By Tim Hand - President & CEO, Interim Physicians
With the physician shortage crimping the supply of doctors available for permanent employment, healthcare organizations should consider using locum tenens not only to meet current needs, but also as a long-term recruiting tool.
There are hundreds of thousands of physicians practicing in the United States. That's a big number, but not big enough to meet current, much less future, demand.
Assuming the provisions of health insurance reform continue to be implemented as planned, an additional 32 million Americans will have health insurance coverage by 2019. This will create a greater demand for doctors, especially those in the primary care specialties. Even if health insurance reform is modified or repealed, the number of individuals in need of medical care will continue to grow as our population increases and baby boomers proceed on their march into old age. The Association of American Medical Colleges (AAMC) says that the demand for doctors will outpace supply until at least 2025.
In response to this imbalance, according to a 2010 AAMC report, the number of positions available for first-year medical students is slated to go up by 23% by 2014 (from the 2002 academic year), with more than 80% of U.S. medical schools increasing the number of doctors they will have the capacity to educate. Residency training programs will be forced to adjust to this new reality. So, while there is relief on the horizon, hospital and clinic administrators are scrambling today to fill open positions.
In this article, I'd like to make the case for healthcare organizations to consider using locum tenens practitioners not only to meet current needs, but also as a long-term recruiting tool.
When healthcare executives think about utilizing locum tenens physicians, one of their main concerns is the cost involved. Indeed, at first glance, filling open positions with temporary doctors does seem like an expensive option. Dig a little deeper, however, and you find that the return on investment is actually quite attractive.
A 2008 ROI report from the National Association of Locum Tenens Organization stated that, for example, the daily locum tenens fee for a family physician averages $865. That doctor's daily billings average $1,535. Even taking practice overhead into account, these figures show that locum tenens isn't out of reach in terms of cost.
For point of reference, here are the same figures for three other specialties:
|Specialty||Daily locum tenens fee||Daily billing average|
Keep in mind, too, that there is more to ROI than just dollars and cents. Having an adequate number of doctors also helps improve patient satisfaction and reduces the risk of burnout among your current medical staff.
Let's look at three other very good reasons to use locum tenens as a strategy for long-term recruitment.
1) Relieve the immediate pressure
Too often, hospitals and clinics rush the recruitment process because they have patients lined up waiting to be seen and doctors screaming, "Get us some help, now!" Bringing in locum tenens physicians to take the pressure off the system buys administrators time to look for the right candidate, rather than hiring the first person to come along who has a medical license and a pulse. At Interim Physicians, we can usually have a primary care or specialty physician placed within 5 days of receiving a request. Those requiring hospital privileges would take a bit longer.
2) The long interview
The typical process for recruiting a doctor involves a review of the CV, a few phone calls, reference checks, a site visit, and perhaps one or more meetings to seal the deal. That's not a lot of face-to-face time during which to evaluate a candidate whom you hope to have around for years, if not decades. When you use locum tenens as a recruiting tool, you have the opportunity to assess not only a doctor's clinical competence, but also his or her work ethic and interpersonal skills over a period of weeks or months. The advantage of this simply cannot be overstated.
3) The physician perspective
Joining a practice or becoming employed by a group or hospital is a huge decision for a physician. Not only are they relocating themselves and often a family, but the pressure to make the best choice is intense because job hopping in the medical profession isn't as readily accepted as it is in some other industries. No physician wants to have a CV cluttered with a long series of short practice stints, unless they've worked that way intentionally as a career locum tenens practitioner.
So, testing the waters before making a commitment is just as valuable for a doctor as it is for the hiring organization. The "try before you buy" arrangement allows a physician to assess all aspects of an opportunity, such as patient mix and volume, collegiality, quality of the staff, whether there is a good organizational fit, and if the doctor and his or her family feel comfortable in the community (i.e., availability and quality of housing, schools, recreational and cultural activities, shopping, places to worship, and so on).
If you agree that using locum tenens providers as part of your overall recruitment strategy is worth considering, the question becomes how to go about it.
First, get your board, recruitment committee, and other stakeholders on board. Discuss how long you'd ideally like to have a locum tenens physician on site before making a decision to offer that individual a permanent position or moving on to another candidate (three to six months is reasonable, but it varies among organizations). Talk to a recruiter here at Interim Physicians about your requirements and about how a locum tenens contract buyout arrangement works, should that become necessary. Some time before your first locum tenens candidate begins work, develop a job description and create an evaluation system so that locum tenens providers will know what's expected of them and you'll know, based on your unique criteria, when you've landed on the right person.
Until the shortage of physicians is relieved, hospitals and clinics are going to have to stay focused on both their short- and long-term goals, and become more creative in order to recruit the best candidates. Utilizing locum tenens is one way to make finding the best doctors less stressful and more successful.