Locum tenens model bridges a gap in psychiatric care

Locum tenens psychiatrists are helping to combat the shortage of mental health providers in rural areas. “There is a critical shortage of providers in rural hospitals, especially in psychiatry, and the locum tenens model for physician staffing is helpful in addressing that need,” says Dr. Heather Cumbo, a board-certified psychiatrist who has been working as a locum tenens provider since 2014.

When on assignment, Cumbo works at a facility in need of a psychiatrist on a temporary basis. In some cases, locum tenens physicians face large backlogs of patients in need of quality mental health care. With changing dynamics of health care and mental health care needs, locum tenens providers help fill the need.

Dr-Heather-Cumbo-3-(1).jpgHigh demand for locum tenens psychiatrists
Mental health staffing shortages exist in urban and rural health care settings, but the problems are even more challenging in rural areas. Cumbo has been on assignment in rural areas of New Mexico and Idaho where she provided coverage for a unit with no permanent psychiatrists on staff. “In states with a low population, there are very few options. In Idaho, for example, there are only 22 child psychologists registered with the state. I’ve worked in facilities with a yearlong waitlist for seeing a psychiatrist,” Cumbo shares.

“We also have a crisis related to physician burnout, especially in psychiatry, and that’s one of the reasons a locum tenens model is so important. Physicians on staff have a certain number of vacation days allowed, but they are unable to take time off because there’s no coverage,” Cumbo says. With a locum tenens model, facilities are able to contract with staffing companies to provide coverage and allow their employees time off so they can stay effective.

How it works
Physicians considering the decision to enter into locum tenens typically work with a recruiter to be connected with available assignments. A phone interview is facilitated by the recruiter, and if all parties want to move forward, the hourly rate or pay rate will be negotiated and the credentialing process begins. “Assignments are usually set for three months at a time, because that’s the length of time for temporary credentialing privileges,” Cumbo explains.

As a new doctor starting out, Cumbo didn’t envision the direction her career path would take with locum tenens. “This was not part of my original plan; instead, you could say I got involved in locum tenens by accident,” she shares. “I was ready to start a contract position in Florida, but the logistics and timing were not lining up, so I ended up doing locum tenens right out of residency to fill my time.”

Cumbo’s first assignment as a locum tenens psychiatrist was in Alamogordo, New Mexico. “It was very rewarding taking care of patients who otherwise would’ve had no access to mental health services at all.” Cumbo says. She has taken on 10 assignments in the past three years, and enjoys the opportunities and flexibility that comes with being a locum tenens provider.

Weighing the pros and cons
Being a locum tenens provider is not for everyone, but it can be highly rewarding and a good fit for providers who have the right characteristics. “Taking on variable assignments for a few weeks or months at a time requires a lot of travel, and you have to be comfortable with moving to new places. The travel can be a plus if you are a free spirit and excited about new opportunities, but it can be a negative for someone who wants to settle down in one place,” Cumbo says.

Being a temporary provider entering an established system also requires adaptability. “You need to have the ability to quickly navigate new situations and establish good relationships. It helps if you can be flexible to conform within the existing system and find the best way to help in a short period of time.”

Cumbo enjoys being in control of her assignments and deciding when she wants to work, and when she wants to be away from work. “This type of work is financially rewarding, and I like being my own boss. The financial structure is in many ways similar to having an independent practice,” she says.

Cumbo’s best advice for new trainees graduating from residency is to look into locum tenens opportunities — and don’t be afraid to be their own boss. “Working in locum tenens is a great way to be in control of your own life. It’s financially rewarding and can help you pay off student loans a lot faster,” she adds.

Making a difference for patients
When a rural health system is short on psychiatrists with a long waiting list of patients, delays in treatment can have devastating effects. “The No. 1 reason we need to address this is so people can access mental health care at the right place and time when they need us most. Suicide is one of the leading causes of death in our country, and this can be a factor in rural communities when there’s no access to care.”

For a facility experiencing a shortage in mental health providers, being able to bring in a physician, whether it’s temporary to provide leave for an existing physician or to fill a gap until someone is hired, using locum tenens providers can be a positive part of the solution. “Even though continuity of care is an underlying concern, we’re glad we could be there to help them today,” Cumbo says.

Connecting hospitals with solutions
CHG Healthcare provides locum tenens staffing to meet the needs in rural communities and works as an advocate at all levels on behalf of rural hospitals and health care providers. With 900 recruiters supporting more than 125 specialties, CHG Healthcare has the comprehensive services to personalize a staffing solution just for you. Contact a strategic advisor today at 800.328.3051.


NRHA commissioned the above piece from CHG Healthcare, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog