Physician Staffing Shortages: A Look At Locum Tenens In The Hospital Setting

The Case of Health Services as It Faces Physician Staffing Shortages

With the physician shortages and staffing shortages in hospitals and medical practices, permanent solutions are necessary to the continuation of care. Our COO Chris Wang talks about the importance of locum tenens as a continuing service provider to hospitals and medical practices. While locum tenens provide temporary services, they prove to be a permanent solution to the shortage of hospitalists and their services in the US.

Full Interview Provided Below by Billian’s HealthDATA

Demand for physicians and health services will increase as millions of previously uninsured people soon expand the health insurance bandwidth due to healthcare reform and 75 million baby boomers begin to retire. Combine these factors with a well-documented doctor shortage and the result is greater demand for locum tenens staffing to maintain an optimal physician staffing mix. The term “locum tenens” comes from Latin, and means “to hold the place of.” Practices often use locum tenens physicians when a regular physician is absent due to vacation, illness, childbirth, business ventures, education, active duty, or when there is a vacancy at the practice.

Members of the Billian’s HealthDATA Portal Perks community recently chatted with DR Wanted COO Chris Wang to get a better understanding of the role locum tenens staffing solutions will play in light of physician staffing shortages.

Portal Perks: How can healthcare organizations use locum tenens to fill temporary staffing gaps without disrupting continuity of care? What is the maximum period of time that locum tenens can provide services?

Wang: “Locum tenens companies can be instrumental in assisting with shortages in physician coverage and prevent disruptions in the continuity of care. Locum tenens agencies are able to provide that stopgap that ensures hospitals and patients never go without coverage. They also provide a flexible solution that enables the hospital to deal with peak needs, as well as shortages. They can provide a qualified candidate, assist with the credentialing, and ensure the provider is in place and able to help keep the hospital running smoothly.

“A locum tenens assignment can go from as little as a few days to multi-year. With current physician shortages and the time it can take to find a permanent solution, locum coverage provides a crucial solution for patient care.

“The specialty of hospitalist—a doctor employed by a hospital to care for admitted patients—began about 15 years ago and stems from a variety of factors including healthcare reform and rising healthcare costs. Hospitalists track the condition of patients after they are admitted—arranging for patient tests and specialist care instead of having primary care doctors attend to them. Motivated by a desire to improve quality and efficiency, an increasing number of hospitals and physicians are moving from systems in which primary care providers manage their own hospitalized patients, or rotate this responsibility among themselves at infrequent intervals, to voluntary or mandatory systems in which patients are cared for by a hospitalist in the hospital setting. Hospitalists also may handle triage in the emergency department, transfer of ‘out-of-network’ patients, management of patients in the intensive care unit, preoperative and postoperative management, and leadership in hospital quality improvement and regulatory work.”

Portal Perks: How has locum tenens played a role in fulfilling the hospitalist shortage and what trends are you seeing?

Wang: “Locum tenens has played a crucial role in the growth of hospitalist medicine. As this is a relatively new subspecialty with stellar growth, locum agencies have been instrumental in finding new providers and assisting the hospitals with licensure and credentialing. This service is necessary as traditional primary care groups change, or are added to facility services. It has provided a great bridge as hospitals have adapted to these new services. Hospitalist medicine will continue to be both a very important and growing segment of our healthcare system.”

Portal Perks: In your experience, what are the top 10 locum tenens specialties among physicians? Do they correlate to the top specialties among hospital-affiliated physicians by overall volume (bottom image, below)? If not, name the order.

Wang’s answer is shown in the image below.



As healthcare leaders focus more on patient satisfaction and clinical quality, Medicare is using patient satisfaction and outcomes to determine reimbursement rates as part of the value-based purchasing initiative. How will locum tenens play a role in maximizing reimbursement for care? How do hospitals pay for locum tenens physicians while remaining in compliance with Medicare and commercial payer guidelines?

Wang: “Locum tenens physicians help hospitals with Medicare compliance in many ways. The additional staff can help shorten patient wait times during peak periods or seasons. They can help ensure hospitals maintain the levels of service during these shortages. There is no difference in the ability of hospitals to bill facility fees for locum tenens providers or the permanent staff for the most part. These physicians are credentialed with Medicare and have their own numbers, which the hospital can use to bill for their services. Thus, hospitals are able to fill in the gaps in their schedules and still maintain the greater portion of their reimbursement for services.”