The Locum Life

March 11, 2007

Researchers state that over 15% of physicians have worked locum tenens (Latin for “place holding”) on behalf of another physician sometime within their lifetime.  That trend is continuing as studies show documented shortages of graduating Residents, upwards to 200,000 across all medical specialties by year 2020; finding private and academic medical groups relying on locum tenens agencies to supplement their physician coverage either on a full or part time basis.  “While health care reimbursement continues to decline, and medical groups find they must see more patients to make ends meet, the ability to self-cover a group practice is virtually impossible,” says health care financial consultant Reed Tinsley, CPA, of Houston-based Reed Tinsley & Associates.   “Taking a full case load of patients and distributing amongst an already saturated schedule compromises the already strained physician / patient relationship.  It makes more financial sense to bring in a qualified physician when you need one rather than carry the overhead of a salary you cannot routinely support”.

Locum tenens groups are the emerging medical group business model.  Tony M. Brown, President of PRIME STAFF Advanced Medical Division makes this observation, “Locum tenens physicians are vastly becoming one of the fastest growing segments in the healthcare industry.  More and more doctors want to spend the majority of their time helping patients with healthcare solutions and not be concerned with the time, expense and liability of running their own practice.  Rising medical malpractice expense and inconsistent reimbursement for services rendered continue to fuel that desire of doctors to take the locum route”.   Historically it was assumed that a locum tenens doctor couldn’t find a real job.  And the risk of medical malpractice in using what was perceived as inferior medical care was too great.  But more and more medical groups have found this not to be the case.  Reputable locum tenens firms carry medical liability insurance to the professional limits required in the Bylaws of their clientele.  Statistics show that the loss history of locum tenens physicians is no greater than the general population of physicians.

The locum tenens physician of today represents doctors highly trained and Board Certified in their respective field.   While seeking relief from the stressors of group practice, they desire a vehicle to provide that quality patient care they signed up for.  The common denominator being they all work as independent contractors through a supplemental staffing firm, credentialed to the highest regulatory agency required by the requesting medical facility / medical group, and is paid to see the expected volume of patients scheduled that day.  “I just see patients, that’s why I did this”, touts a Houston Board Certified Emergency Physician.  “I don’t have to worry with the politics between Faculty, be concerned about where funding is coming from, fret over who’s going to cover for who.  I just see patients for the required hours, devote all of my time to providing care to the Houston community, and then go home.”  Another Board Certified Internal Medicine Physician shares his story.  “I am doing a Fellowship in Pulmonology here in Houston.  I have time on my hands and enjoy the ability to have patients I periodically care for while I am finishing up.  Being a locum tenens Hospitalist affords me that opportunity.  I may join a medical group again one day, but for now I have the best of both worlds.”

If more physicians took their time right out of Residency, identifying the right fit for their career move, the “first year bounce” may not occur as often as it does.  Glenda Thurman, Coordinator for the Family Practice Residency Program at University of Texas Health Science Center in Houston has seen first hand the “first year bounce”.  “Locum tenens opportunities are a wonderful venue for our graduating Residents to identify the environment that is going to work best for them.  Having the opportunity to experience the work ethic and culture of various medical groups seeking a relationship before you sign on the bottom line is better both for the new Doctor and the potential Employer.  I have had several young people share their horror stories of signing with a medical group and then leaving before the end of the first year.  Expectations were not met on either side.  It is demoralizing and doesn’t have to happen.”

Private medical groups and Faculty Practice Plans in the academic arena alike have capitalized on the locum tenens physician available in today’s health care market.    Local health care employers that tout “Best Employer” accolades routinely use credible supplement staffing resources to enhance and provide relief for their medical and clinical staff.  The most recent collaborations between the elite Medical Group Management Association (MGMA) and the National Association of Locum Tenens Organizations (NALTO) and the National Association of Physician Recruiters (NAPR) further affirms the  recognition of the physician who chooses working locum tenens as their response to the demands on the medical group practice.    Locums used to be considered a “dirty word”, now it is an acceptable lifestyle!

Susan R. Waldron, CMPE

Chief Executive Officer

PRIME STAFF Advanced Medical Division

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