Article was published in Medical Economics by Ed Finkel

After more than a quarter of a century, internist Walter Mulchin, MD, retired in 2000 having led emergency departments in New Orleans and Bentonville, Arkansas. 

With his daughter grown and out of the house 10 years later, he returned to practice as an internist and has been working mostly in state-supported living centers in Texas, Oklahoma and Arkansas.

Mulchin is among an estimated 44,000 locum tenens physicians who are working in temporary positions for hospitals and other healthcare facilities, says Melissa Byington, president of the National Association of Locum Tenens Organizations and president of Salt Lake City-based CompHealth. 

For Mulchin, the lure is that he can work where he wants, when he wants—and to say no if he doesn’t want the assignment. He prefers jobs that last a couple of months so he can take time off and return to his wife, Sandra, in Arkansas, although sometimes she travels with him.

“The biggest fun I have is that I don’t have to do it 100% of the time,” he says. “If you don’t like something, you can always refuse in the future.”

The estimate of 44,000 locum tenens physician dates to 2014 and is up from 26,000 in 2002, according to an annual survey conducted by Staff Care, a locum tenens agency, which estimates the number “based on the number of locum tenens physicians who work through us and our knowledge of the temporary physician staffing industry.”

The dramatic increase has come about partly because doctors appreciate the autonomy that comes from not being tied to a specific position, and the internal politics and administrative responsibilities that often comes with it, Byington says. The desire for autonomy has increased as a result of  the Affordable Care Act (ACA) and the growing number of mergers and acquisitions of healthcare practices, she adds.

“Physicians have gone from being their own boss to becoming employees of a health system,” Byington says. She also cites a
CompHealth study of physicians conducted earlier this year showing that more than 40% of physicians are taking secondary jobs such as locum tenens to help combat declining incomes, maintain their lifestyles and pay off debt. 

The 2015 Staff Care survey shows that 91% of hospitals use locum tenens, up from 73.6% in 2012, and that 36% of  respondents worked at hospitals, 17% at medical groups and 12% at Federally Qualified Health Centers.

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