Healthcare organizations frequently face a critical staffing decision: should they hire permanent physicians or rely on locum tenens (temporary) physicians? Both options have unique advantages and limitations. Understanding the pros and cons of each allows hospitals to make strategic decisions that balance cost, flexibility, and quality of care.

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1. Locum Tenens Physicians

Pros:

• Rapid Deployment: Fill urgent vacancies or specialty gaps quickly.
• Flexibility: Scale staffing up or down according to patient volumes or seasonal demand.
• Specialty Coverage: Access hard-to-find specialties without long-term commitments.
• Burnout Reduction: Relieves workload pressure on permanent staff during peak periods.
• Trial for Permanent Hiring: Assess fit and performance before extending a long-term offer.

Cons:

• Higher Short-Term Costs: Hourly rates can exceed the prorated cost of permanent staff.
• Limited Continuity: Frequent rotations may disrupt patient-provider relationships.
• Onboarding Effort: Temporary staff still require orientation to EMR systems, hospital policies, and workflows.
• Potential Cultural Fit Challenges: Less integration into hospital culture compared to permanent staff.

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2. Permanent Physicians

Pros:

• Continuity of Care: Builds long-term relationships with patients and the care team.
• Organizational Knowledge: Familiar with hospital culture, policies, and workflows.
• Leadership and Mentorship: Can take on supervisory roles and train junior staff.
• Long-Term Cost Efficiency: Lower per-hour cost compared to repeated temporary coverage.

Cons:

• Longer Recruitment Process: Finding the right permanent physician can take months.
• Less Flexibility: Permanent contracts reduce the ability to adjust staffing levels quickly.
• Risk of Turnover: Early departures can be costly and disruptive.
• Upfront Costs: Recruitment, onboarding, and benefits increase initial investment.

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3. Strategic Considerations

Hospitals should evaluate:

• Patient Volume Fluctuations: Locum tenens may be preferable for seasonal surges.
• Specialty Gaps: Temporary physicians can cover high-demand specialties quickly.
• Operational Budget: Balance short-term cost of locum tenens against long-term investments in permanent hires.
• Retention and Culture: Permanent hires support continuity, mentorship, and organizational cohesion.

Insight: Many hospitals adopt a hybrid model, combining permanent and locum physicians to maximize flexibility, reduce burnout, and maintain high-quality patient care.

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Final Thoughts

Both locum tenens and permanent physicians play essential roles in modern healthcare staffing. Locum tenens offer flexibility, rapid coverage, and specialty expertise, while permanent physicians provide stability, continuity, and long-term organizational value. By understanding the trade-offs and strategically combining both approaches, hospitals can ensure operational efficiency, quality care, and workforce resilience.