Locum Tenens Goes From Career Closer to Career Path

March 02, 2015

Working as a locum tenens, or substitute, physician used to be a career swan song for older physicians. It's now becoming a career path for young and old alike, as independent practice looks less feasible and Big Box medicine looks too confining.

That's the upshot of survey results released today by Staff Care, a national healthcare staffing firm. Findings on the popularity of locum tenens practice might appear self-serving for a company such as Staff Care, but they nevertheless point to the unsettled nature of the medical profession today, in which some physicians prefer to be itinerants.

Consider, for example, the traditional take on locum tenens medicine as a way for a semiretired, 65-year-old surgeon in Canton, Ohio, to work in Colorado Springs, Colorado, over the summer and do a lot of fly-fishing in the process. There's still truth to that, but less so. The percentage of clinicians aged 61 years or older who practice as locum tenens decreased from 45.1% in 2012 to 35.6% in 2014, according to Staff Care. Meanwhile, the percentage of clinicians aged 40 years or younger working on a substitute basis doubled during that time, from 6.9% to 14% (about 13% of survey respondents were nurse practitioners and physician assistants).

In another sign of this youth movement, the percentage of physicians who took a locum tenens job fresh out of residency training rose from 14.3% in 2012 to 21% in 2014. Likewise, more physicians are entering locum tenens work as a midcareer move — 54.7% in 2014 compared with 33.6% in 2012. Only 24.3% of clinicians in 2014 said they started working as locum tenens after retiring from permanent practice, down from 36.5% in 2012.

Almost 16% of clinicians taking the Staff Care survey said they intended to work in a locum tenens capacity for 11 years or more, another indication that filling in is a way of life for many.

All in all, an estimated 6% to 7% of all physicians view locum tenens as their full-time occupation, said Staff Care President Sean Ebner in an interview with Medscape Medical News. Ebner expects this percentage to increase to roughly 11% within the next two years as the medical profession continues to transition from independent practice to hospital and health system employment.

Ebner bases his prediction of locum tenens growth in part on a 2014 physician survey by the healthcare search firm Merritt Hawkins, a sister company of Staff Care. Merritt Hawkins conducted the survey on behalf of The Physicians Foundation, a nonprofit organization founded and funded by a settlement paid by the health insurance industry to organized medicine in a federal lawsuit over unfair business practices. About 9% of the 20,000 respondents in 2014 said they intended to pursue locum tenens work, up from 7.5% in 2008.

"We're seeing more and more physicians commit to this as a long-term career," said Ebner. "They're exiting the politics and business of medicine and focusing exclusively on the practice of medicine."

In addition, the flexibility of locum tenens practice appeals to female physicians who want to work part-time while they raise young children. As the children grow older, they can "ramp up their schedule" and either take a full-time position or continue as locum tenens.

Said Ebner: "Physicians are choosing more work-life balance."


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