Locum Tenens: A Viable Employment Option for Anesthesiologists

The term “locum tenens” comes from Latin, meaning to “hold one’s place.” Traditionally, locum tenens doctors were hired on a temporary basis to fill in for full-time staff. While locum positions have been common among CRNAs for some time, the model has become increasingly popular among anesthesiologists in recent years [1]. Indeed, an aging population requiring more anesthetic care and a nationwide shortage of anesthesiologists has led to increased demand for locum tenens anesthesiologists [2]. As a result, locums are now ubiquitous across the United States. According to a 2016 survey by StaffCare, 94% of healthcare facilities in the U.S. rely on locum tenens physicians [3].

Locum tenens positions exist in a variety of workplaces, from for-profit agencies, private practices, and individual hospitals to university health centers and state agencies [4]. While positions tend to be short-term — Medicare billing regulations limit locum positions to 60 days — the quality of care has been shown to be equivalent to that of full-time staff [5]. A study by Blumenthal et al found that the patients of locum physicians had similar 30-day mortality rates as the patients of full-time physicians. Moreover, patients of locums were about as likely to be readmitted within 30 days as patients of non-locum physicians [6]. Therefore locum tenens deliver a similar quality of care relative to full time anesthesia providers.

Anesthesiologists who pursue locum work can expect an hourly rate that is roughly proportional to the salaries of their full-time peers. The 2019 Medscape Anesthesiologist Compensation Report found that average hourly rates for locum tenens anesthesiologists were quite comparable to full-time staff, with options for overtime and bonuses [7]. With comparable compensation to full-time positions, many doctors choose to pursue locum work full time. Indeed, a study by Simon and Alonzo found that 62% of locum tenens physicians used it as their primary source of income [8].

The flexibility of locum positions appeal to many anesthesiologists. With short contracts and clear work requirements, locum work allows doctors to choose their own schedule and have control over when they are on call. For some, locum work can offer access to new or different tools, or an opportunity to try out a new work site before applying to a full-time position [9]. Likewise, during transitional periods such as after medical school or between jobs, locum work can offer flexible access to short-term employment. For others, locum positions are a means of winding down at the end of a career. The aforementioned study by Simon and Alonzo found that 38% of locums use their work as a way of augmenting retirement income [8]. While there are a variety of reasons for pursuing these positions, the combination of a flexible work schedule and equitable compensation often appeal to anesthesiologists considering locum work.

References

[1] Johnstone, Robert E. “Anesthesia Practice Trends: What Is Changing? What Does It Mean?” ICAA, American Society of Anesthesiologists, 2012, www.icaa.ir/portals/0/pi_122_johnstone.pdf.

[2] Moghim, Robert. “The Booming Locum Tenens Industry.” Www.onyxmd.com, Onyx M.D., 2017, www.onyxmd.com/about-onyx-md/blog/the-booming-locum-tenens-industry/.

[3] Miller, Phil. “Survey: Use of Temporary (Locum Tenens) Physicians Increasing.” StaffCare, AMN Healthcare Inc., 2016, www.staffcare.com/survey-use-of-temporary-locum-tenens-physicians-increasing/.

[4] Maniscalco, Mary M. “A Physician’s Guide to Working as a Locum Tenens.” JABFM, American Board of Family Medicine, May 2003, www.jabfm.org/content/16/3/242.long.

[5] “Changes to the Payment Policies for Reciprocal Billing Arrangements and Fee-For-Time Compensation Arrangements.” CMS Manual System, Department of Health & Human Services, 12 May 2017, www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3774CP.pdf.

[6] Blumenthal, Daniel M., et al. “Association Between Treatment by Locum Tenens Internal Medicine Physicians and 30-Day Mortality Among Hospitalized Medicare Beneficiaries.” Jama, vol. 318, no. 21, 5 Dec. 2017, pp. 2119–2129., doi:10.1001/jama.2017.17925.

[7] Wood, Debra. “ The Employment Outlook in Anesthesiology for 2019.” Employment Outlook in Anesthesiology for 2019 | Locum Leaders, 2019, www.locumleaders.com/physician-news/employment-outlook-in-anesthesiology-for-2019/.

[8] Simon, Arthur B., and Angelo A. Alonzo. “The Demography, Career Pattern, and Motivation of Locum Tenens Physicians in the United States.” Journal of Healthcare Management, vol. 49, no. 6, 2004, pp. 363–375., doi:10.1097/00115514-200411000-00005.

[9] Weiss, Lisa E, et al. “Locum Tenens 101: What You Need to Know.” ASA Monitor, vol. 82, Dec. 2018, pp. 38–40.