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    Chris Harrop
    Chris Harrop

    In the budgetary battle between reining in expenses and spending more to ensure adequate clinical talent, it appears most medical groups are declaring a draw.

    A Jan. 30, 2024, MGMA Stat poll of medical group leaders asked how their organizations’ use of contract and locum tenens work would change in 2024 versus 2023. A solid majority (60%) reported these levels will stay the same, while about one in four (24%) said they will spend less this year. About 16% of respondents noted they will spend more on contract and locums workers than in 2023.

    The poll had 299 applicable responses.

    These results signal only a slight shift from those of a Feb. 14, 2023, MGMA Stat poll that a slightly higher share (29%) of medical groups were projecting lower contract and locums work in 2023 than those expecting to spend less this year (24%). The 2023 poll also had a slightly larger share (20%) of respondents who expected more contract and locums work that year versus the newest poll (16%).

    What roles are needed?

    • Among medical group leaders who expect their contract and locum tenens work to expand in 2024, most of them only cited the need for locums physicians, with only a few focused on temporary help among physician assistants (PAs), nurse practitioners (NPs) and administrative workers.
    • Among respondents who noted they will use fewer contract or locums workers, the range of needs was more varied, with medical group leaders focused primarily on finding radiologists, technologists, hospitalists, nurses and OB/GYN physicians.
    • Within the majority of respondents whose levels of contract/locums work is likely to remain unchanged in 2024, the top positions sought were physicians, PAs, nurses, administrative staff (especially for billing), sonographers and radiographers.

    Understanding motivating factors to retain physicians

    Medical groups have recently focused on retention as a key strategy to stem the tide of turnover amid worsening physician shortages in certain specialties and regions.

    On a recent episode of the MGMA Business Solutions podcast that featured Dr. Pamela Ograbisz, DNP, FNP-BC, and Scott Selby, senior vice president of enterprise solutions at, Selby noted that this issue “plagues every healthcare organization out there.”

    Part of the impetus for’s recent joint research study with MGMA, The Innovation Imperative for Physician Retention, was understanding that more could be done in medical groups to better understand physician sentiment and motivators for seeking another job or leaving the industry. In fact, a May 2023 MGMA Stat poll revealed that more than three in four medical groups reported not having a formal program or strategy for physician retention.

    “Retaining the clinicians you have on staff today is something that's relatively easy but extremely impactful. … Turnover impacts the bottom line, it impacts patient care, employee morale, team morale, and the overall culture within your organization,” Selby noted.

    A solid first step, Ograbisz said, was doing a better job of understanding how clinicians think about their work. “Healthcare organizations are measuring performance, but not a lot of them are making it their business to measure employee engagement and individual development.”

    It’s important for medical groups to understand the broader opportunities available today for physicians — in working in digital health companies, in temporary/locum tenens settings, etc. — means that it’s important to search within the pool of available clinicians to find someone who is interested in a permanent position.

    Ograbisz said the research also pointed to physicians being motivated to stay with organizations with a stronger amount of clinical support staff. The experience of staffing shortages during the COVID-19 pandemic also led to many permanent physicians getting more exposure working with locums providers and “seeing them as part of the team,” she added.

    “Only 2% of respondents say that they saw locums as a factor for influencing physician retention, but I think that in all honesty, if you were to look at locums as a solution to keeping permanent staff able to get vacations” and secure a better work-life balance, Ograbisz said, it would pay off. “Even though physicians are looking for higher compensation and benefits, they're also seeking out flexibility.”

    Learn more

    Key findings from the MGMA/ research report are included in MGMA’s new, member-exclusive report, Successful Healthcare Hiring & Employee Retention in 2024. MGMA members can download the report for additional insights into:

    • Recent trends in federal employment data specific to physician offices
    • Over-hiring plans to avoid unfilled positions in roles with high expected turnover rates
    • Paths to flexible or part-time physician roles
    • The data behind bidding wars for nursing staff
    • Increased offshoring and automation of certain work
    • Creating a staffing-to-demand model for your support staff
    • Strategies to improve medical assistant recruitment and retention.

    Join MGMA Stat 

    Your contributions are vital to MGMA’s ongoing work to provide great resources, education and advocacy for medical group leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit Polls will be sent to your phone via text message.

    Chris Harrop

    Written By

    Chris Harrop

    A veteran journalist, Chris Harrop serves as managing editor of MGMA Connection magazine, MGMA Insights newsletter, MGMA Stat and several other publications across MGMA. Email him.

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