Use of Locum Tenens Surgeons to Provide Surgical Care in Small Rural Hospitals

Doty, Brit; Andres, Mark; Zuckerman, Randall; Borgstrom, David C.

doi:10.1007/s00268-008-9820-5

Cited by 21 publications

(16 citation statements)

References 20 publications

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“…This may suggest that hospitals need higher flexibility in their capacity to deliver anesthesia services. Historically, this was a case even before the introduction of the ACA [2, 14]. The length of the assignment was quite long suggesting that locum tenens are not hired to cover holidays, but they fill a sustained period of higher demand.…”

Section: Discussionmentioning

confidence: 99%

Content analysis of locum tenens recruitment emails for anesthesiologists

DiMeglio

Furey

Laudański

2018

BMC Health Serv Res

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BackgroundLocum tenens continues to be an increasingly utilized employment option among healthcare organizations to cope with short-term provider vacancies. There exist no studies that explore the job characteristics of such assignments. The purpose of this study was to characterize the clinical responsibilities and compensation of anesthesiology locum tenens positions through content analysis of recruitment emails. Through this data, anesthesiologists interested in locum tenens will be better equipped to evaluate the merit of potential opportunities.MethodsThe study was conducted using a compiled database of unsolicited emails received by one of the authors. A total of 241 emails containing 794 assignments were included during the period of 1/09/17 to 1/26/18 (383 days in total). The information was extracted using a standardized template and was entered into a database. Additional validation of the content was done using a data mining tool.ResultsMost of the job opportunities originated from five staffing agencies. A total of 37, 25, and 17% of the assignments were allocated to hospitals, ambulatory surgical centers, and trauma centers respectively. The mean caseload for the assignments was between 8.5 and 11.1 cases per day. The mean daily work shift was 9.1 hours, and the average duration of the assignment was one week. The most frequently requested cases included general (74%), orthopedics (54%), and OB/GYN (51%). However, information regarding training qualifications and licensing was not routinely provided. Only 13.1% of assignments specified a system of medical documentation with paper charting being the most common. The mean hourly rate for locum anesthesiologists in our sample was $186.19, significantly higher than the national average of $127.88. Around 28% of staffing agencies covered the licensing expenses of specialists while 23% covered the expense of travels and 20% covered accommodation costs.ConclusionsDescriptions for locum tenens positions follow common anesthesiology practices and feature superior compensation to national estimates. However, vital information is often omitted from recruitment emails, and practice settings are highly variable. Anesthesiologists are urged to fully investigate opportunities before accepting based on recruitment emails. Managers should require more details to be provided in job offers.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3758-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Content analysis of locum tenens recruitment emails for anesthesiologists

DiMeglio

Furey

Laudański

2018

BMC Health Serv Res

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“…A potential explanation for this is the use of locum tenens surgeons who fill short-term service needs. A recent study found that locum tenens surgeons were hired in 15% of surveyed hospitals in small urban clusters of 2,500 to 9,999 people, small towns with high commuting to small urban clusters, small towns with low commuting, and isolated rural areas 15 . The proportion of Rural Urban Commuting Areas that meet this description is three times higher in Wisconsin, compared to Maine and South Carolina 14 .The use of locum tenens, the regionalization of healthcare across states 16,17 as well as the retirement of a large proportion of general surgeons 18,19 likely explain the proportions of surgeons with fewer than 10 procedures.…”

Section: Discussionmentioning

confidence: 99%

Specialization and the Current Practices of General Surgeons

Decker

Dodgion

Kwok

et al. 2014

Journal of the American College of Surgeons

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Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment.

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“…Today, we see a handful of pediatric surgeons practicing exclusively as a locum tenens-a financially viable practice alternative that is an increasingly popular option in general surgery [8]. Locum tenens general surgical coverage is common in rural hospitals where the surgical workforce shortage is analogous to the situation seen in pediatric surgical practices [10].…”

Section: Discussionmentioning

confidence: 99%