Rising number of temporary doctors

By Sarah Morgan

NEW YORK—Dr. James K. Sheffield was looking for a way to make a career transition. After working as a neurologist in Seattle for six years, he decided to go into the administrative side of medicine. So, while studying for his MBA in Houston, Sheffield signed up with a temp agency to see himself through the transition period. The agency set him up with a couple of weeklong assignments in a hospital.

He loved being able to set a limit on the number of hours he would work—not like private practice, which is like running a small business. And, because of his experience, Sheffield provided some special skills in treating conditions hospital neurologists don’t see as often.

“I was kind of in the catbird seat,” he said in a recent interview. “They really needed someone, and they saw me as someone who was there to help.”

The idea of a doctor working through a temp agency may sound bizarre, but it’s fairly common, and getting more so. Hospitals or medical practices have long used temp doctors to fill in for physicians who are sick or on vacation. For doctors looking to avoid administrative hassles, working as a temp, or locum tenens, can be an appealing option.

But some say the growing use of temporary doctors is an early sign of a more troubling trend: a shortage of primary-care physicians. Primary-care doctors—a category that includes family care, internal medicine, pediatric and geriatric doctors—are most in demand as temps, and this need is expected to grow as the population ages.

The use of temp doctors by hospitals and medical groups is growing, according to a recent survey conducted by Staff Care, an agency that places doctors in temporary positions. According to the survey, spending on temp doctors nationwide has more than doubled since 2001, and the number of days worked by physicians on a temporary basis has grown by 20 percent from 2006 to 2007.

For doctors, working as a temp can be a way to escape some of the more tedious aspects of medical practice. A doctor can simply tell the agency in what state or what type of practice he or she wants to work, and the agency takes care of the rest: finding a placement; making sure the doctor is properly licensed in that state; arranging and paying for travel; finding accommodations in a hotel, apartment or house; and orienting the doctor to the hospital or medical group where they’ll be practicing. The agency also covers the doctor’s malpractice insurance. A placement can be anywhere from a few days to a few months.

“It sort of gets you off the treadmill of medical practice,” said Phil Miller, spokesman for Staff Care. “You’re basically focusing on the patients.”

Many doctors who work this way are older and moving into semiretirement, but it can also be a way for younger doctors to try out working in different states or different types of practices.

Dr. Paul Hoehner, an anesthesiologist in Virginia who worked as a temp for about five years while going back to school for a PhD, enjoyed the experience so much that he now tells young residents to try it out before settling into a practice.

“This is a phenomenal way to really learn a practice,” he said. “I don’t think I would join a practice without negotiating with them that I would work with them for a set amount of time as a locums first.”

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