Traditionally, locum tenens have been used as a way for hospitals to replace a physician that is out of the office temporarily. But that is not the only way to use locum tenens. The model can be used as a permanent strategy for physician recruitment and retention and a way to lower physician attrition, according to Robert Moghim, MD, founder and CEO of Onyx M.D., a nationwide locum tenens and permanent placement staffing agency.
Competition for physicians is growing due to the physician shortage and the increase in the number of hospital-employed physicians. Hospitals need to make sure their physician recruitment model is competitive to succeed. However, Dr. Moghim says a lot of hospitals do not pay attention to attrition rates in their recruitment strategy. "The attrition rate is often overlooked and is just as important as the initial recruitment efforts," he says. "[Hospitals] spend time and money to get a physician in the door. If [the physician] works for three months and decides to leave, it's a significant financial blow for the facility in actual replacement and opportunity costs."
Using locum tenens to place permanent physicians instead of offering a permanent contract after interviews will lead to lower attrition rates, according to Dr. Moghim.
Using a permanent locum tenens model allows hospitals to bring in several physicians on a temporary basis who could turn in to permanent employed physicians. The model allows the physicians to get to know the hospital and community where they could be living and the hospital can get to know the physicians and see if they will be a good fit in the organization before both parties make a long term commitment to one another.
"Most physicians will know in the first month if they will stay [at the facility] long term or leave. The Locum tenens approach to permanent placement […] increases the probability of finding the right fit longer-term," Dr. Moghim says.
Dr. Moghim says that under this model, physicians would be part of the hospital temporarily from anywhere from one day to one year, but he recommends at least 30 days. After the temporary period, if the hospital and physicians feel like it is a good fit, they can come to a long-term employment agreement.
What to say to hesitant physicians
Some physicians may not like the lack of security that comes with starting in an organization with no guarantee of long-term employment. However, Dr. Moghim says that the process is beneficial both for the facility and the physician.
"I would argue that it is extremely beneficial [for physicians], even if it ends up not being the right opportunity. [Physicians] can learn from that. What is not right for you is as important to know as is what is right for you," he says.
He says that if an organization finds physicians who are hesitant, the hospital should try to convince them that all parties are working towards the end goal of permanent employment.
Dr. Moghim says that using locum tenens as a recruitment strategy might require more planning and strategy than going the traditional route. "I would recommend [that hospitals] have a dedicated and trained recruiting team in order to take on this level of commitment with this approach," Dr. Moghim says. That is because the model requires more phone interviews and faster response times than the usual recruitment model. "[Hospitals] need to be responsive because the physicians are in high demand and typically do not wait long before committing to an opportunity," he says.
Two other roadblocks that hospitals may encounter when trying to use locum to hire are putting strain on the administration department and getting malpractice coverage for the temporary physicians, according to Dr. Moghim. Hiring physicians for multiple trial periods requires higher than usual administrative duties, which some hospitals do not anticipate, Dr. Moghim says. Also, the locum tenens physicians will need short-term malpractice coverage, which Dr. Moghim says can be difficult to arrange.
While doing away with traditional recruitment models can seem quite radical, Dr. Moghim argues there is no better way to judge a physician's fit with an organization than to have them work for the organization temporarily before a permanent decision is made.