Demand up for locum doctors

Recruiters nationwide say the number of days physician offices need temporary doctors to fill in continues to increase as practices can't find permanent employees to fill the jobs. They also are seeing requests from specialties they haven't seen in the past.

Physician staffing firms say those two factors signal that doctors' offices are showing the first symptoms of a physician shortage. The observation comes as work-force experts expect the United States to be short 85,000 to 200,000 physicians by 2020. Recruiters said the locum tenens demand is particularly noticeable in areas with populations of 500,000 or less.

"The No. 1 reason is the physician shortage. Also, locum tenens has become more of an adopted staffing method for large health care systems and organizations," said David Baldridge, vice president of CompHealth locum tenens division and president of the National Assn. of Locum Tenens Organizations.

Staff Care, one of the largest physician recruiting firms, reported requests of 316,946 physician days in 2005, a 37% increase for the company from 2004. The Irving, Texas-based firm anticipates requests will reach 430,000 physician days in 2006, a 36% increase from 2005.

Staffing Industry Analysts, which provides news and analysis of temporary worker markets, expects that type of trend to continue at firms nationwide. It projects the locum tenens market will grow 13% in 2007 with revenues reaching $1.6 billion.

"With only about 3,000 locums working in the United States on any given day, out of 810,000 doctors, the temporary physician business is still small," said Robyn Hessinger, an analyst for Staffing Industry Analysts in Los Altos, Calif. "But it is growing rapidly, and because of the shortage of physicians predicted by the end of the decade, its long-term potential looms large."

Primary care physicians have been in demand for some time, but an increasing number of practices are asking locum tenens recruiters for specialists such as general surgeons and hematologists-oncologists.

"We have had requests from all over the country that we haven't had before," said Joan Pearson, president of Catalina Medical Recruiters in Phoenix, which focuses on recruiting physicians in the Southwest.

Recruiting full-time doctors tough

Jim Bien, MD, a pediatrician and chief medical officer for Arnett Clinic in Lafayette, Ind., is among the physicians who have turned to locum tenens when he hasn't been able to find full-time physicians to fill positions.

"It takes longer to fill positions, and physicians may not want to commit long term to a setting," Dr. Bien said. "We use [locum tenens] for the short term. It's a nice way to check them out, have them check out the practice, kick the tires."

Arnett Clinic, a physician-owned multispecialty practice of 140 doctors, has hired three interventional cardiologists in the past two years after nearly two years of searching. The clinic would like to expand the number of physicians in the practice, not just replace those retiring or moving on. "The competition is stiffer, particularly for certain specialists," Dr. Bien said.

In Jacksonville, Ill., Marc Steinberg also is seeing a change. As vice president of community relations and physician recruitment for Passavant Area Hospital, he is searching for full-time general surgeons and emergency medicine physicians. Until he can fill these positions, Steinberg is looking for locum tenens to share the load. He needs two general surgeons to replace ones who have retired. The problem, he said, is that more general surgery residents are opting to subspecialize and aren't interested in a general surgery practice.

The desire for more work-life balance also is having an impact.

"You have to hire more physicians to get the same number of hours covered," Steinberg said.

Locum tenens track desirable to some

On the flip-side, there are more locum tenens to hire. More physicians are interested in the flexibility of a locum tenens life, Baldridge said.

"It's a paradox," he said. "You've got a physician shortage, and at the same time there are a large number of physicians on the tail end of their careers at 55 or older, who see locum tenens as a way to have more flexibility and freedom. It's becoming more of a recognized career alternative."

Young physicians are choosing to work temporary assignments, too, said Dustin Koger, executive vice president of Staff Care. They see it as a way to test different practice settings.

"If they are not married and don't have kids, they're more flexible at the front end in the type of job they take," Koger said. "It's helped physicians tremendously in determining what they want for a first-time position."

As more locum tenens physicians enter the work force, hospitals and physician practices are becoming more accepting of the temporary doctors, said David Roush, president of LocumTenens.com. "Two or three years ago, no one would want to admit they used locum physicians. Now it's not that difficult," he said.

The clinical performance of these physicians is high, changing perceptions that physicians working locum tenens couldn't get a full-time job, he said, and health care organizations are turning to them more readily to avoid losing patients to long appointment delays.