The gig work adventure of Britton Beatrous, MD, began with what he thought might be an attempt at humor.
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November 2024Dr. Beatrous had just finished residency and started his private practice in the New Orleans region, and his schedule had not become full. The idea of doing an out-of-the-area locum tenens job—a temporary medical position—came from his father, who had done some of this work in the early and latter parts of his career.
So he contacted a recruiter for locum tenens companies and soon got a call that, at first, threw him for a loop.
“She called me back the next day and said, ‘I have the perfect job for you,’” Dr. Beatrous said. “‘It’s in January—and it’s in Fargo, North Dakota.’ I thought she was joking.”
It turned out that the 600-bed Sanford Health Fargo system has a reputation for being a good place to work in a locum tenens position, and Dr. Beatrous said he has had a positive experience, despite a workload that is a bit like residency. Since his first frigid, week-long trip that January, he has been back twice more, and when he returns to New Orleans, his two half-full weekly schedules have been consolidated into one full-week schedule.
“I don’t think it has slowed down my practice, but it has helped me be more efficient when I do come back and have a more full schedule,” he said.
Dr. Beatrous’ experience in gig work illustrates the many-sided phenomenon of medical gig work. It frequently involves venturing to a far-off, perhaps sleepier, place, where the quality of life you will have is not always clear beforehand. The work is often tough, with more medical minutiae to tend to. And it often involves time away from family. But it allows for the experience of a new culture and scenery, boosts income, and often sharpens skills that doctors might not be able to hone as readily in their usual practice back home.
Stats on Gig Work
Gig work has generally been on the rise, fueled largely by a shortage of otolaryngologists, ENT physicians’ desire to limit demanding call work that can lead to burnout, and the need to fill the gaps while healthcare systems conduct time-consuming searches for staff vacancies.
In its 2024 report on the locum tenens industry, CHG Healthcare—the parent corporation of locum tenens companies CompHealth, Weatherby Healthcare, Global Medical Staffing, and RNnetwork—reported that 7% of physicians were working locum tenens in some capacity in 2023 (CHG Healthcare. chghealthcare.com/chg-state-of-locum-tenens-report). That amounts to 51,873 doctors, down from the peak of 68,295 physicians in locums positions in 2019, but the trend has been up each year since 2020 when 37,548 were reported to be working locums. And the 2023 figure is almost double the number from 2015 when 26,325 were working locum tenens, the Latin phrase for “hold the place of.”
No specific numbers that show how many otolaryngologists do locums work are available, but the greatest demand for locum tenens work in 2023 was reported to be in primary care, sub-specialties, and surgical specialties, followed by cardiology/pulmonology and oncology.
According to the report, 44% of physicians said their overall impression of locum tenens work was somewhat positive, while 37% said it was very positive, and 43% said they were extremely or very likely to continue working locums.
The top reason physicians reported for starting to work locums was financial, with 46% saying it was intended to supplement their income. But many report other motivations as well, with 27% saying they wanted to control their schedule, 20% saying they wanted to work while going through a personal life transition, and 13% each saying their motivation was to see the country or the world or to expand their experience through new cases, according to the CHG report.
Most healthcare organizations—88%—reported that they were concerned with the cost of locums physicians; 75% said they were concerned with the physicians’ lack of familiarity with the practice setting, and 67% were concerned with the quality of patient care. But the time to fill a surgeon job is 277 days on average, 240 days for a specialty care physician vacancy, and 180 days for a primary care physician. And the income lost if a hospital doesn’t hire a locums replacement is typically greater than the cost of a locums physician, the report said.
“The flexibility of locums in filling coverage gaps or quickly adjusting staffing levels to meet patient demand will continue to make it the go-to option for healthcare organizations,” according to the report.
Why Consider Gig Work?
Mark Royer, MD, MBA, and Allison Royer, MD, who founded the locums company ENT Surgery Solutions in 2013, said they developed a passion for locums when they saw the value in having coverage when they needed to be out of town and when their daughters were born. They say the trend for ENT physicians doing locums has been on the rise, with their clientele doubling each year since 2017; about 50 physicians now work with them in locums positions on a rotating basis. Mark, who is the medical director for the company, said it has led to better access in underserved areas, a better quality of life, and better care for patients.
[Locums] gives them a lot more flexibility to really have the career and the work-life balance they’re looking for…as the need for it has grown, the possibilities are pretty much endless.” — Mark Royer, MD, MBA