A survey of health care facilities found that 85% had used temporary doctors in the past year to fill in gaps caused by a national shortage of physicians.
“Virtually every hospital in the United States now uses locum tenens doctors [temporary physicians],” said Jeff Decker, president of Staff Care, the health care staffing firm that conducted the survey. “They have emerged as a key part of the medical workforce in an era of physician shortages and evolving delivery models.”
An estimated 52,000 doctors, about 6% of all active and licensed physicians, worked on a temporary basis in 2019, the survey found.
Temporary physicians are filling openings that can last from a few days to more than a year as health care facilities grapple with trying to find primary care physicians and specialties. Temporary doctors also are called on when health care facilities experience turnover of their medical staff, Mr. Decker said.
The survey included responses from 204 executives and managers at hospitals, medical groups and other health care facilities that were surveyed in August, September and October.
In 2016, the last time Staff Care conducted the survey, 94% of health care facility managers reported using temporary physicians. About 74% reported relying on temporary doctors in 2012.
In the current survey, 30% of health care facility managers ranked temporary primary care physicians as their highest need. In 2016, 44% ranked temporary primary care doctors — including family physicians, pediatricians and general internists — as their highest need.
At the same time, the demand for temporary specialists has increased from 11% in 2016 to 21% last year, the survey found. Seventeen percent of health care facilities reported using temporary internal medicine specialists, up from 9%, and 22% reported using temporary anesthesiologists, an increase from 11%.
“I’m not surprised the rate of growth in demand for sub-specialists is faster — that’s where we see the biggest mismatch in supply and demand in the future,” said Dr. Atul Grover, executive vice president of the Association of American Medical Colleges (AAMC).
He said he had no real opinion on the use of temporary physicians to support needs.
“The biggest problem in the long run is the overall shortage which needs a multi-pronged approach,” Dr. Grover said.
An aging population and a physician workforce comprising many specialists who have reached retirement age are driving the national doctor shortage. Last year, the AAMC predicted a shortage of up to about 121,000 physicians — 55,000 primary care doctors and 66,000 specialists — by 2032.
The U.S. currently faces a shortage of about 20,000 physicians, including primary care doctors and specialists, according to the AAMC.
The association’s data shows the deficit has hit the hardest in the South, which has a shortage of 31,400 physicians. The Midwest has a shortage of 12,900 doctors. The West has enough physicians to fulfill demand, and the Northeast has a surplus of 23,900 physicians.
While first-year enrollment at U.S. medical schools has gone up, the AAMC has said the number of hospital residencies has not kept up.
Data from the National Resident Matching Program shows that an average of 10% of medical school students each year do not get placed into a hospital residency to receive training to become a licensed physician — leaving thousands unable to practice and contributing to a growing physician shortage, medical education professionals say.
“Older patients need specialists to care for ailing organs and body systems,” said Mr. Decker of Staff Care. “We simply don’t have enough of them to go around.”
The practice of temporarily swapping in a physician for another traditionally occurred to cover colleagues who were ill, traveling or otherwise away from work.
It wasn’t until the 1970s that the use of temporary physicians evolved from “limited, ad hoc assignments” to a broader, “systematic component of medical staffing,” the Staff Care report says.
Government grants set aside for physicians who work in medically underserved areas has helped transform temporary physician staffing, an industry now worth billions of dollars.
Hospitals and other health care facilities use temporary physicians for a number of reasons, but many providers also are choosing to work on a temporary basis.
Mr. Decker said working as a temporary doctor is “an increasingly popular practice style among physicians because it allows them to focus on what they like to do best, which is to treat patients while minimizing the administrative duties they like least.”
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