Ten years ago, we set out to practice medicine a better way, and we called it The Locums Life. We wanted to explore, travel, and practice medicine in communities in need of high-quality care.
We wanted to be in control of our lives and practices, but we never expected this. We are in an unprecedented situation in this country with the COVID-19 pandemic, and like you, we are on the front lines of medical care in this country. To date in our current communities, we have not had any positive tests, but we are beginning to feel the strain the virus has had on all our practices and preparing for the worst. Elective surgeries are cancelled, offices have gone to telemedicine, emergency rooms brace for the impact, and hospitalists round with nervous energy.
What we are doing about it
In an attempt to clarify where we are and where we are going, The Locums Life has teamed up with Locumstory.com to clarify the current environment for locum tenens doctors and shine some light on why we think locums will prove critical for this pandemic.
As the number of positive COVID-19 cases grows, many locum tenens doctors have encountered unique situations with their practices. We have spoken to dozens of doctors currently on assignment or about to start an assignment about these concerns. We have also met with the team at CHG Healthcare, the largest locum tenens staffing agency in the country (and the owner of locumstory.com), to determine what the staffing agencies are planning for the immediate and long-term future of locum tenens practice. Essentially, we are asking the hard questions for you, on a large scale.
What we know
Here is what we know. Currently, there is a slowly rising demand for locum tenens physicians in hospitals that are short staffed at baseline and are preparing for an increased demand. In addition, those areas of the country with larger potential for outbreak are beginning to prepare for the worst with an increase in demand for pulmonology, critical care, emergency medicine, hospitalists, and infectious disease specialists. We have noted a decline in specialty care such as orthopedics, urology, and radiology. Interestingly, we have noted a decline in inpatient psychiatry, but we anticipate anxiety and burnout will eventually reverse this trend.
Of note, we have found that there is an increasing demand to meet the need for assignments that would be filled by older physicians close to retirement, mainly over 65, who are beginning to limit their commitment to locum tenens. With an average of 30% of locum tenens doctors being over the age of 60, we anticipate a huge demand for younger doctors. There has been an increase in demand for certain geographic regions, namely the California and New York markets, with many specific assignments related to COVID-19 demand.
What is developing
In good news — at least in theory — credentialing is getting easier. Although the President has verbally committed to loosening interstate credentialing obstacles, we have yet to see a formal statewide licensure agreement. We hope this happens soon and we hope physicians are then quickly allowed to pick up assignments across state lines. However, we must point out that staffing agencies are screening locum tenens doctors for risk exposure. Many are frequent travelers and have exposure to high-risk locations that may lead to a 14-day self-quarantine and delay access to locum tenens assignments. To date, no locum tenens staffing agencies are requiring negative COVID-19 testing prior to assignments that we are aware of.
What’s going virtual
We have seen the largest increase in telemedicine demand. CMS has rapidly reduced the barriers for entry and use in this space. Currently, many HIPPA laws have been relaxed and CMS is allowing Medicare and Medicaid patients previously not allowed to use telemedicine to start using these platforms. Many doctors have expressed concern about difficulty with connection, credentialing and licensing on short notice for telemedicine and we are hoping these issues are quickly eliminated.
Unfortunately, the large percent of locum doctors at the tail end of their career have had some issues with assimilation of this new technology, and we are seeing many new physicians sign up for these telemedicine assignments. We should note that this increase in telemedicine has to be in part secondary to doctors having difficulty or concerns flying to assignments. We have found an increasing demand for regional locum tenens doctors for positions closer to one’s home community. Although the national airlines have increased preparedness, we understand the concerns associated with airline travel.
How we’re keeping doctors safe
We have been asked about safety and the practical details for doctors with current assignments or future assignments and we turned to CHG for answers. According to CHG Healthcare, they have changed numerous policies to allow for quick response to the medical and practical needs of doctors on locums assignments. For one, any doctor who tests positive or is quarantined can rest assured that your accommodations and incidentals will be covered. Depending on the assignment, compensation may also be covered during the quarantine or infection period. CHG also explains that they are coordinating with the facilities and the local health agencies to ensure doctors get the appropriate medical care.
As a team, locum tenens physicians and staffing agencies can serve to respond appropriately to increasing demands to COVID-19. We are yet to see a large demand to so called “Hot Zones” but we anticipate this demand in the coming days to weeks. We encourage interested physicians to reach out for assignments in this time of need and take advantage of decreased obstacles to licensure and credentialing. We hope this ends soon and we all are safe.