According CHG Healthcare’s 2023 State of Locum Tenens Report, the number of physicians working locums is estimated to be almost 50,000 — about 7% of the available physician workforce. This represents an incredible 88% increase in physicians working locums since 2015, and the number is only expected to increase further.

For healthcare facilities experiencing staffing challenges, this means there are more physicians available for temporary coverage when needed. It is also an indicator that physician preferences are changing, as many younger physicians are looking for greater flexibility and better work/life balance. Here are five things to know about the state of the locum tenens industry, as reported by CHG Healthcare.

1. Locum tenens use is on the rise

Locum tenens usage is widespread, with the majority of healthcare organizations using locum tenens to maintain staffing levels. Nearly two-thirds (64%) of surveyed facilities reported doing so, and of those, one-third (35%) reported using locum tenens often or very often.

And that number is only expected to increase. While 50% of facilities anticipate they will continue to use about the same amount of locum tenens, nearly a third (32%) expect utilization to increase. Only 14% anticipate using locum tenens less often in the future.

Many facilities hire locums to cover gaps in their permanent staffing roster. Over three-quarters of facilities says they rely on locum tenens to fill a position until a permanent candidate is found (83%) or to fill in for someone who has left the facility (77%).

However, some facilities hire locums to accommodate growth in their organization. "We would love to be 100% employed with permanent staff, but it’s just not possible in the current state. We are growing faster than we can bring on new people, so locums support allows us to keep up with that growth while still offering great patient care," says Allison Spindle, the MPS director of provider recruitment at Inova.

2. Locums provide benefits, despite perceived costs

The number one cited benefit of hiring locum tenens, according to 70% of respondents, is that it allows for continuity of care for patients. This is especially important to Amy Powell, director of medical staff recruitment at Reid Health.

“Our system is big enough that we are able to offer our patients a wide variety of services,” she says. “However, we’re small enough that if one or two people leave, we can feel a significant strain on staffing. Locum tenens lets us cover those gaps and keep offering our patients the care they expect.”

Healthcare facilities are also using locums to help combat physician burnout. Over half of respondents (56%) also mention that reducing burnout in existing staff is a benefit of locums, a number that has nearly doubled since 2020 (30%).

Despite these benefits, healthcare facilities also see drawbacks to hiring locum tenens physicians, the largest of which is that they cost more than permanent physicians (noted by 82% of respondents).

This doesn’t always have to be the case, says Melinda Giese, senior vice president, CHG Healthcare. She suggests that locum tenens should be seen as a profit center rather than a cost center.

"When locums physicians are used and, even more importantly, billed for correctly, they can bring in as much as three times the revenue compared to what they cost. Cutting locums to save money is in reality just costing you a lot more money,” she concludes.

3. Physicians who work locums are trending younger

One-third of surveyed physicians reported having experience working locum tenens — either currently working locums or have done so in the past. Of those who haven’t worked locums, nearly half (45%) say they know someone who has worked locums.

Younger physicians are also discovering locum tenens work. While locums physicians in the past tended to be older, more than half (58%) of respondents working locums are now under 55 years old.

This data reveals that locums is a well-known option among physicians and is being pursued by younger doctors, who are perhaps looking for more flexibility and control over their careers in addition to increased compensation.

“Working locums is also a great way for physicians to find better work/life balance for themselves by working where and when they want,” says Scott Beck, CEO, CHG Healthcare. “Locums lets physicians bend their work around their life, in contrast to the years they spent bending their lives to fit around their education, training, and careers.”

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4. Locums oncologists and psychiatrists are in high demand

The most utilized specialties for locums have remained fairly consistent across the years of the report. While demand for family practice locum tenens professionals is still strong, emergency medicine has seen a regular decline.

Other specialties are seeing post-pandemic growth. “This past year we have seen tremendous growth in the need for both psychiatrists and oncologists,” says Brooke Bowers, president, CompHealth.

“Both needs stem from the pandemic but for very different reasons. We’re seeing more patients wanting to address mental and behavioral health issues, many that were overlooked or brought on during the pandemic. And oncology is unfortunately seeing an increase due to many people not seeking the cancer care they needed during the pandemic and are now faced with more serious diagnoses and medical needs,” she says.

5. Compensation contributes to physician satisfaction with locums

The top reason why physicians start working locum tenens is to supplement their core income, with a smaller percentage using locum tenens as a way to earn income while searching for a full-time position, during a life transition, or as a bridge between residency or fellowship and full-time work.

They continue working locums for similar reasons: to supplement their income (27%), the attractiveness of the salary (13%), and the ability to have more say in their availability and schedule (11%). Additionally, 8% of respondents cite the ability to “make a difference where healthcare is needed” as a core driver for continuing locums work.

These reasons undoubtedly contribute to the large number of physicians (82%) who stated they’ve had a positive experience with locum tenens, with 26% reporting a "very positive" experience and 56% reporting a "somewhat positive" experience.

The future of locum tenens

One clear takeaway from the 2023 State of Locum Tenens Report is this: The locum tenens industry is a key contributor in helping healthcare organizations meet their staffing needs, whether they arise from departing physicians or system growth. Physicians are also discovering locum tenens at a younger age, drawn to its higher compensation, work/life balance, and flexibility.