Locums CME #41 | New Locum Providers Plan to Continue Temp Work, Simplifying State Licensing, Surgical PAs Raking it In, Locums for Neurologists & More

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Welcome to Locums CME 41, Locumpedia’s bi-weekly roundup of news designed to help physicians and APPs maximize the locum lifestyle.
 

Our lead story: A recent Barton Associates survey found that 64% of providers who adopted locum tenens work in response to the pandemic will continue working temporary assignments. 

Overall, 24% of physicians and 39% of nurse practitioners reported that the pandemic prompted them to pursue locum opportunities. Despite varying motivations across specialties, most respondents agreed they chose locum work for flexibility and increased autonomy.

Also in CME 41: Locumstory offers tips to simplify licensure; locum tenens surgical PAs say they can earn 40% more than perm PAs; most rural communities lack access to a neurologist; how hospital M&As could harm patient care quality; new compensation stats that have physicians optimistic about the future, and more.

Continue your locums education with Locums CME 41 below.

In CME 41:

The Pandemic Led Many Providers to Try Locums, and Most of Those Plan to Continue

September 17, 2024 | Barton Associates

Out of nearly 400 locum tenens providers surveyed, 33% said the pandemic influenced their decision to take on locum work. Of those, about 55% cited geographic flexibility as their main motivator. Most plan to continue in locum roles, including 64% of those who started during the pandemic and are still interested in working locums today.

The number of nurse practitioners was above the overall average, with 39% saying that the pandemic directly influenced their decision to try locums. Most (62%) said their reason was location flexibility, and 70% planned to continue working locums. 

Physicians were less likely to attribute their career change to the pandemic, with only 24% saying it encouraged them to consider locum tenens. Location flexibility remained the top reason, although less (43%). Just as many physicians reported choosing locums due to the ability to control their assignments and schedules. Most said they wanted to continue working locums (58%).

While healthcare professionals’ motivations for pursuing locum tenens assignments varied during the pandemic, the overarching theme was a greater desire for flexibility and autonomy. Providers’ continued enthusiasm for locums opportunities suggests an ongoing refocus on work-life balance. 

Your Locums Prescription

Key Steps to Simplify the State Licensure Process

September 18, 2024 | Locumstory

Obtaining additional licensure for each state in which you want to work as a locum tenens provider can feel complex and overwhelming. But if you prepare, start the process early (at least 90 days before an assignment begins), and add a time cushion for any unforeseen delays, it is doable. 

To streamline the licensure process, it’s essential to scan and file all necessary documents, including transcripts, certificates, and records of any past disciplinary actions, in a single, easy-to-access electronic location. Keeping these files organized will help ensure a smooth application process. Additionally, updating your resume with accurate dates and locations of your work history is crucial for a seamless experience.

Registering with the Federation Credentials Verification Service (FCVS) can also be a valuable step. The FCVS maintains a shareable repository of verification documents, making it easier to manage the credentialing process across states. While 14 states require FCVS, all state medical boards recognize it for primary source verification, making it a particularly helpful resource for locum tenens providers.

If you hold a license in a state that participates in the Interstate Medical Licensure Compact (IMLC), it’s worth checking whether you’re eligible to benefit from its expedited licensing process. The IMLC facilitates faster information-sharing between states, which can significantly reduce the time needed to obtain additional licenses.

Lastly, consider asking your locum tenens agency if they cover any of the costs associated with licensure, such as fees for state licenses, FCVS applications, DEA registrations, Controlled Substance Registrations, and additional expenses like fingerprinting.

Once you have your additional licenses and registrations, record when they’re due for renewal—this will make the next round of applications even more manageable.

Surgical Physician Assistants Enjoy a Variety of Benefits with Locums

September 9, 2024 | CompHealth

With an increasing demand for surgical services across the country and particularly in underserved communities, locums positions offer surgical physician assistants (PAs) a chance to enjoy greater flexibility and a variety of experiences while often earning higher pay than permanent roles.

As locum surgical PAs, you have the freedom to set your own schedule, taking as much time off between assignments as you like. Plus, you get to choose where you work, so you can pick a location that aligns with your interests or hobbies. On top of that, locum surgical PAs can choose which communities to serve. Supporting underserved groups or communities they feel connected with can make the work even more rewarding.

Some locum surgical PAs say they earn 25% to 40% more than they would in a permanent role. Housing is usually included too. Plus, with many assignments paying by the hour, longer days mean more pay, so those extra hours really add up.

Locums work stands out as an appealing option for those surgical PAs seeking both professional growth and meaningful contributions to patient care.

Unlocking Growth: How Locum Tenens Opportunities Enhance Neurologists’ Careers and Patient Care

September 12, 2024 | Caliber Healthcare Solutions

Neurologists can find professional and personal growth by working locums. Beyond the benefits available to all locums—such as controlling their schedule, including where and when they work, and often earning more than in permanent roles—here are opportunities that may not be immediately considered: 

  • There is often a greater need for locums neurologists in underserved communities; for example, only 21% of rural residents with a neurological condition have access to a nearby specialist.
  • Locums neurologists often see patients with a broad spectrum of neurological conditions, providing additional experience and opportunities to expand their skill set.
  • Locums neurologists usually work alone, leading patient care in many cases rather than having another neurologist on staff.
  • Neurologists working locums can have the opportunity to leverage advancements in telemedicine to serve a wider community.

