Though hospitalist programs have long relied heavily on locums and continue to do so, increasing controversy surrounds the practice according to this article in Today's Hospitalist. Staffing company and hospitalist program leaders interviewed for the article say the difficult issues are the high cost of hiring locum doctors, instability of group culture and perceived quality problems. Quality issues are not necessarily inherent in the locum doctor, as many excellent hospitalists see locum work as an opportunity for flexibility and better compensation. But even great locum docs may look inferior on various metrics (artificial quality surrogates) because they lack a sense of group ownership and are not under institutional performance incentives. Part of the appeal of locum tenens work may be a sense of freedom from performance pressure.
If hospitalist groups intend to rely less on staffing companies as some leaders claim the trade off is to look to other sources of temporary help such as within-the-group moonlighting. No matter how you slice it staffing shortages remain critical and there's no sign of relief, making me wonder if last year's downtick in hospitalist compensation was an anomaly.