Rebalancing Physician Staffing: Reduce Locum Reliance and Strengthen Clinical Stability

The US locum tenens market hit an estimated 9.6 billion dollars in 2025, and it kept growing even while nearly every other healthcare staffing segment shrank.

Every healthcare staffing market besides locum tenens contracted or stabilized in 2025. That single fact shows just how dependent hospitals have become on temporary physician coverage.

Locums fill urgent gaps, but leaning on them too heavily can chip away at continuity of care, team culture, and budgets.

That's why more health systems are actively working to reduce locum tenens reliance without leaving coverage gaps behind.

Why Have Hospitals Leaned So Heavily on Locum Tenens?

Physician vacancies are expensive to leave open. Unfilled physician positions cost up to $2.6 million in lost revenue each, so hospitals bring in locums to protect both patient access and financial performance while a permanent search continues to fill the vacancy.

Usage has consistently outpaced expectations. In 2024, healthcare organizations' actual locum utilization was 25% higher than projected.

That reflects just how tight the permanent hiring market has become across nearly every specialty.

Locum work has also changed from a stopgap into a real career path for physicians. An estimated 56,000 physicians now work as locum tenens, driven by lifestyle preferences and a core career pathway.

That shift means the temporary workforce isn't shrinking anytime soon on its own.

What Are the Risks of Relying Too Heavily on Locums?

• Continuity of care suffers when patients see a different physician every few weeks.
• Care teams also spend extra time re-training temporary staff on internal protocols, which slows everyone down.
• Over time, this can affect patient satisfaction scores and staff morale alike.
• Costs add up too. Ongoing dependence on locums is typically more expensive than building a stable permanent team, especially once travel, housing, and premium hourly rates are factored in the billing process.

How Can Health Systems Rebalance Their Staffing Mix?

Rebalancing does not mean eliminating locum tenens. It means using it intentionally, for planned leaves, seasonal volume, or the search period for a permanent hire, rather than as a default fix for chronic understaffing.
Capline Healthcare Staffing supports hospitals with both permanent placement and temporary coverage, helping leadership shift the balance toward long term stability without disrupting patient care in the process.

How To Strengthen Permanent Hiring and Onboarding

• Build a clearer permanent hiring pipeline by defining workload, call expectations, and compensation up front so candidates know what the role actually requires.
• Improve onboarding with structured milestones, early mentorship, and consistent support from leadership so new physicians settle in faster and stay longer.
• Reduce avoidable turnover by addressing flexibility, administrative burden, and physician well-being, since retention is a direct way to lower future locum dependence.

What Role Does Retention Play in Reducing Locum Dependence?

• Every physician who stays has one less vacancy to fill.
• Burnout remains a major driver of turnover across the industry right now. Stress and anxiety among physicians have returned to levels last seen during the pandemic, pushing more clinicians toward flexible locum work instead of staying in permanent roles.
• Addressing burnout directly, through manageable schedules, adequate support staff, and competitive compensation, helps hospitals hold onto the permanent staff they already have in their workforce.
• That's often more cost-effective than continuously recruiting to replace people who leave.

How Should Hospitals Start the Rebalancing Process?

• Start by auditing where locum spend is going.
• Some departments may need temporary coverage occasionally. Others may be relying on locums simply because permanent recruiting has stalled.
• Separating these two situations makes it much easier to build a targeted plan.

Frequently Asked Questions

Why do hospitals rely so much on locum tenens physicians?

Locums help hospitals avoid the high cost of unfilled positions and cover unexpected vacancies while permanent hiring continues.

Is locum tenens usage still growing in 2026?

Yes, it remains one of the only healthcare staffing segments that has grown consistently since 2021.

What is the downside of relying too heavily on locum staff?

It can affect continuity of care, increase long term costs, and slow down the development of a stable core team.

How can hospitals reduce locum dependence without hurting coverage?

By auditing locum usage by department, investing in retention, and building a proactive permanent hiring pipeline alongside targeted, intentional locum use.