Neurologists need to consider each assignment thoughtfully since they often take the lead on client cases, and must be upfront about expectations and boundaries. Because locums neurologists treat critical cases yet are temporary team members, they should work with their facility and locums agency to maintain clear communication about continuity of care.

Physician Wellness Retreat

Navigating Challenges: How Hospital Consolidation Affects Physician Satisfaction and What to Do About It

September 18, 2024 | TechTarget

Hospital consolidation is becoming increasingly common, and this trend poses significant challenges for physicians. A recent nationwide survey reveals that many physicians feel consolidation undermines their ability to deliver quality care, exacerbating their burnout and dissatisfaction. As mergers and acquisitions reshape the practice environment, understanding the impact on medical professionals and listening to their ideas for improvement is crucial for fostering a healthier healthcare system.

Over a third (36%) said mergers and acquisitions harmed the quality of patient care, 35% said they impeded their independent medical judgment, and 30% said they negatively affected patient healthcare costs. All this led to half of physicians reporting job dissatisfaction.

There was resounding agreement from responding physicians on ways facilities could support them during and after consolidation:

  • Continued physician autonomy (90%)
  • Maintained patient standards (87%)
  • Increased transparency and disclosure (86%)
  • Ongoing assessment of the long-term effects of the consolidation (84%)

Addressing these issues thoughtfully during mergers and acquisitions will be essential for retaining talent in an increasingly challenging environment, ultimately paving the way for a more sustainable and effective healthcare system.

Doctors Call for a Cultural Shift Around Physician Mental Health

September 16, 2024 | AMA

In a recent PermanenteDocs Chat podcast episode, two doctors shared what they believe would be a game-changer in fighting physician burnout: removing stigmas around physician mental health. 

Research shows that as many as 40% of physicians are reluctant to seek mental health support because they fear being looked down upon at work or facing repercussions that affect their licensure. Yet doctors have higher rates of depression and suicide than the general population. 

Willie Underwood III, MD, MSc, MPH, the immediate past chair of the AMA Board of Trustees, and Alex McDonald, MD, a family and sports medicine physician, discussed how problematic it is for licensure applications to ask for comprehensive information about physician mental health. They also shared that the workplace culture too often views physicians as weak if they ask for support. 

They also discussed improvements in culture:

  • The Joint Commission, the Federation of State Medical Boards, and many national organizations no longer require physicians provide their mental health history. 
  • More than half of state medical boards’ licensing applications and a growing number of health systems no longer ask invasive medical history questions. 
  • The AMA offers tools that support physician self-care and facilities redesigning workplace environments.
  • The AMA Joy in Medicine Health System Recognition Program honors organizations that reduce the drivers of burnout at the system level.

As discussions around mental health for physicians gain momentum, the focus must remain on creating safe spaces where seeking help is normalized rather than stigmatized. 

Strategies to Reduce Administrative Burden on Physicians

September 12, 202 | Advisory Board

In a survey conducted by the AMA, physicians were asked to consider the time they spent on administrative tasks outside of their regular work hours. About 20% reported that documentation added significant hours to their already packed schedules. 

Combining administrative tasks with patient care, those in hospital medicine worked an average of 67 hours per week, internal medicine physicians clocked 60 hours, and OB/GYN physicians averaged 59 hours. No specialty reported working less than 53 hours per week.

To help reduce the individual administrative burden, here are a few strategies to consider.

  • Seek help with documentation. Some facilities have begun training medical assistants to be notetakers.
  • Ask your facility leadership about new expectations around documentation and time-based billing.
  • Use AI to draft and edit visit notes and patient messages, when approved by your facility.
  • Team up with colleagues to jointly manage inboxes and share best practices around EHRs.

By fostering an environment that prioritizes patient care and physician well-being, healthcare organizations can improve job satisfaction and ultimately enhance the quality of care delivered. Recognizing the invaluable contributions of physicians and actively working to minimize their administrative load is vital for a healthier, more efficient healthcare system.

Cultivating Connections to Combat Physician Burnout

September 8, 2024 | KevinMD.com

Physician burnout (feeling stressed and overwhelmed) and rust-out (feeling disengaged) are often driven by familiar challenges: workforce shortages, poor communication between leadership and physicians, and heavy administrative burdens. To address these issues, healthcare systems are focusing on long-term strategies that improve workforce support, boost recruitment and retention, and create a workplace culture that prioritizes well-being.

At the core of these efforts is the need to foster strong, meaningful relationships—not just between providers and their patients but also among colleagues. Working together to tackle shared challenges promotes lasting, sustainable change, while compassionate connections bring a sense of purpose and meaning to the work.

Addressing physician burnout requires more than just recognizing the symptoms; it necessitates a cultural shift within healthcare organizations that values connection and collaboration. Ultimately, by embedding these values into the fabric of healthcare, organizations can create a healthier and more sustainable future.

