You may not have heard the term “Locum Tenens” before, but most doctors have. Translated from the Latin, it means “to hold the place of, or substitute for.” Many doctors, instead of having an office they go to every day, and a practice they either own outright, or are responsible for, work “in place of” other doctors on a temporary basis while that doctor is absent for a length of time. They are employed by a company that assigns them to temporary, fill-in positions, much like a local “temp agency” would assign temporary staff to an office.
Locum tenens doctors usually practice the same specialty as the doctor they replace, and often are recent graduates of residency training. They may be using locum tenens to find a practice they can join or take over. Or they may be an older physician who is nearing retirement and wants to work only part-time. This may also be an opportunity for them to live in an area they are considering for their permanent retirement home and be paid while checking it out.
From the perspective of the physician being replaced, it gives him/her the opportunity to take time away from practice for a longer-than-normal vacation he/she has been putting off, or for a medical procedure that involves an extended period of recovery and rehabilitation. Locum doctors are also available on an immediate basis to fill in when the doctor has to be absent for a personal or family emergency. Underserved areas, especially rural or urban communities with few or no physicians, are benefitted greatly by the use of Locum tenens doctors. Downtown neighborhood/county clinics and the Indian Health Service are good examples.
There are several companies who have been in the business of employing physicians for Locum tenens activity. The largest are Staff Care in Dallas, Comp Health, in Salt Lake City, Utah, Vista Staffing in CottonWood Heights, UT, and Weatherby Healthcare in Fort Lauderdale, Florida. Comp Health and Weatherby are both owned by the parent company, CHG Healthcare in Salt Lake City.
Locum doctors are paid hourly or on a per diem basis. Their pay is competitive with, and sometimes exceeds, the pay of the physician being replaced. Physicians employed by a Locum company are fully vetted, credentialed, and covered by a malpractice insurance carrier to reduce the liability risk to the absent physician. State licensing is a major hurdle for the locum doctor, but the companies make that easier. If they do not provide licensing assistance, there are companies that specialize in physician licensing and will accomplish that task for the locum doctor. Travel arrangements and living quarters are arranged by the locum employer relieving the physician of that worry.
The question then arises: “Who pays for all of this?” As you might suspect, the physician who is being replaced is responsible. He/she is charged a fee that covers the expenses and salary of the locum doctor, and since the locum doctor is generating revenue, the expense is paid by the practice.
Fifteen to twenty years ago, when my practice was having reimbursement problems, I briefly considered locum tenens work. I saw it as a path of less (not least) resistance. I would have been an employee and no longer have to run a business—a business that was busy enough to provide me a decent income, but because of abysmally low reimbursement, was not. I was struggling. Fortunately, an opportunity to be an employee of a multi specialty group came along, and I chose that instead.
Locum tenens work requires the physician to adapt to an unfamiliar office, patients, staff, and location plus the adjustments your spouse or family must make to their new, temporary home. It isn’t for everybody, and I’m glad I decided it was not for me.
It is estimated as of 2022, that 7% of physicians, or 52,000, were locum tenens doctors. That number has doubled since 2002 (there were 26,000 locum doctors in ‘02). It is also projected that by the year 2030, the number of locum doctors could increase by 50%. For practicing physicians who desire, or must, take an extended period of time off, locum tenens coverage is an ideal option. There is the potential for it to be costly for the absent doctor, but if his patients accept the replacement physician (96% of patients do), it should be financially a win-win arrangement.
References: www.comphealth.com
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