JAMA Study Shows Locum Tenens Physicians Do Not Lead to Higher Rates of Mortality
Hospital administrators often wonder if patients are more likely to face higher risk under locum tenens physician care compared to full-time permanent staff. In the first-of-its-kind study, this common concern can be answered, at least within rural and suburban hospitals. There is no difference between locum tenens internal medicine physicians and employed physicians when it comes to 30-day mortality rates among hospitalized Medicare beneficiaries patients, according to a break-through analysis recently published in the Journal of American Medical Association.
Led by Harvard Medical School researchers, the study examined almost two million Medicare beneficiaries hospitalized between 2009 and 2014. They found treatment by locum tenens physicians overall was not associated with increased mortality ratings compared to non-locum tenens physicians.
While an increasing number of facilities are finding the benefits of employing locum tenens providers to help fill gaps, combat shortages or improve patient access to services, many hospital leaders question if this is diminishing patient care and are hesitant to hire locum tenens physicians. The researchers behind this major study aimed to determine if there is factual evidence to prove one way or the other.
The sample of patients was drawn from all acute care hospitalizations from a random sample of Medicare beneficiaries, including hospitalizations with internal medicine physicians.
“The lack of significant overall difference in mortality rates between patients treated by locum tenens and non-locum tenens physicians is reassuring, and it argues against the presence of systematic differences in the quality of care administered by these two groups of physicians,” the study authors conclude.
The researchers also analyzed secondary outcomes, including readmission rates, costs of care and length of stay. Patients cared for by locum tenens physicians had lower 30-day readmissions, which was an additional positive finding.
However, patients treated by locum tenens had longer length of stay by 0.43 days and higher costs by $124. The authors of the study think these two differences could be attributed to varying factors, including the need for improved onboarding practices at the hospitals. “Temporary physicians, including locum tenens physicians, may initially struggle to efficiently and effectively deliver care or coordinate care transitions.”
Every hospital differs in size, staff, regulations and technology. Effective onboarding practices could help solve the issues with length of stay or higher costs. LocumTenens.com’s “6 Tips to Improve Your Orientation for Locum Tenens Physicians” offers detailed suggestions to increase a new doctor’s productivity and improve efficiency, based on our own locum tenens physicians’ experiences.
The Harvard Medical School researchers say this study is the first to use national data to analyze locum tenens physicians’ quality and costs of care compared to non-locum tenens. They state more studies are necessary in the future, but data show locum tenens is certainly a safe strategy for small and suburban hospitals considering this model as part of their healthcare strategy.