Doctor’s Notes

Telemedicine Trends: Examining Gender, Age, and Geographic Differences in Physicians’ Virtual Care Usage

September 17, 2024 | Medical Economics

A recently published study of telehealth usage found stark distinctions based on physician and practice characteristics.

Among the findings:

  • Female doctors had a larger percentage of telehealth claims across evaluation and management claims, compared with male physicians overall (9% versus 6%); in primary care (9% versus 6%); in psychiatry (49% versus 45%); and in neurology (16% versus 12%).
  • Male doctors outpaced their female colleagues only in the percentage of overall usage of National Provider Identifiers with at least one telehealth claim, 65% versus 43%.
  • Doctors aged 40 to 59 years were the most likely to offer telemedicine services, compared with both younger and older physicians.
  • Doctors of all specialties in urban areas used virtual options more than their colleagues in rural areas.

From this data, the study authors drew several conclusions, including:

  • Female physicians may have greater responsibilities outside of work, leading them to prioritize location flexibilities.
  • Virtual options for behavioral healthcare are not inferior to in-person care, which could expand patient access and outcomes.
  • There needs to be a better understanding of how access could be expanded in rural areas, especially since they often face acute workforce shortages.

Recent Physician Compensation Figures Show Growth

September 12, 2024 | Becker’s ASC Review

A recent set of findings from across the healthcare landscape highlights several reasons for physician optimism, particularly when it comes to compensation trends. 

One standout pattern in the data shows increased earnings and financial security among physicians. Here are a few stats that have physicians feeling optimistic about their future:

  • Approximately 60% of physicians reported a net worth of $1 million in 2024. Even with medical school loans, six in 10 physicians in the US have a net worth that exceeds that of the average family. 
  • Four specialties saw an increase in gross income between 2022 and 2023:
    • Internal medicine: $270,000, up from $253,000
    • Family medicine: $265,000, up from $245,000
    • Pediatrics: $235,000, up from $216,500
    • Obstetrics and gynecology: $290,000, up from 285,500
  • Physicians owning a private practice generally earn more than those who work for a health system; for example, physician owners earned $295,000 in 2023 and nonowners earned $283,000.

Time Sink: Physicians Spend a Disproportionate Amount of Time on EHR Work Compared to Patient Care

September 11, 2024 | AMA

Physicians of all specialties report spending significant time on EHR-based work including documentation, chart review, orders, and inbox management. A study of the EHR activity of more than 200,000 doctors estimates that the number is nearly six hours in the EHR for every eight hours spent on patient care. Across all physicians, over a fifth of these hours were spent outside of the regular workday. 

The report found some specialties feel this administrative burden more than others. For every eight hours of patient time, specialty physicians spent the following hours in their EHR:

  • Infectious disease—8.4
  • Endocrinology—7.7
  • Nephrology—7.5
  • Primary care (family and internal medicine)—7.3
  • Hematology—7.2

Several strategies can be implemented to reduce the time physicians spend on EHRs. One solution is to delegate tasks such as order entry and responding to inbox messages to other care team members. Additionally, physicians and healthcare leaders can explore policy changes, like those found in the AMA STEPS Forward “Taming the EHR Playbook,” to improve system efficiency. Vendors and health systems also play a role by streamlining EHR processes, reducing the number of clicks and screen changes required for each task. The excessive time spent on EHRs, compared to direct patient care, highlights a growing concern in a healthcare system that increasingly depends on digital tools. Tackling these issues is crucial to improving physician satisfaction and patient care outcomes.

Physicians Use Collective Action to Help Make Their Voices Heard

September 6, 2024 | Medscape

In 2022, at least 70,000 physicians (8% of all physicians) were union members. Those numbers have grown in 2024, as nine residency programs formed unions. 

Drivers for unionizing include physicians’ desire for greater autonomy over how much time they spend with patients and wishing to reduce burnout, especially over administrative burdens. Feeling that their voice is increasingly silenced at work, unionizing physicians hope that speaking with a collective voice will amplify their requests regarding patient care, workplace safety, working hours, and benefits. They see unions as returning some of their power and allowing them to help fix challenges in the healthcare industry. 

However, forming a union can be time-consuming and difficult. Unionization laws differ by state and facility type (public versus private). Plus, doctors are used to working alone and not as a collective. While many physicians tout the benefits of union membership, physicians have not historically unionized. This leaves a gap in experience and understanding among both physicians and hospital management, and interested doctors do not have an easy automatic path toward unionization. There can be misperceptions about unions among both physicians and leadership, including that physicians only join unions to make more money, that unions exist only to argue against management, and that unions may work at cross purposes for physician goals.

As more residency programs form unions and the call for collective advocacy gains traction, it is clear that physicians are striving for greater autonomy and a more significant role in shaping their work environments. Comprehensive data collection and education about union dynamics will be crucial to support these efforts. Empowering physicians with the necessary knowledge and resources can facilitate more informed discussions around unionization and ultimately lead to a more balanced and equitable healthcare system.

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