The nationwide physician shortage is intensifying. A limited supply of qualified primary care physicians graduate from medical school each year, the costs of maintaining a private practice are increasing, and the quality of patient care is compromised. Several factors combine to exacerbate the physician shortage in the United States. Many physicians wish to practice in urban settings, and they find little incentive to relocate to rural areas where primary care physicians are in higher demand. The current economic recession is causing tuition expenses and the costs of operating a private practice to soar. Many medical students opt to pursue specialized fields, rather than primary care, and more physicians are seeking an optimal work-life balance.

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A realistic solution to the physician shortage is the locum tenens industry. New graduates who wish to fine-tune their skills in a variety of settings, physicians who choose to close their private practices, and baby boomers who postpone retirement are among the ideal candidates for locum tenens practice. As facilities of all shapes and sizes—including acute care hospitals, ambulatory surgical centers, and private practices—must supplement permanent staff, the locum tenens recruitment industry offers solutions.

Hospitals and medical facilities across the country rely on locum tenens physicians to fill the gaps in staffing shortages. "The demand for locum tenens surgeons is most definitely there, the majority of which continues to be generated from rural facilities," says Jonathan Simon, MBA, manager of the surgery division for Weatherby Locums, a consulting firm based in Fort Lauderdale, Fla. Physician staffing agencies offer incentives to practitioners who opt to temporarily relocate to rural settings, and practicing in such locations affords opportunities to work with a variety of patients and perform a variety of procedures. According to a 2008 study published in the journal Academic Medicine, 9 percent of physicians practice in rural areas, but 20 percent of the population live in those communities. Moreover, rural residents tend to be older and experience more health complications. "You have to think about where the need for physicians is greatest in this country, and rural areas have a long-standing, persistent need for physicians, particularly generalists," says Mark Doescher, MD, MSPH, director of the WWAMI Rural Health Research Center at the University of Washington Center for Health Workforce Studies in Seattle.

"The largest demand for physicians has been for family practitioners comfortable with the full spectrum of care," says Sean Clark, division manager for family medicine and maternal/child health for VISTA Staffing Solutions, a staffing agency based in Salt Lake City. "However, because many of our clients are group practices with multiple locations, a family practitioner more comfortable in an outpatient setting can be accommodated, and the help is more than appreciated." He notes that VISTA has seen a growth trend in larger medical groups with multiple locations. "We see demand for primary care physicians in a wide variety of settings, ranging from solo practitioners in outpatient offices to large hospital-based systems. We have also seen a large growth of federally funded community health centers with a rampant need for primary care providers and large patient populations in need of care," he says.

WHO SHOULD CONSIDER LOCUM TENENS PRACTICE?

For medical school graduates, an early career in locum tenens presents several benefits. For starters, new physicians who fulfill temporary contracts may experience a diversity of healthcare settings and learn a variety of techniques. In a January 2010 interview with LocumLife, Rutherford "Ruddy" Polhill III, founder, president, and CEO of HealthCare Partners in Duluth, Ga., and president of the National Association of Locum Tenens Organizations, commented, "Fifty percent of the people who come out of training and start a full-time job today will change jobs within the next year. As an industry, we tell physicians, 'When you come out of training, work in many different environments.'" Clark agrees: "Locum tenens serves as a way for physicians in transition to experience different practice settings and explore different areas of the country before settling into a permanent practice," he explains.

Another contributing factor to the nation's physician shortage is the cost of operating private practices. Overhead costs and declining reimbursements are prompting many physicians to close their doors. Locum tenens is a profitable option for such physicians. "Ultimately, physicians need to find places to practice medicine that provide them with fulfillment and keep them in medicine," Clark says. "We can't afford to lose good doctors to the wrong experience when the right one might just be the next assignment. ... As the economy improves and more physicians consider changes to their current work situations, more physicians will enter the locum tenens arena," he says.

As the baby boomer generation nears retirement, locum tenens presents an ideal opportunity to combat the physician shortage. "Many family practitioners are nearing retirement age, and locum tenens remains a great tool for physicians to transfer to more manageable workloads that allow pursuit of other interests," Clark states. "Locum tenens provides a legitimate opportunity for physicians of retirement age to continue to make substantive contributions to the medical community in the face of the predicted increasing shortage of physicians." He also observes that doctors who consider locum tenens, but decide not to embrace this lifestyle, typically retire completely.