Locum tenens positions originated in the 1970s, and what was intended to be a stopgap solution for rural hospitals in dire need has become a commonplace fixture of modern medical organizations. For much of the four decades since the establishment of the first locum tenens staffing agency in 1979, growth of the locum tenens industry has been strong but steady.
That has changed radically in the years since the passage of the Affordable Care Act in 2008. Prior to ACA, almost 75 percent of hospitals hired temporary physicians for almost 600,000 days of service each year. Today, almost 90 percent of hospitals report using a locum physician. In the decade since 2002, when there were 26,000 physicians working locum tenens assignments, that number has grown to more than 40,000. An estimate by the Physicians Foundation suggests that in the coming years, the number of locum tenens physicians could top 80,000.
This historic surge can be linked to two important social events: the Great Recession and the Affordable Care Act. American health care has long been a fragile thing, but these two disruptive events brought into sharp relief the cracks in the system. From 2009 to 2011, when there was a major downturn in the economy and elevated unemployment, the number of average doctor visits dropped from 7.34 to 6.95. This, of course, contributed to a lower demand for medical professionals.
The pent up need for health care—which would have been considerable in any case—coupled with greater access for more than 8 million newly insured through insurance exchanges has placed a staggering burden on an already demanding profession following the economic downturn. As a result, physicians are increasingly looking for any way possible to ease the crippling administrative burdens placed upon them.
A study by the Urban Institute found that almost 30 percent of doctors aged 35 to 49 plan to leave medicine in the next five years, while almost 52 percent over age 50 had similar plans. Early retirement and career changes are possible solutions for burnout and professional frustration, but many clinicians are committed to helping patients. Their solution is locum tenens, which provides greater freedom to serve patients without the administrative responsibilities.
The professional environment for temporary physicians has changed dramatically in the past few years. Just a few years ago, permanent staff were resistant to the use of locum physicians because they were perceived as less committed to patient care, unwilling to work collaboratively and overpriced.
A changing health care environment, however, has many organizations embracing locum tenens professionals. The growing shortage of physicians has made temporary placements a constant in most hospitals. Now, staff are eager to welcome locums and help make their stay as pleasant as possible in an effort to attract top professionals for permanent positions.
There is also a cultural change occurring. Fewer physicians are willing to remain in a single locale for decades at a time, so professional wanderlust no longer has a negative connotation. Hospital staff are more accustomed to working with locum physicians, and there is more willingness to embrace “itinerant” medical professionals.
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