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    Permanent hires remain in short supply for America’s medical groups, with demand for contract and locum tenens work remaining steady in the early months of 2023.

    The demand for contract and locum tenens work in medical groups appears steady in the early months of 2023 after the staffing shortages that marked 2022, per an MGMA Stat poll.A Feb. 14, 2023, MGMA Stat poll asked medical group leaders how their levels of contract and locum tenens work would change in 2023 versus 2022. A solid majority (52%) said they expect those levels to stay the same compared to last year, while almost 3 in 10 (29%) expect to use less contract/locums work, and only 20% reported an expected increase in the year ahead.

    The poll had 307 applicable responses; the figures reported do not add up to 100% due to rounding.
    Among respondents who expect to use more contract and locums work this year, the top roles they’re seeking were:

    1. Physicians — 63%
    2. Nurses and Advanced practice providers (APPs) — 14%
    3. Administrative — 7%
    4. Other — 7%
    5. Nurse practitioners — 5%
    6. Medical assistants — 4%.

    Besides physicians (especially in emergency medicine), travel nurses and APPs, the top contract and locums roles expected to decrease this year were technicians, contract revenue cycle staff and various other roles, including therapists, educators, contact tracers and greeters.

    Additionally, several respondents noted that they did not have any contract or locums workers on the clinical side or only used a limited number of nonclinical temporary workers at lower-wage positions.

    Labor availability, expenses remain crucial

    Several major health systems posted major losses for 2022, including a $4.5-billion net loss for Kaiser Permanente, driven in large part by surging expenses brought on by inflation, labor shortages and continued higher costs related to COVID-19 care.

    Those pain points were echoed in the results of a recent survey of hospital CEOs, which found that workforce and financial challenges rank as the top two concerns facing their organizations. A January 2023 Kaufman Hall flash report dubbed 2022 “the worst financial year for hospitals and health systems since the start of the COVID-19 pandemic.”

    As COVID-19 hospitalization rates stabilized in the past year and a winter spike in cases did not reach the previous year’s levels amid the initial Omicron wave, many medical groups reported a continuing surge in demand for care, with many groups experiencing increased outpatient volumes as patients avoided inpatient settings, per the Kaufman Hall report.

    The most-recent jobs report from the Bureau of Labor Statistics (BLS) confirms that ambulatory care has helped drive employment growth across the healthcare sector, which added 58,000 jobs in January and got closer to pre-pandemic levels.

    Continued clinician interest in locum tenens

    In a recent webinar on the future of work arrangements for clinicians, Chris Franklin, president of, and Dr. Miechia Esco, a vascular surgeon and chief medical resource advisor for, detailed the forces affecting today’s clinicians and how many are looking to redefine their work-life balance to mitigate burnout, improve flexibility and forge new career paths.

    “Our study found that 80% of respondents were willing to consider nonclinical roles on a project basis as they move forward,” Franklin said. Understanding these trends is especially vital amid projected physician shortages and a trend of providers who are leaving clinical practice at earlier ages than ever before, as outlined in the recent whitepaper, The Future of Work: Redefining the Role of Physicians in The Gig Economy:

    • 11% of clinicians under 40 are not currently practicing medicine
    • 12% of clinicians in their 40s have left clinical practice
    • 15% of clinicians in their 50s no longer practice medicine.

    Burnout, the COVID-19 pandemic, existing plans to retire and plans to leave medicine for another career were the top reasons cited by clinicians in the study for leaving patient care, but recent economic shifts might give some pause, Franklin noted.

    “These are traditionally the prime or peak earning years for clinicians, so to see more movement away from traditional practice, from a younger demographic of clinicians is something that will be very interesting to watch in the coming years,” Franklin said. “With factors like inflation, with the stock market falling off a bit, I do think that that will have some impact on some early retirements and maybe get some clinicians to kind of rethink or maybe postpone retirement or maybe even come back out of out of retirement.”

    These demographics mirror what Franklin has seen relative to the clinicians who work locum tenens assignments. “The number of clinicians with 10 years of practice experience or less, we've seen that number double on a percentage basis over the last three years,” Franklin said. “And we see that to be one of the fastest-growing demographics within locum tenens clinicians.”

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