The Executive Suite: National Locum Tenens Week: How we can continue to facilitate access to care

When COVID-19 hot spots began popping up in the US, legislators enacted temporary measures to make it easier for clinicians to practice across state lines and quickly travel to provide care where it is needed most. Although the legislation is helping increase access to care during an unprecedented time, it will soon expire in many places, either on a predetermined date or when the states are no longer under a state of emergency. States of emergency can be extended, but even when they expire, it doesn’t necessarily mean the need to bring in additional clinicians from out of state to care for patients will wane in every single hospital, especially those in rural areas.

The measures enacted in response to COVID-19 are very similar, or a temporary version, of something called the Interstate Medical Licensure Compact (IMLC), which some states have participated in since 2017. The IMLC is a voluntary agreement between participating states that facilitates the licensing process for physicians practicing outside of their state of residence. Prior to the pandemic, 28 states or territories had already enacted some form of the compact licensure legislation, and there are 24 states and one territory in which a doctor can carry their State of Principle Licensure (SPL), which is required to get a license in another state participating in the compact. The IMLC greatly reduces the time and administrative burden it takes for a physician to be granted rights to practice outside of their home state and therefore increases access to care.

The pandemic has shown many what those practicing in SPLs have understood for quite a while: the adoption of permanent nationwide legislation is necessary to ensure patients across the country have timely access to the lifesaving care they need both today and in the future.

Although the physician licensing requirement was implemented with the goal of keeping patients safe and has served its purpose well, the current system can hinder many clinicians as they try to quickly move across state lines when they’re needed elsewhere. This especially encumbers locum tenens clinicians who typically have a wider area of practice than those who are permanently employed by a healthcare organization.

Locum tenens clinicians have traditionally been utilized to fill gaps in coverage at healthcare organizations by entering into short-term agreements facilitated by locum tenens agencies. Over the past few years, the IMLC has greatly benefited locum tenens physicians and their patients who are living in SPLs and other member states, as many locum tenens providers have always traveled across state lines to provide care per their contracts. This practice has only heightened during the pandemic, and locum tenens staffing solutions have been an essential part of the pandemic response. In fact, at the height of the pandemic, 83 percent of the physicians and advanced practitioners sent to New York traveled there from out of state, and 63 percent of those clinicians weren’t actually licensed in New York.

Many locum tenens agencies already have the benefit of housing internal CVO departments full of dedicated specialists who are well equipped to navigate changes in policies and procedures. They partner with practices to take care of the administrative red tape required to get clinicians into their facilities. And during this time of crisis, CVO departments across the country have stepped up to provide pandemic management services, fulfilling the administrative requirements to get the right clinicians in the right places as quickly as the law allows. But more states either entering into the compact post-pandemic or working toward becoming SPLs would help these departments operate more smoothly, efficiently, and get the right people in the right places sooner so healthcare organizations are never having to wait for relief and patients aren’t having to wait for care.

This week is National Locum Tenens Week, the time when we honor our locum tenens clinicians, many of whom have crossed state lines to serve on the frontlines during the COVID-19 pandemic. As we move past the point of crisis, it is time to reflect on the incredible selflessness they and other clinicians demonstrate daily and consider how temporary legislative measures have greatly benefited healthcare organizations and their patients. It is my hope that this experience will encourage decision makers living in states that are not currently participating in the IMLC to consider participating in the contract or move to become SPLs if they aren’t already. Our clinicians do so much for our healthcare organizations and our patients; the least we can do is make it easier for them to get to where they need to be.