How locum tenens physicians compare to staff physicians in quality of care

Patients should receive the same quality of care whether they’re being seen by a staff physician or a locum tenens provider, and reputable locums agencies like Weatherby Healthcare go to great lengths to ensure the quality of their locum tenens providers. These efforts were reflected in three recent studies that compared patient outcomes and quality between locum tenens and permanent physicians. Researchers found that patient outcomes were similar for both physician types and—according to one study—costs to the healthcare facility were actually lower for those patients being seen by locum tenens physicians.  

Comparing locum tenens physicians’ patient outcomes to permanent staff physicians

“The lack of significant overall difference in mortality rates between patients treated by locum tenens and non-locum tenens physicians is reassuring, and it argues against the presence of systematic differences in the quality of care administered by these two groups of physicians,” concluded the authors of a study published in the Journal of the American Medical Association.

This study, led by Harvard Medical School researchers, examined almost two million Medicare beneficiaries hospitalized between 2009 and 2014. They found that treatment by locum tenens physicians was not associated with increased mortality rates compared to staff physicians. The mortality rate for patients seen by staff physicians was 8.7% compared to 8.83% for locum physicians.

Comparison of 30-day mortality rate for patients seen by staff and locum physicians

These results should foster confidence in hospital systems and individual facilities that use locum tenens to fill in for gaps in coverage. Locum tenens physicians are as knowledgeable, skilled, and concerned about the quality of patient care they deliver as employed physicians.

“You still bring the same skill set wherever you go,” says OB-GYN Dr. Roseann Freundel. “You still bring the human compassion component, the love of the work you do.”

She explains that mindset doesn’t change because she’s a locum, and her patients still get the benefit of that. “Even though you may be a new provider someplace, you still approach your patients with that level of sensitivity and acceptance.”

The researchers also analyzed secondary outcomes, including readmission rates, costs of care, and length of stay.

Patients cared for by locum tenens physicians had a slightly lower 30-day readmission rate (23.83% compared to 22.80% for staff physicians)

Comparison of 30-day readmission rate for locum and staff physicians

The length of stay in days was slightly longer for locum physicians at 5.64 days, compared to 5.21 days for staff physicians.

Comparison of length of stay for locum and staff physicians

Costs and quality of locum tenens physicians compared to permanent staff physicians

A second study conducted by researchers with the University of Toledo College of Medicine/ProMedica found that patients treated by locums had shorter hospital stays and decreased hospital costs—but no increase in readmissions or mortality. Medicare fee-for-service beneficiaries treated by locum physicians had similar mortality rates compared to those treated by non-locum internists.

Researchers also found that patients seen only by locum tenens were associated with an adjusted length of stay of one day shorter—with an adjusted average hospital cost saving of $1,339 per hospitalization. Locum physician care resulted in a 23% lower cost compared to staff hospitalists.

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Productivity of locum physicians compared to permanent staff

A third study conducted by the U.S. Acute Care Solutions Research Group compared productivity, quality, and utilization of locum vs staff physicians between January 2021 and July 2023. During the first 100 days of an assignment, the mean patients per hour was moderately lower for locum physicians at 1.7, compared to 1.8 for staff physicians who are already trained and used to the process flow. RVUs were also lower with 4.4 units for locum physicians vs 4.7 for staff. These findings are not surprising because of the time required to onboard and familiarize a locum at a new location.

Comparison of physician productivity for locum and staff physicians

However, similar to the other studies, researchers also found there were no statistical differences in returns, admissions, length of stay, or procedures.

Debunking misperceptions about locum tenens physicians

The University of Toledo study also found a prevalent misconception among employed physicians that locum physicians provided lower patient safety and quality of care.

Locum tenens cardiothoracic surgeon Dr. Carlos Garcia mentioned in an interview with Weatherby Healthcare that he feels some doctors view him as a novice when he is introduced as a locum, despite the fact that he graduated from medical school in 1978.

“This may sound terrible, but most places I’ve gone, I’m either one of the most qualified or the most qualified guy in town,” he says.

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Surprised by the findings about locum tenens physicians

The University of Toledo researchers indicated they were surprised that the results showed similar readmission and mortality rates for patients seen by locum tenens and employed hospitalists.

Lead author Moaath K. Mustafa Ali, MD, MPH, shared one theory with Medscape Medical News: “Locums have a lot of competition. They want to do well, so they get called for additional shifts, and that could play a role.”

Even with competition for jobs in the back of their minds, locum tenens physicians are as committed to their patients as their staff physician counterparts. Part of this may be that they can focus more on patient care, without the distraction of administrative responsibilities.

“Even if you have a heavy load, you know you’re going to be with your patients. You’re not going to be pulled out for some meeting or something like that,” Dr. Freundel says. “That’s what I went into medicine for—to be with my patients.”

Locums have also reported that—even though their stay is temporary—they generally feel connected to their patients and are able to spend more time with them.

“People will say you can’t establish relationships, but I’ve found that’s totally untrue,” says hospitalist Dr. Lee Green. “I’ve established a lot of strong relationships. I think being a locum makes me a better patient advocate because I know the only thing that really matters to me is the quality of patient care.”

Weatherby Healthcare can provide you with quality locum tenens physicians, PAs, and NPs to provide coverage at your healthcare facility. Give us a call at 954.343.3050 to learn more.