Why More Physicians are Choosing Locum Tenens with Jeff Decker | Ep. 18 | Full Episode

Hi Carrie, thank you very much. It's a pleasure to be here today. Looking forward to talking with you.

Yeah, it's a great question, Carrie. So let me first say that we take a survey, and we do this on an annual basis. And what we look at is, in the context of what are today's healthcare trends, we surveyed physicians and APs who work on a locum tenens basis during a time when many of our healthcare professionals are reexamining how and where they work. This includes physicians and APs. If you think about it, these providers were ground zero of COVID-19 when the world changed. The stress and trauma that they experienced caused many to make other decisions about where they wanted to work, how they wanted to work. Many decided to retire, many changed jobs entirely, and certainly decided on how they wanted to practice forward. One of those options out of this time was to step back a bit from some of the permanent roles they were in and try to look at how they could practice differently. Locum tenens became an opportunity for them. So much so that you ended up with about 60,000 of our physicians that now work locum tenens annually today, and that's more than double what it was 10 to 15 years ago. So the main reason that they are turning to locum tenens is because they're looking for a different type of work experience and a better work experience overall.

I think what makes it better is the flexibility that it offers. So if you think about 97% of the physicians and advanced practice providers that were surveyed, they really did talk about physician freedom and flexibility as the most rewarding aspects of working locum tenens. And if you think about how they can work, they could even be augmenting their current experience by working locums if that's what they choose to do, which means they can hold down a full-time physician or AP position, but they can also augment their income with locums. Some decide that they don't want to get out of practice, but they want to pull back substantially, so they can make choices. They can work two days a month, they can work so many days a year, they can work full-time locum opportunity if that's what they choose to do. So I think it's the flexibility of schedules that allow them to live a professional life that they want to stay intact with, but it also allows them on the personal side to make other options and really enhance their personal lives as well.

Well, physicians and AP providers got into the practice because of one thing: they really wanted to care for patients. That was their primary attraction. And what you find is that once you get into it, the administrative duties and responsibilities, reimbursement challenges, all of those things come into play. 86% of those surveyed said that the reduction in bureaucracy and paperwork was the most important deciding factor for them to work locum tenens. So you think about medical practice today and the huge commitment of the physician's time to non-clinical paperwork. Locum tenens provides those providers the ability to focus much more on patient care and less on those administrative sides of the medical practice. They can do what they were trained to do in the first place and do what they wanted to do, which is to see and take care of patients.

So think about what physicians and AP providers went through during COVID. The amount of time, the patient loads were enormous, the stress on physicians enormous. It took a toll. Even if you look at what Harvard School of Public Health identified back in 2019, before the pandemic, they were talking about how physician burnout had really become a public health crisis, and it only got worse as COVID continued. So 80% of those that we surveyed said that addressing feelings of burnout was one of the reasons that they chose to work locum tenens. So locum tenens is keeping physicians in the workplace longer, in the workforce longer, that might have otherwise burned out and retired. So the fact that they can work locum tenens is helpful, but again, it's not the answer to all the problems that we have with physician burnout.

I think it depends on the facility and the system. But what we do find is that physicians and APs that we surveyed, they would go back to a permanent position if conditions were such that they could have a more flexible schedule. So remember what we said at the top of the call, that was around feeling of needing flexibility, that they wanted to have more balance in their lives. Coming through COVID, where so much was put on them to attend to a very difficult situation, now you find that if healthcare systems and those that are allowing more freedom and more flexibility, that are certainly even looking from a compensation standpoint and other conditions to be more favorable, they would continue working in those permanent roles. They just need to see an improvement in their daily work experience. So as we think about improvement that can take place, reducing some of the bureaucracy and letting physicians be physicians, that's part of it. But the other part is to make sure that we've got a very good mix, so retaining physicians, retaining advanced practice professionals, having nurses and other healthcare workers where you've got the right complement to make sure that the ongoing challenge that is causing some of the burnout for these physicians and AP professionals, we need to make sure that they have a very good work experience, and that will certainly help keep physicians in practice longer.

