Author: Ashley Simpson, President, IMN Enterprises

Rural healthcare is in a crisis – personnel shortages and hospital closures are burdening overworked professionals and leaving patients in need of care. This infographic lays out the many challenges, notably that 80% of rural America is medically underserved and only 10% of U.S. physicians practice in rural areas, despite these communities representing nearly 20% of the population.

There’s a strategy that hospitals, clinics, and private practices are increasingly using to address these healthcare barriers. By employing trained and licensed locum tenens (locums) – temporary physicians and advanced practitioners – a facility can fill-in coverage gaps and continue delivering quality care to its patients. Locums are also being hired to service off-site facilities such as schools, nursing homes, large job sites, and prisons so that permanent staff isn’t further reduced to cover these needs.

Recognizing the High Cost of Provider Shortages

Without adequate physician coverage, healthcare facilities suffer. For example, without a surgeon or anesthesia provider, surgery comes to a standstill – putting patients at risk and forcing them to seek care from a competitor. When facilities lack certain specialists such as cardiologists or gastroenterologists, patients often move to a practice or system that offers doctors in all their areas of need. 

Over time, these provider shortages damage a facility’s reputation and its bottom line. A Chartis study found that 43% of America’s rural hospitals have negative operating margins, making them highly vulnerable for closure. Not only is this devastating to patients and the medical staff, but hospitals are large employers with job opportunities in a range of positions. These losses impact the wider community and its overall economic health.

Understanding the Cost Benefits of Locums

Locums can help overcome these shortages, but healthcare leaders are often apprehensive because they misunderstand the cost implications. Instead of being a financial burden, locums are a smart investment. They reduce coverage gaps to help deliver quality care to patients, keep surgery suites operating, mitigate turnover, decrease staff burnout, and support the facility during peak seasons – all of which contribute to generating revenue. Locums are also a fixed cost with a pre-determined hourly rate, an agreed upon daily schedule, and definitive start and end dates.

Locums actually provide a cost savings in a number of ways. Because they’re temporary, they allow facilities to selectively employ only when needed, they can be ready to work much more quickly than hiring full-time staff, they’re already trained and often bring fresh perspectives, and facilities can cherry pick specific specialties based on current needs. Plus, locums don’t incur expenses related to benefits, unemployment, or paid time off.

Selling the Benefits of the Rural Lifestyle

Rural facilities struggle with recruiting providers because they lack the resources and contacts to reach larger markets. This is where an outside agency can help, not only by accessing a nationwide talent pool but knowing how to attract providers to the opportunity. Here are two approaches:

1. Locums are often experienced physicians and advanced practitioners who are looking for a more flexible schedule and less hectic pace. They appreciate experiencing different communities and pursuing new interests. They also enjoy focusing on patient care without the stress of running a business. Being a locum checks off many of their wish-list boxes.

When recruiting for these positions it’s important to not only focus on the benefits of working as locums, but what a temporary assignment in a rural community has to offer. This can include the hospitality and respect from the community, the opportunity to explore a new environment, and access to the different leisure activities available in each location.

2. Another opportunity to recruit locums is by reaching out to residency programs across the country. The average resident is fielding over a hundred job offers, many from large hospitals or practices in busy metro centers. But a temporary assignment in a rural location presents unique benefits to new graduates, such as:

A premium rate with all expenses paid, which can help them pay off student loans faster or save for their future.

• The ability to experience different practice models and settings. This can help them determine what facility type they like best when they are ready to settle into a longer-term position.

• The opportunity to learn from different professionals, helping to sharpen their skills and build confidence.

• A chance for the provider to "try out" a facility before committing to a full-time position.

Providing a Seamless Transition

Regardless of the length of the assignment, it’s important to have a strong onboarding strategy that introduces the locum to the practice and the permanent staff. It helps for a manager or administrator to reach out in advance to provide an overview of the facility, including staff and equipment availability, and explain the expectations for scheduling, treatment planning, and office procedures.

In small communities, patients and providers may cross paths outside of the healthcare setting and have more personal and less transactional relationships than larger hospitals and offices. To put them at ease, be sure to communicate that although the locum is temporarily serving the community, they are equally as qualified, if not more so, as the permanent staff. And, assure them that there will be continuity of care with all of their treatment plans and charting information being shared with the locum.

Expanding Telehealth Services

According to a recent study, 73% of rural respondents reported using telehealth for everything from prescription refills and minor illness, to mental healthcare and emergencies. As these services become more popular, creative staffing solutions can help organizations address the changing needs and volume of virtual patients. Locum physicians and advanced practitioners are vital to addressing these demands and can also be used to help get new programs running, fill gaps in schedules, and expand office hours for working patients.

A program that has significantly improved the ability to provide telehealth services is the Interstate Medical Licensure Compact, which streamlines the licensing process for physicians who want to practice in multiple states. For locums that still want flexibility but don’t want to keep relocating, it allows them to provide temporary telehealth services in other states from their primary residence. Beyond telehealth, the Compact gives all eligible physicians the ability to complete just one application, yet still receive separate licenses from each state in which they intend to practice. Currently 40 states are participating and more are in process – ultimately this will greatly expedite physician mobility.

Transforming Communities with Access to Healthcare

Access to robust healthcare facilities and services are vital to rural communities – not only providing much-needed patient care but broader benefits that touch on employment opportunities, economic development, and educational programs. Recruiting more locums can help a facility address the staffing shortages negatively impacting its ability to fully serve patients, remain profitable, avoid closure, and thrive as an essential resource in small towns across the country. 

Author Bio

Ashley Simpson, President, IMN Enterprises has been in the healthcare industry for over 14 years. She began her career with ICON Medical Network as one of the founders. After the acquisition of ICON by IMN CEO, Janet Elkin, Ashley remained with the company and was appointed president in February 2024. Ashley is pioneering new lines of business and growing a world-class team across IMN’s family of staffing agencies, including ICON, Independence Anesthesia Services, and MedAdventures.

Originally published in Healthcare Business Today

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