Integrating Locum Tenens Physicians to Solve the Rural Healthcare Talent Gap 

In rural communities across the U.S., a severe shortage of physicians creates both immediate and systemic impacts. Even as facilities navigate revenue shortfalls and scheduling nightmares, the lack of qualified specialists threatens patient outcomes and institutional stability. 

According to the Association of American Medical Colleges, the United States faces a shortage of 86,000 physicians by 2036, with deficits across diverse medical specialties. Some of the areas with the most severe shortages include cardiology, anesthesiology, radiology, neurology, and gastroenterology. For example, almost half of U.S. counties don’t have a single cardiologist, and rural areas face over 80% less access to neurologists than metropolitan regions. These gaps leave patients without critical care and force facilities to make difficult choices to maintain services.

To bridge these growing vacancies, rural hospitals and healthcare facilities can leverage locum physicians to address critical staffing needs and ensure consistent access to essential care. By integrating locum physicians strategically, facilities can stabilize services and protect patient outcomes during periods of physician scarcity.

Understanding the Impact of Specialist Shortages

The downsides of specialty medical care “deserts” are multi-dimensional and far-reaching. Patients, physicians, and administrators suffer the consequences of unfilled vacancies. 

• Diminished patient care, safety, and outcomes

A recent study from ECG Management Consultants found that wait times for new patient appointments across 11 medical specialties averaged 38 days, far exceeding the industry benchmark of 14 days. In some regions, patients wait up to 70 days for an appointment. 

If patients can’t get in to see a physician, they’ll often delay care, exacerbating the elevated health risks present in rural communities. Delayed care can lead to increased condition severity and other complications, ultimately worsening patient outcomes and experiences.

When access is limited, patients may also seek care somewhere else, such as an emergency room, urgent care setting, or competing facility. These ripple effects create volume spikes and census fluctuations, straining facility and community resources further. 

• Rising rates of physician burnout 

Addressing physician burnout is among five of the leading strategies the American Medical Association proposes to improve rural health care access. Workforce burdens—including the two hours spent on administrative tasks for every one hour face-to-face with patients—drive burnout and early retirements with the potential to disproportionately affect rural communities due to their already strained resources. 

• Decreased capacity leading to lost revenue 

When they don’t have the necessary specialists, healthcare facilities also run the risks of unmet demand and lost procedures, disrupting revenue streams. For example, if a hospital doesn’t have an anesthesiologist, operating rooms face the risk of closure and profitable surgical procedures could be canceled, severely impacting the hospital and the community it serves. 

In the time it takes to fill the highest revenue-generating roles, healthcare facilities forgo millions of dollars. Over the eight months typically needed to hire a full-time physician, facilities lose an average of: 

• $2.46 million per cardiovascular surgeon
• $2.32 million per cardiologist (invasive)
• $1.54 million per cardiologist (noninvasive)
• $2.29 million per neurosurgeon
• $2.19 million per orthopedic surgeon
• $1.98 million per gastroenterologist
• $1.91 million per hematology/oncologist

Realizing the Benefits of Locum Physicians

In addition to locum physicians delivering high quality patient care and minimizing revenue losses, other specific benefits include:

• Access to top-tier talent 

Rural facilities may lack the infrastructure or case volume to justify hiring full-time physicians in highly specialized fields. Locum physicians offer a viable alternative to better align supply and demand, delivering well-rounded and just-in-time expertise to communities in need. 

But when it comes to recruitment, hospitals in rural areas struggle to compete with their metropolitan counterparts. With so few rural-area medical school graduates, the natural pipeline starts at a disadvantage. And facilities simply can’t compete with the pay scale or advancement opportunities offered in larger markets. 

Fortunately, the flexibility of locums is mutually beneficial. Local, full-time physicians can maintain a reasonable schedule while facilities reduce on-call and overtime requirements. Locum physicians can gain well-rounded clinical experience and additional income, without compromising their preferred lifestyle. 

• Bridging gaps due to hiring delays

While the rate for a locum physician may be higher than the salary of a full-time physician, leveraging their expertise helps healthcare facilities minimize losses and maintain continuity of care while a permanent search is underway. For example, if a locum physician costs $2,500 per day but the facility is losing $5,000 per day without coverage, using that staffing model still generates $2,500 in revenue each day. 

It’s also important to remember that hiring a permanent physician involves more than their base salary. Recruitment costs—such as interview expenses, sign-on bonuses, relocation costs, and student loan repayment—can total up to $181,000. While many facilities have internal teams dedicated to permanent recruiting, rural institutions often face the added challenge of balancing immediate shift coverage with the need to thoroughly vet potential full-time hires. Partnering with an external staffing agency can ease this burden and provide access to a roster of high-quality physicians who work locum tenens for career development, extra income, and lifestyle flexibility.

The benefits of leveraging locum tenens are clear. Specialists such as cardiologists, neurologists, anesthesiologists, radiologists, gastroenterologists, and oncologists infuse vital expertise into rural communities while allowing facilities to operate more efficiently. The question is: how can healthcare facilities set locum physicians up for mutual success? 

Creating a Cohesive Care Team

Locum physicians may be temporary staff by nature, but with proper integration, their impact is permanent. An intentional and thoughtful orientation ensures a smooth transition and embeds them into the team, making a critical difference in the continuity and quality of patient care, while also sustaining a facility’s revenue during the transitional period of recruiting permanent specialists. 

Even before the assignment starts, facility administrators can take action to begin onboarding. If the facility worked with a staffing partner to secure the locum physicians, they can collaborate to organize logistics such as travel and housing. Offering assistance to get settled minimizes disruptions and serves as a precursor to a seamless transition into the unit. 

A thorough orientation program familiarizes locums with required procedures, protocols, technology, and other processes. Setting clear expectations and workflow guidelines helps ensure seamless patient care. Additionally, designating a point person to answer any questions during or after the formal orientation helps administrators anticipate and respond to  issues before they arise. 

Ensuring Clear Communication and Precise Scheduling

Clear and open communication and scheduling are critical tools to optimize staff integration. While locum physicians are accustomed to change and settling into new work environments, open communication helps them quickly learn the nuances of a particular facility and team. 

Facilities often leverage locum tenens to fill gaps and bolster float pools. While offering flexibility, these physicians provide specific services and experience, and administrators need to be clear about scheduling shifts to optimize the benefits of a blended team. For example, unified communication tools and real-time scheduling allow administrators to add locum physicians to shifts, taking all new and existing physician preferences into consideration. The whole team benefits from a single source of truth for scheduling, allowing no misunderstandings about who is working or on call at any given time. 

Locum Tenens: a Lifeline for Rural Patients and Hospitals

Locum physicians provide an essential lifeline—and a sustainable source of ROI—to rural healthcare systems facing severe shortages, particularly in specialties like cardiology, neurology, anesthesiology, radiology, gastroenterology, and oncology. With over 700 rural hospitals at risk of closure, the need for action is urgent—not only to sustain these facilities, but also to serve the most at-risk patients who rely on local care. 

By adopting locum tenens as a strategic workforce solution and ensuring comprehensive support for these physicians, rural hospitals can secure access to critical care and improve health outcomes for the 60% of Americans who call these communities home. By proactively managing costly vacancies and decreasing staff attrition from burnout, they can also realize an average of 3.2x (or 220%) return on their investment. The choice is clear: invest in locums now to preserve the future of rural healthcare.