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Case Study

Restoring Primary Care with APP-run Telehealth Model

How one healthcare organization’s facilities brought their primary care service back from the brink by leveraging technology and a clinician workforce.

It’s not a secret that clinicians are struggling with burnout at work – a growing challenge that certainly predates the pandemic, but which was thrown into stark relief by that era of fluctuating workloads and responsibilities. While the nation was setting up “heroes work here” signage outside of hospitals, the clinicians inside those facilities were facing increased dangers and unprecedented stress on the job.

Many departments in healthcare facilities across the country suffered as a result, and consequentially so did communities’ health. This case study examines one hospital that partnered with LocumTenens.com to rebuild an entire department and reinstate care in an innovative way.


One leading health network suffered a near-catastrophic loss of headcount in its Primary Care specialty, particularly with a focus on geriatric patients, in a number of facilities located in Arizona. It is an inopportune time to lose geriatric care clinicians, as this specialty is becoming progressively trickier to staff for. While there was a general sense of the pandemic eroding headcount, the hospital administration nonetheless conducted a series of exit interviews in order to get at the heart of the matter.

As expected, burnout was indeed one primary driver of clinicians exiting the teams. But while studies show that burnout is a chief reason for leaving, it is often a symptom rather than a root cause. Primary Care physicians also cited another frustration: having to spend what they felt was an inordinate amount of time executing on necessary administrative tasks – namely writing, refilling and managing patient prescriptions – was keeping them from sharing sufficient time and energy with their patients.


No staffing solution is one-size-fits-all, and healthcare staffing is no exception – staffing for clinicians requires in-depth knowledge of the facility’s needs. Drawing on an extensive network of talented clinicians and acute understanding of the modern healthcare landscape, LocumTenens.com custom-tailored a solution for the client that combined innovative technology and advanced practice provider (APP) headcount.

The plan included:

  • A robust telehealth program which strategically reduced the need for in-person meetings with patients without causing them to feel like they were not getting the attention they deserved.
  • A swift, temporary headcount infusion of 12 board-certified family nurse practitioners to tackle the department’s prescriptions, daily charting and patient check-ins.

This 7-month telehealth program was launched in July 2022 and staffed solely by APPs in order to allow for more direct patient care on the part of the physicians without creating an interruption in ongoing administrative processes. It provided a critical onramp to restore Primary Care service back to its previous pace for the Arizona facilities.

12 APPs credentialed in Primary Care and provided by LocumTenens.com


This multifaceted solution highlights the innovation needed to keep up with the demands of both patient communities and clinicians in order to stay ahead of labor challenges. Instead of simply throwing headcount at the problem, the client experienced a number of benefits to this strategic approach:

  • Hiring APPs is often more cost-efficient than increasing full-time physician headcount and can allow for more practitioners in the workforce.
  • Empowering APPs to deliver on day-to-day tasks frees up physicians for better direct patient care and leads to higher patient satisfaction rates. APPs want to be trusted with meaningful responsibilities, and excel when they are given the opportunity to "practice to the top of their license.”
  • With this problem no longer dominating the facility administration’s time, the client was able to focus on their own internal recruitment efforts.
  • Telehealth, when applied effectively and pragmatically, is a plus for clinicians and patients alike. Patients spend less time wringing their hands in a waiting room, and clinicians are able to see more patients.

"Telehealth, when applied effectively and pragmatically, is a plus for clinicians and patients alike."


This originally time-limited program saw a number of positive results.

  • This rapid infusion of clinicians to the team in the form of APPs on a locum tenens basis allowed the client to scale quickly while continuing the search for permanent clinicians – the perks of a strategic solution rather than traditional staff placement.
  • Clinician retention increased during the program, as clinicians felt more supported by their facility’s administration and less burned out.
  • The virtual component of the telehealth program enabled the client to support multiple locations within their health system with these APPs, as the clinicians were not limited to one physical location.
  • At the end of their contracts, 6 of the APPs were hired full time by the client, a testament to the matchmaking adeptness of the recruiters.
  • Additionally, due to the success of the program, LocumTenens.com is looking to replicate and scale this model and program – adding it to the toolkit for other clients with similar needs.


The complexity of this client’s APP-run program of staffing and telemedicine – with time, open roles, and physical and remote work all representing their own complexities – is indicative of an era of healthcare staffing that relies heavily on the industry expertise and consultative acumen of those involved in the hiring process. The needs of patient communities and the job demands of healthcare workforces are already manifesting in plain sight in the form of a growing labor shortage. Telehealth and flexible staffing, as well as APP deployment, will be meaningful components in overall staffing strategies going forward for healthcare organizations that want to keep their physicians happy and their patients healthy without significant interruptions.

Looking Ahead

Restoring Primary Care Looking Ahead

Our research shows that as clinicians battle burnout across the country, the erosion of the medical workforce becomes a more serious and urgent threat to the state of our nation’s health. Clinicians will no longer brook disproportionate demands on their time and energy, and they continue to seek opportunities elsewhere and even exit the clinician workforce at younger ages.

The needs of patient communities and their healthcare providers often intersect when they are not parallel – the perfect place to start formulating quick-turnaround solutions with lasting impact.

See our staffing optimization solutions, or get in touch with a sales representative today to start talking through the details of your facility’s staffing needs, and LocumTenens.com can find the solution that’s right for you and the community you serve.

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