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Healthcare’s Smokejumpers: Filling Critical Clinical Gaps with Independent Contractor Physicians

What if working with independent contractor physicians is the key to unlocking a more stable sustainable healthcare workforce?   

These days, one topic echoes louder than most around healthcare water coolers: the urgent need for innovative solutions to tackle clinician shortages, ease the burden of burnout, and improve patient access to care. It’s a conversation that reverberates across boardrooms and break rooms alike, yet one idea frequently remains surrounded in misconception: the stereotypes of the temporary doctor. 

Picture this: independent contractor physicians (often referred to as locum tenens) akin to “smokejumpers” of the healthcare realm, leaping into action to help put out the flames of workforce shortages. But here’s the twist — despite their potential to be the much-needed remedy for a growing crisis, the concept of an independent contractor physician still remains somewhat taboo. You hear everything from that they aren’t as skilled at their craft or they can’t find permanent jobs to they are grossly overpaid, when in fact they are as knowledgeable and concerned about the quality of patient care they deliver as employed physicians. Research has shown no increase in mortality rates for patients treated by locum tenens physicians compared to staff physicians.

What if working with independent contractor physicians to not only fill critical temporary gaps in care, but also to support new innovations, business models, and extend care holds the key to unlocking a more stable sustainable healthcare workforce?   

Independent contractors to fill needed gaps

Drawing inspiration from the highly specialized firefighters who provide rapid response to remote wildfires, healthcare “smokejumpers” — in this case, independent contractor physicians — are uniquely positioned to tackle many of the emerging challenges the sector continues to face. 

Independent contractor physicians are not bound by the traditional employment structures that medicine has instituted for decades, but instead possess the flexibility and adaptability to deliver care where and when it is needed most — a boon for the physicians who want more flexibility and ownership over how they practice medicine, especially in rural pockets where accessing care is challenging for patients.

Independent contractor physicians also fill critical gaps in care delivery, particularly for underserved populations reliant on Medicare or Medicaid. By bridging these gaps, they not only support the financial sustainability of healthcare organizations, but also ensure equitable access to care for all patients. However, the role of independent contractors extends beyond filling gaps in hospital settings — they also help organizations advance new business models, support getting new health technology off the ground, and contribute to revenue generation by accelerating the delivery of care. 

Additionally, and importantly, these temporary roles can enable those physicians to feel empowered as to how they want to develop and roll out their career. Soaring rates of burnout have shown us that the days of practicing medicine solely within the four walls of a clinic and enduring long shifts are not sustainable, as physicians desire more flexibility and more control. 

For example, a South African study found physicians working up to 60 hours a week were physically and emotionally exhausted and neglecting families, self-care, and patient empathy, with up to 80% experiencing burnout. In response to physicians’ requests for more flexible work options, a large regional training hospital converted some full-time positions to part-time, creating stability and continuity in the health team. According to the study authors, “Reducing working hours and creating flexible options were concrete ways of promoting resilience and retaining competent doctors.”

Beyond filling crucial gaps in care

Independent contractor physicians serve as more than just stopgaps in care. Beyond addressing immediate clinical needs, these physicians can help advance health technology, enabling new business models to get off the ground, and broadening patient access, particularly in burgeoning sectors like home health, remote monitoring, and AI applications.

This network of independent physicians serves as a catalyst for launching new markets, offering a turnkey solution for organizations where tapping existing clinician pools may not be an option. Their flexibility helps expedite the translation of innovative ideas into actual tangible services — not an easy venture to accomplish in healthcare.

In the wake of entrants like Amazon and One Medical seeking to secure physician resources, the demand for independent contractor physicians has soared. Their role extends beyond filling staffing voids in hospitals, encompassing the facilitation of new care models, improved access for payers, and seamless integration with emerging market players. Think more broadly about the “smokejumper” metaphor — independent contractor physicians also serve as linchpins in shaping the future of healthcare, offering adaptability, expertise, and a bridge to innovation for all stakeholders in the evolving healthcare marketplace.

Think ahead and build a framework

The healthcare sector is working hard to find long-term solutions to the workforce crisis; however, having a strategic approach in place is necessary to address this short-term as well. For example, finding a thoracic surgeon from 1,000 miles away to fill the midnight shift in Billings, Montana, is great, but it’s also expensive and not a long-term solution. The hospital CEO will want to see a comprehensive framework and strategy in place to fix this ongoing problem. It’s critical to involve your teams in the implementation and plans so that they value the “smokejumpers,” overcome stereotypes, and realize they are part of the overall healthy operations of your organization.

Another option that some hospitals choose is to build their own physician float pools internally — their own “mini smokejumper crew,” if you will. Instead of finding a staffing partner, they have a floating pool of part-time physicians that can start new projects or roll over into different ones or fill gaps in care. Some hospitals view this as beneficial as the physician is grown within the hospital’s own four walls, trained with the hospital’s philosophy, and does not have to learn different EMRs. 

The concept of “smokejumpers” in healthcare represents a large shift in addressing provider shortages and improving access to care. Independent contractor physicians can offer a dynamic and responsive solution to the sector’s evolving needs, whether it’s due to technology and innovation or patient demand and physicians wanting better work-life balance. These physicians play a part in moving things forward and making medicine sustainable. By embracing the role of “smokejumpers” in healthcare, stakeholders can build a more resilient and sustainable healthcare ecosystem for the future.

Photo credit: Flickr user Yuya Tamai

Matthew Brown is Vice President of Advisory and Telehealth at CHG Healthcare, where he leads the company’s advisory, virtual care, and new market initiatives from a product, operational, and business perspective.

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