Use of temps, PAs, NPs on the upswing

As the physician shortage continues to grow and changes wrought by health reform begin to take shape, more healthcare providers are moving beyond the use of locum tenens physicians to also using nurse practitioners (NPs) and physician assistants (PAs).

These are the findings of a nationwide survey conducted by temporary healthcare staffing firm Staff Care. The survey, which polled managers of hospitals and medical groups, found that requests for NPs and PAs went from less than 2 percent of requests in 2010 to more than 10 percent in 2012.

 “The shortage of primary care physicians is driving some of this, that’s the first thing you need to look at for this increase,” said Bonnie Owens, senior vice president of client services with Staff Care. “It is largely being touted as [the best] solution right now for solving the physician shortage in primary care and we will continue to see that.”

But in addition to hiring temporary “physician extenders,” Owens noted, the trend also reflects a shortage of NPs and PAs themselves.

“There are not enough PAs and NPs to make up for provider shortages in primary care and other areas,” said Sean Ebner, president of Staff Care, in a press release announcing the survey findings. “Today, both advanced practitioners such as PAs and NPs and physicians are in short supply.”

The survey also shows a continuing trend toward increased use of temporary physicians as a method of managing healthcare staffing and to fill the void as the industry continues to see a shift toward physicians leaving practice for an employment arrangement.

“We have seen an increase from our clients looking for contingent labor to fill in for staff who have left,” Owens said. “What this said to us was that in previous years our clients were asking us to fill in until they found a permanent doctor for whatever specialty they were looking for. This year it was to replace physicians who had left.”

Replacing physicians who had left was the number one reason cited by provider managers for using temporary healthcare workers (cited by 58 percent). “Because this moved to the number one reason for using locum tenens physicians," Owens said, "we see this as a shift in the market, as more physicians go to work for an employer.”

In total, the Staff Care research showed that 74 percent of providers surveyed had employed temporary healthcare labor in the past year. That's not a surprise to Owens, who noted that healthcare companies are catching up with other industries in terms of using a temporary workforce as an effective management tool.

“We are starting to see in the healthcare space our clients getting much more sophisticated in managing their contingent labor,” said Owens. “Where before it may have just been to bring somebody in to stop the bleeding, now if you think about the ebbs and flows of the employment model and where you might need to adjust for that, our clients are using [temporary staff] as a buffer for that.”

Two examples of this are when a group sees demand for healthcare begin to increase, but they are not certain the increase is going to be permanent, and to help staff the burgeoning walk-in clinics sprouting up in suburban areas and maintain flexibility while the clinics become established.

More physicians and other advanced practitioners are seeing temporary positions as a viable employment option as the demand for temporary healthcare workers is projected to continue to increase in the coming years. According to Staff Care, there were roughly 26,000 locum tenens physicians 10 years ago, and that number has grown by nearly 50 percent to 38,000 in 2012.