Op-Med is a collection of original articles contributed by Doximity members.
The Decline of Self-employed Physicians
Recent changes in the medical business environment have led to a decline in physician ownership of their practices. The cost of complying with government regulations, maintaining an electronic medical record, and navigating constantly changing insurance networks have evolved into formidable and unrewarding challenges. Diminished reimbursements from Medicare and private insurance companies constitute further barriers to a successful and satisfying private practice. As a result of these obstacles, only 17 percent of today’s physicians are solo practitioners.
For the first time in recent history, less than half of physicians own their practices. As employed physicians, they work for large groups, clinics, hospitals, or academic institutions. Many physicians, accustomed to making independent and complicated medical decisions, chafe at being told what to do by health care administrators who lack clinical training and perspective. The prevalence of job dissatisfaction and physician burnout have never been higher.
Why Locum Tenens?
Locum tenens, or temporary placement, allows physicians to work when and where they want without a long-term contract. Locum tenens has emerged as a practical solution for physicians wishing to devote 100 percent of their energies to patient care and eschew administrative tasks. It’s a beautiful solution. Doctors need only show up and care for patients. That’s it.
Who are Locum Tenens Physicians?
The number of locum tenens physicians has blossomed from 25,000 in 2002 to 50,000 and is likely to continue to grow. Many physicians, now free from ownership responsibilities, are available to travel and try out different practice locations and opportunities. Most locum tenens physicians are mid-career (49 percent), while 15 percent are just out of residency and 36 percent are phasing out their careers. About 34 percent of locum tenens physicians practice full-time, 45 percent practice part-time, and 21 percent are “moonlighters” who work locums in addition to their regular jobs. Locum tenens opportunities are available to any licensed physician.
Locum Tenens and Vacation
About 80 percent of locum tenens physicians rely on staffing companies to contract temporary employment and professional liability insurance, as well as arrange travel and housing. Locum tenens opportunities may be available in a physician’s home community, tourist destinations such as Alaska, Florida, and Hawaii, far-flung destinations like Australia or New Zealand and many other locations. Because staffing agencies pay for transportation to and from the worksite, some physicians combine travel vacations with locum tenens assignments.
Cumbersome and expensive government regulations coupled with diminished income expectations have eroded the practicality of private practice for many physicians. However, the alternative of permanent employment leaves many physicians unsatisfied. Another option, locum tenens, offers flexible and temporary patient care assignments, which may be more appealing. As long as private practice and permanent employment opportunities remain suboptimal, physicians are likely to continue to take advantage of locum tenens opportunities.
Andrew Wilner is a neurologist and blogs at andrewwilner.com. This article is adapted from his latest book, The Locum Life: A Physician’s Guide to Locum Tenens, available on Amazon.