While staffing needs continue to evolve across hospitals and health systems, shortages aren't going anywhere for the foreseeable future — prompting healthcare leaders to hone their workforce strategies in ways that uphold quality patient care and drive volume, efficiency, and revenue.
Becker's Hospital Review recently spoke with staffing experts from Jackson + Coker Locum Tenens — Dave Booher, executive vice president of sales and recruiting and Robert Paredes, vice president of strategic solutions — about how organizations can strategically address staffing challenges by partnering with a locum tenens agency.
The perception and use of locum tenens has evolved
Locum tenens clinicians (or locums) are physicians and advanced practice providers who work at healthcare facilities on a temporary basis. They typically substitute for full-time clinicians or fill a vacancy until a permanent replacement is found. Throughout the COVID-19 pandemic, organizations routinely relied on locums to fill workforce gaps.
The role of locums has evolved from the traditional use as a "travel clinician" filling a temporary need. These valued professionals now also play a vital role in supplementing the workforce and helping to create more flexible staffing solutions. Some staffing models include locums as part of float pools of professionals who can be called upon during patient surges, like flu season or to help scale new programs. "Through this shift, over 85% of healthcare facilities rely on locum tenens in some way," Booher said. "Conversations have changed significantly in the last 15 years from explaining what locum tenens are to building strong relationships that help healthcare organizations to realize their growth objectives. This creates more meaningful partnerships between hospitals and locums agencies like Jackson + Coker."
Clinicians' perceptions have changed, too. Previously, locums assignments were not considered prestigious, but now they are a common career choice made by healthcare professionals who want to improve mental wellness and gain more control over when, where and how much they work. Locums assignments also enable clinicians to supplement their income while diversifying their professional experiences; work less, if desired (e.g., if they are semi-retired); or serve communities they feel passionate about or drawn to, such as rural areas or communities facing workforce shortages.
Organizations are using locums to address strategic priorities
Along with provider organizations' evolving perception of locums, the strategic use cases for locums in health systems are growing. As noted earlier, one compelling use case is to improve patient access by addressing shortages in rural areas where it is difficult for hospitals to fill permanent positions. This approach can support organizations' broader health equity strategies.
Locums are increasingly being recognized as revenue generators — not cost centers. The pandemic spurred the widespread adoption of telehealth services. This allowed providers to bill Medicare for care regardless of location, prescribe controlled substances via telehealth, and use waivers for telehealth reimbursement. To take advantage of these opportunities, many organizations increased the use of telehealth locum providers. "Health systems don't want to miss out on revenue because a patient can't be seen due to staffing shortages," Paredes said.
When choosing a locum agency partner, think strategically not transactionally
With more than 200 locums agencies in the U.S., choosing the right partner can be a daunting task.
However, some agencies, Paredes and Booher said, are largely transactional in their approach, filling staffing needs as they arise without regard for the organization's broader, long-term workforce strategy or vision.
For health systems that operate across multiple states, this method can be short-sighted, given the wide range and depth of staffing challenges. Such organizations should take a more strategic view when evaluating agency partners and considering the agencies' capabilities, geographic reach, and availability of a specialized corporate or national accounts team. An experienced partner, Paredes said, is critical. "Locum tenens is not an easy business," he said. "There are so many moving parts. It's a fluid industry with many demands that make it really important to have support from a true partner."
"A national accounts team can help health systems by providing a consultative approach to incorporating locum tenens services into overall workforce planning versus transactionally filling a need," Paredes said. He noted that a locums agency partner can also add value by offering a market view of the industry to complement the health system's view.
Paredes explained how a national team centralizes contracting across a health system's facilities, which reduces the variability of terms, billing rates, insurance, and communication channels. This type of team can also ensure uniformity throughout the locums onboarding process, including credentialing, privileging, licensing, and compliance with regulations and other protocols.
Jackson + Coker follows a more strategic approach, which Booher said his team reinforces with deep understanding and relationship building. "With all the complications that come with working in this industry, it still boils down to creating a good relationship and understanding what an organization needs," he said.
An effective locums partner takes a long view of clients' challenges and provides strategic, flexible and comprehensive solutions to address an organization's specific staffing needs. These specific supports can include utilizing locums providers within a value-based care spectrum. Partner support can also mean contracting not just locums physicians, but also advanced practice providers, certified registered nurse anesthetists, and even non-clinical professionals, such as interim medical directors.
"We're in the business of finding providers and matching them with the right opportunities," Paredes said. "At the end of the day, it boils down to the patients — the patient that needs to be seen, that community that needs more help. This is the overriding goal of why Jackson + Coker exists and why we work every day as passionately as we do."
To learn more about Jackson + Coker, listen to their featured episode on the Becker's Healthcare Podcast.