Quality and Extent of Locum Tenens Coverage in Pediatric Surgical Practices

摘要

The prevalence and quality of locum tenens coverage in pediatric surgery have not been determined. An Internet-based survey of American Pediatric Surgical Association members was conducted: 1) practice description; 2) use and frequency of locum tenens coverage; 4) whether the surgeon provided such coverage; and 5) Likert scale responses (strongly disagree, disagree, neutral, agree, strongly agree) to statements addressing its acceptability and quality (two 3 five contingency table and x2 analyses, significance at P 0.05). Three hundred sixteen of 1163 members (27.2% response rate) responded. One-fourth (24.1%) used a locum tenens regularly. Reasons were long-term inability to recruit a full-time surgeon (35.2%) and short-term vacancies (32.4%). One-fifth (20.4%) did locum tenens work; one-fourth (27.0%) plan to do so in the future. Two-thirds (64.2%) believe that surgical care in a locum tenens situation does not provide the same level of care as a full-time community-based surgeon. Most support locum tenens for short-term coverage (87.3%) and recruitment problems (72.1%), but not long-term vacancies (38.8%; P 0.001) or permanent coverage (27.0%; P < 0.001). Locum tenens coverage is an established feature of pediatric surgery. Most view it as a stopgap solution to the surgical workforce shortage. Widely seen as a stopgap measure, locum tenens coverage has become a commonplace feature of the clinical practice of surgery. Locum tenens arrangements have become an accepted solution to temporary and protracted shortages of surgeons imposed by unexpected illnesses and departures, retirements, and long-term vacancies in a practice. Many hospitals pay for part-time surgeons because hospitals depend on uninterrupted surgical coverage. Contracted part-time practice arrangements may become a long-term situation should it become difficult to establish a stable practice of adequate size.