Introduction to locum tenens
Millions of Americans lack convenient access to healthcare or struggle to access specialists. Locum tenens addresses this problem with a medical practice model where a physician or advanced practice provider (referred to as a “locum”) temporarily fills in for another provider — either on a short-term or an extended basis. Locum tenens physicians, PAs, and NPs work assignments wherever they’re needed, particularly in rural and underserved areas. Loc*ms also cover other providers’ vacations or personal leaves and fill gaps in coverage while a healthcare facility is actively recruiting for an open permanent position.
CHG Healthcare and locum tenens
The locum tenens industry was started in 1979 by CompHealth’s founders to provide coverage for rural physicians who needed time off to receive updated training. Today, CHG Healthcare — the parent company of CompHealth, Weatherby Healthcare, Global Medical Staffing, RNnetwork, Modio Health, and Loc*msmart — is committed to building a sustainable healthcare workforce that improves patient care wherever it’s needed most.
CHG Healthcare works with more than ten thousand locum tenens providers every year, who treat more than 11 million patients. Current estimates indicate that about 52,000 physicians work temporary locum tenens assignments in the U.S. annually, and CHG works with more than 21% of them.
The State of Locum Tenens in 2024
President of CHG Healthcare, Leslie Snavely
Welcome to the 2024 State of Locum Tenens report. I hope the data and analysis contained here can help you gain insights into the current state of the industry, guide your business decisions, and navigate the ever-changing healthcare landscape.
Healthcare organizations continue to face a challenging environment with a physician marketplace that is tighter than ever as physicians look for new career solutions that work for them. Our job as an industry is to ensure the delivery of high-quality patient care, closing coverage gaps in a way that delivers for both physicians and healthcare organizations. As you’ll see in this report, these care gaps in the market would be even greater if not for locum tenens.
Some of this year’s key findings:
- The growing provider shortage has made hiring much more difficult for healthcare organizations, and more and more are utilizing loc*ms as a way to meet increasing patient demand
- Burnout remains a huge issue, and many organizations are looking to loc*ms to help relieve the pressure and provide much-needed respite for their staff
- While the cost of using loc*ms remains a concern for some, a growing number of organizations are finding that loc*ms generate revenue when billed for correctly
- Organizations that are hesitant to utilize locum tenens often suffer from lack of coverage and lost revenue
There is so much fascinating data here, but the overall message is clear — locum tenens providers play a vital role in assuring that patients receive the high-quality care they need, close to home, and without waiting months for an appointment. The work we do truly has an impact on patients, their families, and their communities, and we’re honored to be part of the delivery team to meet this crucial challenge.
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Locum tenens usage by healthcare organizations
Source: 2023 Client Awareness and Perceptions Study
Locum tenens providers are primarily used to provide coverage while a healthcare facility tries to fill an open position. In a 2023 CHG Healthcare study, a vast majority of healthcare facilities (82%) surveyed said their top reason for hiring loc*ms was to fill an opening until a permanent candidate could be found.
However, the growing provider shortage has made hiring much more difficult, especially for high-demand medical specialties. As a result, many healthcare facilities are turning to locum tenens providers as an agile way to quickly scale up and down services. Health systems are also using locum providers to relieve pressure on permanent staff — either for leave coverage or to improve working conditions for medical staff.
Why do healthcare organizations hire loc*ms?
Source: 2023 Client Awareness and Perceptions Study
“Burnout is an ongoing concern for all health systems, and at Sanford the use of loc*ms can help fill gaps in rotations that will give our permanent providers time to decompress.”
Darin Musser, Sr. Director | Locum Tenen Services, Sanford Health
Source: 2023 Client Awareness and Perceptions Study
Benefits of locum tenens
When billed for correctly, locum tenens is a revenue generator. In 2023, nearly half of health care organizations surveyed (46%) said a top reason they used locum tenens providers was to prevent revenue loss.
Source: 2023 Client Awareness and Perceptions Study
A CHG Healthcare study found that healthcare facilities which consistently enroll locum tenens providers with payors and bill correctly generate an estimated 400% more revenue than those that lack a well-defined process.
Run your own numbers:
Calculate potential revenue from locum tenens
Source: 2023 Client Awareness and Perceptions Study
In addition to generating revenue, locum tenens allows healthcare facilities to ensure continuity of treatment for better patient retention and loyalty, prevent staff burnout, and try out candidates before extending an offer. The timely availability of locum tenens providers is also cited as a top benefit.
Source: 2023 Client Awareness and Perceptions Study
Loc*ms as a remedy to provider burnout
Provider wellness continues to be a concern for healthcare organizations as indicated by the 42% who view locum tenens providers as a resource that can help reduce burnout among existing staff. The level of concern was highest in 2021, when CHG’s Client Awareness and Perceptions Study found that nearly 56% of healthcare organizations viewed locum tenens as a solution to burnout.
