Jon Osborne's Blog

The coming boom in locum tenens

My advice to owners of locums staffing firms: start shopping for a really good private banker, yes the kind that comes to your home to discuss how to invest your millions -- sometime shortly after 2014 you will need that caliber of investment advice. 

My advice to staffing firms not operating in locum tenens: keep reading.

When the effect of healthcare reform kicks in a few years from now, demand for healthcare professionals will go through the roof.  But in most skills, supply will gradually expand as well, and over the long run shortages will not be much worse than they are now.  It's just not that hard to become a physical therapist or even a registered nurse.  Those jobs will eventually get filled. 

But it is a hard, and very lengthy process, to become a physician, and in many cases physician jobs will not get filled.

Physician supply can't react quickly to demand, because there simply aren't that many spots in U.S. medical schools, and nothing in the healthcare reform bill will materially change that.

So to sum up, demand for physicians will boom but supply will remain fairly static.  Get the picture?  More than ever it makes sense to either be a doctor or marry one.  Short of that, the next best thing is to get in the locums business.

The physician shortage is already bad enough today, you say?  It will not be allowed to get worse, you say?  The public will not stand for it?  Some change will occur to relieve it?  Maybe.  But I offer a piece of contrary historical evidence. 

As long ago as 1958, economists noted that the American Medical Association, which had been exclusively empowered to certify medical schools, was behaving very much like a monopoly, limiting supply in order to increase price (in this case, the salaries of their constituent doctors).  The topic is so old that economists have lived and died talking about it, and today students are routinely assigned the task of re-investigating the case as a matter of academic exercise.  And yet nothing was ever done to change that situation, despite fifty years of talk.

My guess is that the physician shortage (already at just 0.5% unemployment) will get much worse.  The only likely relief is greatly expanded use of nurse practitioners -- but that too is locums business, isn't it?

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