For hospitals and medical groups, assigning extra shifts to full-timers may feel like the fastest way to fill gaps. But what begins as a short-term fix can quickly turn into a long-term financial and clinical burden.
Paying up to twice a physician’s base hourly rate can strain budgets, and the hidden costs are even greater. Overtime drives burnout, increases turnover, and raises the likelihood of medical errors. Nearly half of physicians nationwide report symptoms of burnout, according to the American Medical Association. Every time a clinician leaves, the cycle of recruitment, onboarding, and lost continuity of care begins again.
In short, overtime may solve today’s staffing challenge, but it can compromise tomorrow’s workforce stability.
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How Flexible Staffing Works in Practice
Flexible staffing models such as locum tenens, reduced FTE roles, per diem shifts, and job sharing allow hospitals to adjust coverage without overextending their core teams.
For example, a hospital might schedule certain departments at 80% of full-time hours, then use locum tenens or per diem clinicians to cover seasonal surges. Incorporating telehealth blocks can also ease in-person workloads while maintaining patient access to care. These approaches keep schedules resilient and support long-term workforce balance.
Cost Comparison Snapshot: Overtime vs. Locum Coverage
When evaluating options, it helps to look beyond hourly rates and consider the broader financial picture.
While locum tenens rates can appear higher on paper, the return on investment becomes clear when factoring in lower turnover, often fewer errors, and improved continuity of care. Flexible staffing allows hospitals to pay only for coverage they truly need.
With the Association of American Medical Colleges projecting a physician shortfall of up to 86,000 by 2036, retaining clinicians through strategic staffing has never been more important.
Strategic Coverage Models That Work
The most effective staffing plans blend multiple coverage options that shift in response to patient demand, clinician availability, and specialty needs. These models help hospital practice partners manage overtime while maintaining consistent, high-quality care.
Gap Coverage and Workload Stability
When physicians begin approaching overtime limits, locum tenens or per diem clinicians can step in to help. Whether covering seasonal peaks, vacations, or parental leave, additional staffing keeps schedules steady and prevents fatigue among full-time team members.
Predictive Scheduling and Preparation
Using data from previous years helps leaders anticipate when coverage gaps are likely to occur. Hospitals can then plan locum or per diem coverage in advance, protecting clinicians from excessive workloads and ensuring patients continue to receive uninterrupted care.
Part-Time and Job-Sharing Options
Offering part-time and job-sharing schedules appeals to physicians seeking flexibility. According to a PubMed Central systematic review, part-time work is associated with better retention, while longer hours are tied to a higher risk of turnover.
Key Planning Considerations
Before adopting a flexible coverage model, healthcare leaders should plan for a few operational and cultural adjustments:
- Hourly rates: Locum tenens physicians may cost more upfront, but can reduce overall expenses by lowering turnover and recruitment costs.
- Credentialing and onboarding: Plan for lead times related to paperwork and orientation.
- Continuity of care: Rotating clinicians can temporarily affect patient relationships. Strong communication and handoff protocols help maintain trust and consistency.
- Cultural fit: Building a preferred pool of locum and per diem physicians supports smoother transitions and a stronger sense of team.
Thoughtful preparation helps ensure flexible staffing enhances both care quality and workplace culture.
A Roadmap to Sustainable Staffing
Transitioning to a flexible staffing model works best when implemented gradually. These steps can help hospitals and medical groups build success over time:
- Assess overtime hotspots: Identify departments or specialties with consistently high overtime.
- Pilot a flexible model: Test one department or specialty before expanding.
- Build a vetted clinician pool: Pre-credential locum and per diem clinicians for faster deployment.
- Use scheduling analytics: Track utilization patterns and assign shifts strategically.
- Evaluate and refine: Monitor overtime, costs, and physician satisfaction to guide continuous improvement.
Starting small and scaling with intention helps facilities adopt flexibility without disruption.
Organization Tips and Best Practices
Preparation is not just about gathering documents; it’s also about organizing them effectively. Consider these habits:
- Keep both hard and digital copies of all documents.
- Use secure cloud storage services such as Dropbox, Google Drive, or OneDrive, and organize your files into clear folders labeled with categories like “Licenses,” “Certifications,” “Health Records,” and “References.”
- Track expiration and renewal dates for licenses, certifications, and health checks.
- Set calendar reminders 90, 60, and 30 days before renewals.
- Immediately scan or photograph any new documentation and add it to your files.
These steps will make you more responsive when new locum opportunities arise.
Achieving Balance and Long-Term Success
Physician overtime may feel unavoidable, but sustainable staffing strategies can prevent it from becoming the norm. Flexible coverage models protect budgets, support clinician well-being, and ensure reliable care for every patient.
At OnCall Solutions, we partner with hospitals and medical groups nationwide to build smarter, more adaptable staffing strategies. Request a consultation to learn how we can help reduce overtime and strengthen your workforce.