Sources: 2023, 2021, 2019 Client Awareness and Perceptions Studies
Challenges of locum tenens
Not all healthcare organizations are on board with the concept of locum tenens providers as revenue generators. About 88% balk at the higher cost of locum tenens providers and would rather hire permanent employees than bring on locum providers. Other top concerns include worries about quality and continuity of care and locum providers not being familiar with local systems and processes.
Source: 2023 Client Awareness and Perceptions Study
Source: 2023 Client Awareness and Perceptions Study
Locum tenens cost vs. lack of coverage
Healthcare facilities that are resistant to hiring locum tenens providers due to cost often suffer from lack of coverage when they are unable to maintain adequate staffing levels. Data from the Association for Advancing Physician and Provider Recruitment (AAPPR) 2023 Internal Physician and Provider Recruitment Benchmarking Report shows it can take months to fill an open position with a new permanent hire, with some hard-to-fill specialties taking a year or more to fill.
Source: AAPPR 2023 Internal Physician and Provider Recruitment Benchmarking Report
Without a locum tenens provider in place, the loss of revenue can be significant. The average physician generates $2.4 million in net revenue per year — revenue that is lost without a replacement. So, while the average hourly or daily rate of a locum provider is usually higher than the wage of an employed provider, the potential for lost revenue is much greater, especially since locum providers are revenue generators when billed for correctly.
Locum tenens quality of care
Despite the common concern about the quality of patient care, mortality rates are similar for patients treated by loc*ms compared to those treated by employed physicians. In fact, one study found that patients treated by loc*ms had a lower 30-day readmission rate.
How healthcare organizations are
managing locum tenens
The effort associated with managing multiple providers is also cited as a challenge of using loc*ms. The most commonly cited administrative burdens of locum tenens are credentialing issues (cited as a challenge by 52% of respondents), managing multiple locum providers (45%), and billing for locum tenens services (29%).
Source: 2023 Client Awareness and Perceptions Study
Centralization as a locum tenens management strategy
One of the ways large healthcare organizations are coping with the administrative burden of recruiting and managing multiple locum providers is by centralizing their locum tenens hiring function.
Parkview Health dedicated one internal point person for locum tenens hiring and streamlined its locum tenens hiring process. When a need is identified, departments make the request to that single point of contact who helps them get the locum tenens providers they need.
“Now we have one person who understands the credentialing process and who can create efficiencies with our medical staff. When a department needs a locum, they're going to deal with one person who will know what they want, make sure they get it, and make it as easy as possible.”
Angela Pulcini, Director, Provider Services | Parkview Health
UnityPoint Health also funnels all locum tenens requests through one central department and hires the bulk of its locum tenens providers through CHG Healthcare. This centralization has allowed UnityPoint Health leaders to have increased visibility into loc*ms usage.
“The centralized process makes it much easier for us to make strategic decisions.”
Alan Johnson, Director of Provider Recruitment | UnityPoint Health
Locum tenens industry trends
Healthcare organizations continue to increase their use of locum tenens physicians. Nearly half (46%) increased loc*ms usage in 2022 compared to the prior year, while 20% stayed about the same. Only 29% reported decreased usage.
Source: 2023 Client Awareness and Perceptions Study
Similarly, AAPPR found that the percentage of provider searches using locum tenens grew from 10.7% in 2021 to 14.9% in 2022 for physicians. Usage of advanced practice providers has declined slightly from 3.3% in 2021 to 2.3% in 2022.
Source: 2023 Client Awareness and Perceptions Study
When searching to fill an open position, surgeons (19.8%) are the most common type of locum brought in to provide coverage, followed by other specialists (16%) and then primary care (12.8%).
Source: 2023 Client Awareness and Perceptions Study
The highest demand specialties for locum tenens during a physician search were psychiatry (32.6%) and gastroenterology (30.8%). This is double the prior year where just 15.5% of gastroenterology searches used loc*ms and only 15% of psychiatry searches.
Source: AAPPR 2023 Internal Physician and Provider Recruitment Benchmarking Report
“As we are beginning the ‘silver wave’ of provider retirements and experiencing rapid growth, we have leaned heavily on locum tenens providers to help us deliver uninterrupted care to our rural communities.”
Brianna Erickson, Director of Provider Experience | Aspirus Health
Provider workforce challenges in 2024
The top priorities for health system human resource leaders in 2023 are focused on developing more flexible staffing models, managing labor costs, and improving the care team experience. Locum tenens will continue to be an important solution to help these leaders achieve their goals.
Source: Academy IQ CHRO roundtable May 2023
High staff turnover in healthcare
In addition to the growing provider shortage, high turnover is making it challenging to keep departments fully staffed. The average hospital turnover rate over the last five years has been 105%.
According to AAPPR, nearly half (44%) of physician searches in 2022 were to replace a departing physician and 48% of searches were to replace a departing APP.
Source: AAPPR 2023 Internal Physician and Provider Recruitment Benchmarking Report
2024 locum tenens forecast
Source: 2023 Client Awareness and Perceptions Study
A majority of healthcare organizations (56%) expect to increase or maintain their current levels of locum tenens use in 2024.
