There’s a increasing chance that the next time you undergo surgery, it will be by a locum tenens physician.
Because of rising overhead costs, combined with declining surgeon pay, more physicians are opting to become temporary doctors. They travel from hospital to hospital, and are paid a fixed rate, without worrying about office costs and struggling to stay open.
Numbers estimate that 1 in 20 general surgeons operate on this temporary basis, and this opens up a host of concerns. The first being the difficulty with follow-up. Surgeons are reluctant to follow another’s complications, but with so many working on a temporary basis, this is sometimes forced to be the case.
Furthermore, hospitals hiring on a temporary basis often incur greater costs, but when faced with the alternative of closing down, the costs are tolerable.
This scenario is another instance of how the downward pressure on physician salaries leads to the unintended consequence of exacerbating health costs.
On another note, the WSJ Health Blog points out that it’s actually primary care that’s most in demand on the locum tenens circuit. Having such a high proportion of temporary physicians in generalist practice certainly makes continuity of care difficult, however, with the dire shortage, I suppose that even a temporary doctor is better than none at all.
Update:
Jeffrey Parks doesn’t think the locum tenens model is for everyone, and indeed, is “a career paradigm of last resort.”
Related posts:
- Doctors respond to economic incentives
- Will the current economic woes save primary care?
- Retired physicians are going back to work, but are there jobs waiting for them?
- Do doctors set themselves up for physician burnout?
- Should doctors be on a salary?
- Barriers to the medical home
- Medicine and the economic crisis
{ 3 comments }
My former doctor was part of a clinic that utilized temporary doctors. These temporary docs have done more harm to my health than good. I have moved my primary care to a nurse practitioner, who can still offer me quality continuous care unlike my former physician.
Kevin, as you know, I am a Locum Tenens Pediatrician . . . and I have been making my living that way for eleven years: http://drjshousecalls.blogspot.com/2008/02/my-interview-with-locums-life-magazine.html
I’m a (very good) Pediatrician who was forced to turn to the road for a living when my hometown hospital did me wrong. It was a last resort, but a reasonable one. I did not want to move/uproot.
I tend to take longer assignments . . . 6 months or more . . . within a half-day’s drive of home . . . and I commute home when I can. I work when I want to – and take breaks (sometimes for months or more) when I want to. I bill a fixed rate. I don’t have to worry about overhead. All my expenses are paid.
It’s not ideal. But it’s a way to pay the bills. And at this point I am in better financial shape than some of my salaried/private practice friends.
I often find myself covering practice disasters or meltdowns – really awful situations. I have found that many “permanent” physicians (and patients) do not appreciate the services provided by Locums – or the sacrifices they make to cover a practice or hospital when no one else will.
Until the profession wakes up and starts treating doctors as something more than pawns on a chess board, the trend towards temps (especially in areas of dire need) is going to continue.
What some people may not realize is that locum tenens physicians undergo even more scrutiny than those practicing in a full-time position.
A good locum tenens firm that places physicians performs prescreening and credentials verification even before a facility perfoms the physician credentialing. The more place a locum tenens physician works, the more times his/her credentials are scrutinized.
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