Well, you're right. The earlier adoption of locum tenens is really coming about because you've got people graduating from programs that are increasingly valuing that flexibility and diverse work experience right from the start of their careers. It used to be that healthcare systems and certain facilities required that you have at least two years of experience before you could work and consider working locum tenens. Things have changed given where the shortages are. To meet their growing demand, we're finding that education is getting out to would-be physicians and AP providers, so they're learning about locum tenens sooner than they did, and there's just much more education around it. We also find that technology is allowing firms like AMN to be able to reach candidates much, much faster. So with that growing demand, understanding the shortage is becoming more acute, and there's all of the competition that we have for physicians and advanced practice providers. We know that it's essential that we get to those candidates sooner, faster, make sure that they are well educated, and then we also put systems in place by which we can have greater outreach, if you will, to make sure that they are learning of opportunities faster and that they can engage with us in a meaningful way. So I just think that there is much more value placed on the opportunities that exist in locum tenens for new graduates.

There are lots of things that are changing and advancements that are being made, Carrie. When we think about our very own vendor management system, or you'll hear it referred to as VMS out in the marketplace, where there's an integrated management solution, for example, when you have a VMS technology, it really streamlines orders, it allows for a different type of approach to staffing, it really does help health systems with their compliance, and it really makes that order-to-fill process easier and more efficient for the health system. Our VMS platform, for example, it activates multiple sourcing channels, including internal float pools, for example, or direct hire aggregation, staffing agency management, where you've got how many contracts does a healthcare system have to manage through that have very different components. So being able to manage those contracts and independent contractors, it really does help health systems get their arms wrapped around that most expensive part of their P&L, which is really on labor. So it helps speed up the recruitment process, helps reduce cost, and in terms of positions and AP, it drives revenue faster. So vendor management systems allow you to take a look more holistically at your workforce and how to manage that to a more efficient and more cost-effective operating model.

Well, look at how AI is certainly, we're hearing so much about it, and it's going to continue to evolve. And we think about how exciting it is, especially with some of those more manual pieces of what it is to find candidates. It starts with a sourcing process that you go through through a database, and you're trying to match candidates to job opportunities, their skill sets, there's credentialing, there are licenses, there's so many things involved in finding a candidate that is suitable for a particular opening. And what AI and some of the technology like a text kernel, for example, which we utilize, it allows us on the front end to much more quickly, the system can generate a list of candidates by skill set, credentials, location, where they want to work, type of environment. It really does aggregate those very, very quickly, much more quickly than we could have done manually before, so that we can actually get a list of suitable candidates in front of a healthcare system much faster than we ever could before. And then it's also helping us curate that list down to where we have our recruiters who have the ability then, with the information provided, to make the best connection for that healthcare facility. And in some cases, Carrie, if you think about even advanced technology like our Passport, it actually does that work, which is sourcing and matching, and then it can also submit that candidate immediately to a client. So think about the speed at which this can happen now. Prior, it might take days, weeks, lengthy periods of time for us to make those matches, and now it is done exponentially faster, really putting a provider in front of a decision maker very, very quickly.

You know, there's so much happening, Carrie, and it's an exciting place to be. When you look at the advancements of technology and how it's really allowing us to make those more proper fits faster, that's important. And I think around that, it also just helps our health systems to be smarter. So when we think about the work that we're doing currently, where we're trying to make sure we have the best possible experience for a provider to get matched to a job more quickly, also making sure that our clients have a much better experience with what it looks like not to be inundated with so much that's coming at them from a lot of directions, but really seeing those candidates that are the best fit, have schedules that can support, by the time our customers are looking for providers, they typically have already stretched their internal staff beyond where they would like to be stretching them. They've looked at their internal float pools, and then they're having to reach out. Well, there can be a gap in revenue between all of that when they finally decide to bring in a locums. Those that can provide that locum tenens faster is going to support getting that system, that healthcare facility, what it needs, which is really someone in place to drive not only revenue but of course to serve the needs of their community and their patients. So I think it's an exciting time. It's evolving, and it's a wonderful time to be where we are and how we can help our health systems do exactly that: the hard work of finding people to put in place quickly to address their constituents' needs.

Thank you, Carrie. A pleasure to be here. Thank you.