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3 New(ish) Key Truths in Locums Delivery

The world of locum tenens is changing at a pace that most, if not all of us, probably have not seen in our careers. We are seeing many statements or surveys that show that upwards of 40-50%+ of all physicians and providers are doing or open to locums/moonlighting work, 30-40%+ are moving to a locums lifestyle for a work life balance or to supplement their income, and that certain specialties are seeing spikes in utilization so are creating crisis level coverage issues driving department/unit closures or diversion of services.

While some may feel that statistics, percentages, etc. can be used to argue both sides of the discussion, what really is not in question are the underlying reasons the questions are being surveyed and analysis being done, which is that our healthcare delivery models and desires of the workforce are changing.

“From our recent implementations and client business reviews, we are seeing significant movement and changes occurring every day in locums delivery,” Karen Little, VP of Locums Client Delivery at HWL notes. “It is clear that more leaders are involved, more focus is being placed on locum tenens decisions, and overall, there is a huge desire for transparency in this space.”

Stemming from discussions among Karen, myself and our leadership team here at HWL, we have noted the following 3 new or revived “Key Truths” that are consistently discussed in the area of locum tenens staffing.

  1. Locums use is on the rise and delivery is more complex.

Whether we want to pin it on the pandemic, work life balance, or supply issues; the use of locum tenens physicians and providers is on the rise. While the initial focus for locums was the definition of locums tenens “to hold the place of, to substitute for”, the world has drastically changed. Now organizations need to respond, and it is not just using for coverage during medical leave, vacation, while waiting for a permanent hire to start, or to help in rural locations; locums are becoming a true staple in healthcare delivery.

Locums may not ever make it to being seen as a true core alternative model to full time employment, but when used the right way, a system can drive cost containment, while focusing on meeting patient care demands as a great complimentary strategy. The old adage that using locums is just too expensive has been replaced by, yes it may not be “cheap”, but the real expense is on not delivering care to those who need it (both financially and reputationally).

Given the above, it is becoming clearer to many organizations that locums are not simply a “necessary evil” but are a complimentary and vital component to delivering care. While this is a win philosophically, it does bring more eyes to the table and therefore increase the complexities of delivery.

  1. New executives are getting involved in locums management.

With all the changes in delivery, desires of candidates for permanent roles that might only be 2-4 days per week, lower shift requirements, etc.; there are many new CXOs joining the locums conversation.

Today, CFOs are realizing that costs are high and want to drive savings, COOs are engaging service line leaders to find out why locums are in place and how this is affecting care delivery or even expansion plans, CMOs/VPMAs want to know what qualifications these candidates have. All of this is typically because the CEOs and boards are facing new challenges rarely or never before seen so need to take action. While education and knowledge sharing is vital in these discussions, the CXOs concerns are real and not going anywhere anytime soon.

With more decision makers involved, complexities and competing priorities are also increasing, which can create paralysis by analysis and cause unnecessary harm. If an organization can really peal back the onion and focus on creating an environment that reduces the noise and standardizes the processes, a clear and consistent process can then deliver patient care and meet the needs of each individual leader and the collective organization.

  1. Data is King.

We seem to now be living in a world where every day a new article comes out about how AI is going to put everyone out of work. While there of course is real value in AI and deep learning in healthcare and overall delivery, the human element is not going anywhere anytime soon. What is though abundantly clear is that process optimization and throughput as well as analytically based decision making is becoming the human capital focus of healthcare organizations today.

Whether it is a build vs buy decision or a more qualitative one, leaders are making decisions not on a “gut feeling” or “because it has always been done this way” but on data and analytics. This is a great thing when you have access to the data, but in locums in particular, the disparate processes have made it so that many times the data on spend, usage, or the financial impact downstream is buried too far down to make it actionable.

This is leading many organizations to think differently when it comes to locums. The number of requests for not only rate data, but usage, trending and forecasting are increasing exponentially and what seems to be the biggest burning topic is how to centralize it all and simplify it so teams can use this data to make a real impact daily.


With all these changes and nuances occurring, there is certainly no single answer for everyone. What is clear though is that the days of just randomly utilizing locums or getting a body in the seat from a department or individual user level are shifting rapidly to a more strategic solution design.

June 28, 2023/By Trevor Strauss, FACHE
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Author: Trevor Strauss, FACHE

Trevor Strauss serves as a Vice President for HWL and has been designing new solution design and driving go to market strategy within healthcare workforce and human capital delivery for organizations since 2008. His expertise comes from having lead deal teams from inception through implementation across the entire labor continuum from search to enterprise-wide workforce and technology solutions. His passion is helping organizations reposition themselves to create the future they desire to meet their operational and financial goals, while ensuring patient care delivery. He received his BS from Lock Haven University, MBA from East Carolina University, and is Fellow of the American College of Healthcare Executives. He is based out of Atlanta, GA and can be reached at tstrauss@hwlworks.com or 770-298-0122.
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