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The use of locum tenens, or fee-for-time temporary physicians and nurses (commonly referred to as traveling nurses), is becoming more and more popular in our hospitals and clinics. Locums today encompass over 75 specialties including Nurse Practitioners (NP), Physician Assistants (PA), Certified Registered Nurse Anesthetists, Nurses, and Dental Specialists.
This type of work arrangement is critical to the smooth running of our healthcare system because of the widespread shortage of medical professionals at a time when the need for them is only growing. Hospitals need locums to offset physician burnout, turnover, and to stay fully staffed during peak volume times – as we saw recently during the Covid‑19 pandemic. They are essential placeholders until a permanent staff member is found.
Locums are especially needed in underserved areas such as rural communities, VA hospitals, and Health Service facilities.
Not surprisingly, such pressures are changing the way healthcare facilities are staffed and demand for locums is growing. Nearly three quarters (72%) of healthcare facilities were looking for locums in 2021, up from 47% in 2016 and 39% in 2012.1
Locum Tenens Profiles2 |
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58% of providers began working locums in mid‑career |
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45% of locum tenens providers are female |
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More than 50,000 physicians work locum tenens assignments annually |
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Locum tenens work in all 50 states |
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Over 90% of U.S. healthcare facilities use locum tenens every year |
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90% of physicians say locum tenens is as rewarding as a permanent position |
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16% of locum tenens are nurse practitioners or physician assistants |
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58% of physicians ages 55+ plan to work locum tenens after retirement |
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16% of locum tenens started as such right after training |
The supply side of the equation is changing too. There’s a growing recognition among locums – both physicians and nurses – that contract work has certain advantages. Such flexible arrangements are appealing because there is more opportunity for the medical professional to control their own schedule. Physicians and nurses can be employed for long periods and then take months off work; equally, they might be able to work fewer hours and yet achieve the same level of income.
Meanwhile, it’s recently become easier for doctors and nurses to work further afield from a licensing point of view. In 2017, a new Interstate Medical Licensure Compact was created that introduced an expedited pathway for physicians who wish to practice in multiple states.
Changing work patterns have implications for Disability Income insurance underwriters. In particular, they need to clarify the contractual arrangements of locums when looking at a proposal.
Locum tenens contracts can be written directly with a hospital or clinic, or their contract can be with a specialist employment agency that provides staff to hospitals and clinics. The contractual timeframe varies for each role, and this can make it difficult to determine insurability and the amount of earned income for disability coverage.
Generally, locums are paid as independent contractors and receive form 1099‑NEC income for tax reporting purposes. The contracts may allow lodging, travel, and mileage reimbursements. But from an earned income standpoint, it’s best to ignore the reimbursements and focus on the payment for services. Overall, locum tenens and traveling nurse proposals should be evaluated on a case-by-case basis.
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Thousands of healthcare professionals contract with locum tenens companies that provide physician staffing services to hospitals, outpatient medical centers, government and military facilities, group practices, community health centers, and correctional facilities. The industry keeps growing as more and more physicians, advanced practice providers, and psychologists choose this flexible way of practicing medicine. According to the U.S. Bureau of Labor Statistics, overall employment of dentists is projected to grow 19% by 2026,3 much faster than the average for all other occupations.4
It follows that they will all consider obtaining income protection; indeed, well underwritten insurance is crucial to making sure this shift in work patterns can continue to serve practitioners, providers – and their patients.
Don’t hesitate to contact us if you want to know more about underwriting best practices in locum tenens Disability insurance.