Source: 2023 Client Awareness and Perceptions Study
The flexibility of loc*ms in filling coverage gaps or quickly adjusting staffing levels to meet patient demand will continue to make it the go-to option for healthcare organizations in 2024. This is especially true for the highest-demand specialties, which continue to be a challenge for physician recruiters.
Telehealth and locum tenens
More than a third of physicians (37%) say they’re interested in working telehealth locum tenens as a side job, and 30% are interested in loc*ms telehealth full time.
However, only 20% of physicians had the option to work telehealth as part of their loc*ms assignment in the past year, indicating that demand for this option still outweighs the supplied opportunities.
Source: 2023 Client Awareness and Perceptions Study
High provider interest in working telehealth combined with an industry shift toward more virtual care will likely produce more telehealth locum tenens opportunities in the future. McKinsey & Company estimates that 50 million in-person visits per year could be converted to virtual visits if adoption were extended equally across patient segments.
Source: 2023 Client Awareness and Perceptions Study
Locum tenens provider profile
An estimated 7% of the available physician population (about 52,000) is working locum tenens either full or part time. This is a 97% increase in physicians working loc*ms since 2015.
Sources: 2023 Locum Tenens Awareness and Perception Study; Association of American Medical Colleges U.S. Physician Workforce database as of Nov. 2023
Physicians who require a visa to work in the United States constitute about 24% of the total physician population and are not normally eligible to work loc*ms. Removing this population from AAMC’s 2023 U.S. Physician Workforce Data Dashboard (989,320) and comparing it to the number that reported they currently worked loc*ms in 2023, the total would be 51,873 physicians.
Source: 2023 Locum Tenens Awareness and Perception Study
How experienced are physicians with locum tenens?
Although only 7% of physicians say they are currently working locum tenens, 21% of physicians surveyed have worked locum tenens in the past.
Source: 2023 Locum Tenens Awareness and Perception Study
When do physicians start working locum tenens?
Most physicians (56%) work locum tenens early in their career, with 13% working loc*ms right out of residency.
Source: 2023 Locum Tenens Awareness and Perception Study
How much do physicians work locum tenens?
More physicians work locum tenens full time (39%) than part time (37%), but the difference is slight, and about a quarter of physicians (24%) have worked both full- and part-time gigs. Most physicians (61%) work locum tenens assignments in addition to an employed position or private practice.
Source: 2023 Locum Tenens Awareness and Perception Study
Source: 2023 Locum Tenens Awareness and Perception Study
Source: 2023 Locum Tenens Awareness and Perception Study
Physicians who work locum tenens typically do so for years, and more than half (65%) of those who are currently working locum tenens say they are at least moderately likely to continue.
Source: 2023 Locum Tenens Awareness and Perception Study
Why do physicians work locum tenens?
Most physicians work loc*ms assignments for the money. Nearly half (46%) choose to work locum tenens to supplement their core income, while 29% say it was because the salary was appealing.
Locum tenens is also frequently used to fill a career gap, whether it’s between phases of training (13%), searching for a new job (24%), or transitioning to retirement (13%).
Another top reason is to have more control over their schedule for a better work/life balance (27%). Hospitalist Dr. Tammy Allen says, “Having the ability to decide how much or how often I work rejuvenates me and prevents the burnout I see in my colleagues.”
Source: 2023 Locum Tenens Awareness and Perception Study
What are the highest-demand locum tenens physician specialties?
The highest-demand specialties for locum tenens have stayed fairly consistent over the past five years. The biggest shifts were pandemic related, with an increase in cardiology/pulmonology and a drop in surgical specialties from 2020 – 2022. In 2023, surgical specialties and anesthesiology rebounded as demand for surgical services has increased.
Source: CHG Healthcare internal data, Nov. 2023
How positive is the locum tenens experience for physicians?
Most physicians (81%) say they have had a positive experience working locum tenens.
Source: 2023 Locum Tenens Awareness and Perception Study
Finding the balance in healthcare
Thanks for checking out the State of Locum Tenens report. I hope it has provided some perspective and insightful data.
As I reflect on the information we’ve shared here, the theme that keeps recurring to me is balance. Hospital staff are looking for a better work/life balance that will allow them to provide the best in-patient care while being present with their families, hobbies, and life outside of work. Healthcare organizations are struggling to balance coverage gaps with the growing burnout crisis and provide the highest-quality patient care in a timely manner. And everyone is looking to balance their books.
Locum tenens can help organizations and individuals achieve these balancing acts. It’s not the magical panacea that will fix all of the issues in healthcare, but it can aid in many situations that are close to the breaking point.
Our providers, hospitals, and healthcare organizations play such an indispensable role in our communities. We are proud to help them find that balance they seek, while assuring that patients receive the life-saving care they need.
Scott Beck
CEO, CHG Healthcare
Methodology
CHG Healthcare compiled these statistics from surveys issued to physicians and healthcare organization leaders, along with internal data and third-party sources.
View last year’s report: 2023 State of Locum Tenens
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