 77% of U.S. counties are experiencing a severe shortage of Psychiatrists (HealthLeaders, March 30, 2017). The shortage of psychiatrists and other behavioral health professionals has been a staffing challenge for at least the last ten years, a fact reflected in demand for locum tenens psychiatrists, which is particularly acute among facilities providing inpatient behavioral health services.

In 2014, 29.9% of facilities surveyed by Staff Care indicated they had used locum tenens behavioral health professionals sometime in the last 12 months, a number that declined to 23.1% in 2016 and to 18% in the 2020 survey. Though demand for locum tenens behavioral health professionals has diminished over the last several years, it is anticipated to rise in the future, given the high incidence of behavioral health problems in the U.S. and the fact that 60% of psychiatrists are 55 years old or older compared to 42% of all physicians.

Physicians specializing in hospital inpatient care, known as hospitalists, also remain in strong demand as locum tenens. These physicians allow for the more efficient treatment of hospitalized patients and can reduce costs, particularly in capitated/quality-based payment models. They also relieve office-based physicians of hospital inpatient work and therefore can be an important asset to physician retention programs.

In 2014, 21.9% of facilities surveyed by Staff Care indicated they had used locum tenens hospitalists sometime in the previous 12 months. That number rose to 25.3% in 2016 and declined slightly to 25% in 2019.

52,000 locum tenens doctors

Each year it conducts the survey, Staff Care estimates the number of physicians who work as locum tenens based on the number of doctors the company places annually and its knowledge of the locum tenens staffing industry. Staff Care estimates that approximately 52,000 physicians worked as locum tenens in 2019, or about six percent of the active physician workforce.

Locum tenens is an increasingly popular practice style among physicians because it allows them to focus on what they like to do best, which is treat patients, while minimizing the administrative duties they like least,” said Decker.         

For complete results of Staff Care’s 2019 Survey of Temporary Physician Staffing Trends visit www.staffcare.com.   

About Staff Care

Staff Care is a leading healthcare staffing firm providing temporary physicians, advanced practitioners and dentists to hospitals, medical groups, government facilities, and other healthcare organizations nationwide. Staff Care is a company of AMN Healthcare (NYSE: AMN) and is the sponsor the Country Doctor of the Year Award. For more information about AMN Healthcare, go to www.amnhealthcare.com.

About AMN Healthcare

AMN Healthcare is the leader and innovator in total talent solutions to healthcare organizations across the nation. The Company provides access to the most comprehensive network of quality healthcare professionals through its innovative recruitment strategies and breadth of career opportunities. With insights and expertise, AMN Healthcare helps providers optimize their workforce to successfully reduce complexity, increase efficiency and improve patient outcomes. AMN delivers managed services programs, executive search solutions, vendor management systems, recruitment process outsourcing, predictive modeling, mid-revenue cycle solutions, credentialing and other services. Clients include acute-care hospitals, community health centers and clinics, physician practice groups, retail and urgent care centers, home health facilities, schools and many other healthcare settings. AMN Healthcare is committed to fostering and maintaining a diverse team that reflects the communities we serve. Our commitment to the inclusion of many different backgrounds, experiences and perspectives enables our innovation and leadership in the healthcare services industry.

For more information about AMN Healthcare, visit www.amnhealthcare.com.