Locum tenens is often viewed as a short-term solution that should be utilized only when absolutely necessary. However, this reactive approach to temporary physician staffing can result in unexpected costs, lost revenue, and added stress for the physician recruiters who have to deal with last-minute requests for locum tenens coverage.
On the other hand, high-performing healthcare organizations often plan for locum tenens coverage as part of their strategic staffing planning process. When planned for effectively, locum tenens providers can extend patient coverage, generate revenue, and reduce stress on permanent staff. We spoke to two leaders who intentionally plan for locum tenens coverage to find out how this strategic approach has benefitted their organizations.
Keeping schedules manageable
Dr. Michael Goodman, chief of neurosurgery at Saint Luke’s Health Care, has experience with locum tenens from both sides of the table. After more than three decades in academic and nonacademic practice, he began working as a locum in semi-retirement. Then when he transitioned from locums into an administrative role at Saint Luke’s, Dr. Goodman looked to make locums a strategic part of how he would meet his neurosurgery department’s staffing needs.
“Instead of being one of the guys scheduled as a locums, I’m now the guy who calls to hire the locums,” Dr. Goodman says. “It’s a little different, but it’s a very comfortable and established relationship. I look at my relationship with my recruiting team as more than transactional. It’s an HR partnership, and we view them as valuable associates in maintaining our capabilities.”
The primary reason Dr. Goodman hires locums is to help keep schedules manageable for the four full-time neurosurgeons on staff who cover the level-one trauma center and comprehensive stroke center he manages. It also helps maintain consistency during unpredictable recruitment periods.
A prolonged interview process
Dr. Goodman says he also likes to think of locum tenens as a prolonged interview process and a great way to source physicians interested in the possibility of eventually transitioning to a permanent position.
“Locums is an excellent way to really look at somebody and decide whether he or she is a good fit for your practice,” Dr. Goodman says. “In an interview, a candidate will be primed to be on their best behavior and give answers they think you want. It’s a limited, artificial situation. With locums, you get a much more honest appraisal of their strengths, their weaknesses, and what it’s going to be like to work with them. It gives you unparalleled ability to evaluate somebody you’re considering for a permanent position.”
Making the finances work
To manage costs and generate revenue, Dr. Goodman dedicates locums to hospital-based work where he can bill for more of their services. He also ensures all locums are credentialed and enrolled with third-party payors.
He also urges leaders in his organization to keep an open mind about locums, which he believes has evolved since the early days of his career.
“What I’ve discovered has been an eye-opening experience. A lot of the people finishing fellowships now are not sure where they want to go to practice geographically or what kind of practice they’re interested in — academic, small group practice, single specialty, or large multispecialty group,” Dr. Goodman says. “When I finished training many years ago, this wasn’t something any of us considered. It just wasn’t an option. But actually, it’s a very good option. It allows a lot of flexibility and the ability to try a few options to see what you like. Some physicians are even finding out that what they like is not what they anticipated, and that’s a good thing.”
A solution to the physician shortage
The physician staffing shortage has been an ongoing challenge for MedExpress, a network of more than 170 brick and mortar urgent care centers.
Neil McKay, senior director of medical operations and workforce management for MedExpress, says the pandemic has only made the problem worse. “COVID has had a significant impact in the depletion of healthcare workers — especially in our space within the market,” he says. “Urgent cares were overrun by COVID testing, and it made for a very monotonous day-to-day for providers — many of whom were anticipating different type of work when they went into this field. The challenge now is, how is healthcare going to come out? And how do we continue to staff — or staff a little differently — based on these changes?”
McKay describes the impact as a shift from controlled and anticipated demand to open-ended and greater demand overall.
“Demand for urgent care services is ongoing, and I don’t see a slowdown coming anytime soon,” McKay says. “It’s definitely put a strain on staffing and a strain on our business’ ability to meet that demand.”
Treating locums like permanent providers
One way MedExpress is addressing the challenge is by leaning more heavily into their already established locums staffing strategy. To manage costs, McKay approaches locum tenens the same way he approached hiring full-time providers, including how they credential and enroll locums with payors.
“We go through a full credentialing process with our locums. There isn’t really much of a difference from a training or working perspective with locums versus a full-time provider we would be employing ourselves. We want our locums to be seen,” McKay says.
A strategic staffing partnership
For healthcare organizations that want to be more strategic in their approach to locums, McKay advises treating the relationship as a partnership.
“We view locums agencies as partners, working together for common goals versus in isolation. A big part of that partnership is ensuring these are the right candidates who are going to help us meet those goals,” McKay says.
“It’s important to establish trust with your recruitment team. Spend time getting to know the group you’re working with and what their goals are, what your goals are and balance those,” he says. “Strategically, it comes down to forecasting and understanding what you’re going to need, and I think if you have good partners, someone you trust will go the extra mile for you, it’s much more achievable.”
Every healthcare organization strives for the ideal level of permanent providers, but there will always be staffing shortfalls and a need for temporary coverage. Integrating locum tenens into your strategic staffing plan can help your organization be more successful in addressing ongoing staffing challenges.
Weatherby Healthcare has the locum tenens physicians and advanced practice providers to help you meet your healthcare staffing needs. Give us a call at 954.343.3050 to learn more.