By John Commins

"About 6% to 7% of physicians consider locum tenens to be their fulltime occupation and we anticipate that will grow to 11% of the workforce within the next 18 months," says the head of a healthcare temporary staffing firm.

More new physicians entering the workforce are opting for jobs as locum tenens in hospitals, physician practices, and other provider sites, an industry survey shows.

One healthcare temporary staffing firm based in Irving, TX, polled 2,087 locum tenens physicians and found that 21% began temp work immediately after finishing their medical training. That's up from 16% in 2013 and 14% in 2012. A separate survey found that 46% of doctors will change their practice styles within three years, and 9% plan to work locum tenens.

Sean Ebner, president of the staffing firm, says a growing number of physicians are gravitating toward nontraditional work models, including employment by a hospital or a large practice, part-time practice, concierge medicine, and administrative-only practice.

"The physician workforce is evolving. About 6% to 7% of physicians consider locum tenens to be their fulltime occupation and we anticipate that will grow to 11% of the workforce within the next 18 months," Ebner says.

"A lot of physicians that did locum tenens had sold their practice, they were in quasi-retirement and came back as locums. That demographic is changing significantly, where new physicians and mid-career physicians are making the choice for flexibility, working in different environments, being able to focus on the practice of medicine and not the politics of the organization, the reimbursement facilities and all of the bureaucracy around the business of medicine."

The staffing firm also found that 91% of the 259 healthcare facility managers who responded to the survey said they had used a locum tenens physician at least once in the past year, and 42% said they are looking for one or more locum tenens physicians. Primary care physicians are in the most demand as locum tenens, followed by psychiatrists and other behavioral health specialists, and hospitalists.

"From a healthcare system perspective there is a recognition of leveraging physicians in a temporary contingent format to deal with the peaks and valleys of census and demand rather than committing to fixed costs and having to staff to a certain threshold for the whole year irrespective of the demands for those services," Ebner says. "It puts a big tax on those systems. Sometimes they have to overstaff and sometimes they stretch their community too far."

About 44,000 physicians nationwide practice as locum tenens, up from 26,000 12 years ago, Ebner says, adding that there's no timeline on when, if ever, locum tenens workers will pursue a more permanent setting. "Physicians do come in and out of locum tenens for a number of reasons," he says.

"Some physicians want to earn an income if they switch specialties from what they first signed up for out of medical school and there is a lag in between fellowship programs. More importantly it gives physicians the flexibility to kick the tires in a number of different settings, geographies and delivery systems before settling down."

The survey suggests that demand also is growing for temporary non-physician clinicians such as nurse practitioners and physician assistants.

In 2012, 4.8% of healthcare facility managers surveyed said they had used locum tenens NPs in the previous 12 months. In 2014, that number rose to 17.4%. The number of PAs rose from 4.7% in 2012 to 7.6% in 2013. The survey findings are consistent with those from a benchmark survey released last summer.