How locum tenens physicians compare to staff physicians in quality of care

Patients should receive the same quality of care whether they’re being seen by a staff physician or a locum tenens provider, and reputable locums agencies like Weatherby Healthcare go to great lengths to ensure the quality of their locum tenens providers. These efforts were reflected in three studies published between 2017 and 2025 that compared patient outcomes and quality between locum tenens and permanent physicians. Researchers found that patient outcomes were similar for both physician types, and, according to one study, costs to the healthcare facility were actually lower for those patients being seen by locum tenens physicians.  

Key findings: Locum tenens vs. staff physicians

• Mortality was similar. In a JAMA study of Medicare patients hospitalized from 2009 to 2014, 30-day mortality was 8.70% for staff physicians and 8.83% for locum tenens physicians, a difference the authors did not consider significant.

• Cost and length of stay varied by study. A University of Toledo study of hospitalists found shorter stays and lower hospital costs for patients seen by locum tenens physicians, with no increase in readmissions or mortality.

• Early productivity was modestly lower. An emergency physician study found locum tenens physicians were slightly less productive than staff during their first 100 shifts at a site, with no statistical differences in returns, admissions, length of stay, or procedures.

Comparison of the 30-day mortality rate for patients seen by staff and locum physicians

The 30-day mortality rate for patients seen by staff physicians was 8.7% compared to 8.83% for locum physicians. The study was observational, so it shows an association, not cause and effect.

These results should foster confidence in hospital systems and individual facilities that use locum tenens to fill in for gaps in coverage. Locum tenens physicians are as knowledgeable, skilled, and concerned about the quality of patient care they deliver as employed physicians.

“You still bring the same skill set wherever you go,” says OB-GYN Dr. Roseann Freundel. “You still bring the human compassion component, the love of the work you do.”

She explains that her mindset doesn’t change because she’s a locum, and her patients still benefit from it. “Even though you may be a new provider somewhere, you still approach your patients with that level of sensitivity and acceptance.”

The researchers also analyzed secondary outcomes, including readmission rates, costs of care, and length of stay.

Comparison of the 30-day readmission rate for locum and staff physicians

Patients cared for by locum tenens physicians had a slightly lower 30-day readmission rate of 22.80% compared with 23.83% for staff physicians.

Comparison of length of stay for locum and staff physicians

The length of stay in days was slightly longer for locum physicians at 5.46 days, compared to 5.21 days for staff physicians. Medicare Part B spending was also somewhat higher for patients treated by locum tenens physicians.

Costs and quality of locum tenens physicians compared to permanent staff physicians

A second study by researchers at the University of Toledo College of Medicine/ProMedica, published in the Journal of General Internal Medicine in 2021, compared locum tenens and employed hospitalists in a prospective cohort at ProMedica Toledo Hospital (1,273 admissions, February to April 2019). It found that patients treated by locums had shorter hospital stays and decreased hospital costs—but no increase in readmissions or mortality. The study took place at a single hospital, so its results may not apply to every facility.

Researchers also found that patients seen only by locum tenens had an adjusted length of stay 1 day shorter and an adjusted average hospital cost saving of $1,339 per hospitalization. In a log-cost model, locum physician care was associated with 23% lower cost compared with employed hospitalists.

Cost center or revenue driver? When to bring in a locum physician

Productivity of locum physicians compared to permanent staff

A third study by U.S. Acute Care Solutions researchers compared productivity, quality, and utilization of locum vs staff physicians among emergency physicians between January 2021 and July 2023. During the first 100 shifts at a site, the mean patients per hour was moderately lower for locum physicians at 1.7, compared to 1.8 for staff physicians who are already trained and used to the process flow. RVUs per patient were also lower with 4.4 units for locum physicians vs 4.7 for staff. These findings are not surprising because of the time required to onboard and familiarize a locum at a new location. Preparing a locum before the first shift can shorten that ramp-up.

See: Onboarding a locum tenens physician

Comparison of physician productivity for locum and staff physicians

However, similar to the other studies, researchers also found there were no statistical differences in returns, admissions, length of stay, or procedures.

Debunking misperceptions about locum tenens physicians

The University of Toledo study also challenged the common expectation that locum physicians provide longer stays, incur higher costs, and deliver worse outcomes. 

Locum tenens cardiothoracic surgeon Dr. Carlos Garcia mentioned in an interview with Weatherby Healthcare that he feels some doctors view him as a novice when he is introduced as a locum, even though he graduated from medical school in 1978.

“This may sound terrible, but most places I’ve gone, I’m either one of the most qualified or the most qualified guy in town,” he says.

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Surprised by the findings about locum tenens physicians

The University of Toledo researchers indicated they were surprised that the results showed similar readmission and mortality rates for patients seen by locum tenens and employed hospitalists.

Lead author Moaath K. Mustafa Ali, MD, MPH, shared one theory with Medscape Medical News: “Locums have a lot of competition. They want to do well, so they get called for additional shifts, and that could play a role.”

Even with competition for jobs in the back of their minds, locum tenens physicians are as committed to their patients as their staff physician counterparts. Part of this may be that they can focus more on patient care, without the distraction of administrative responsibilities.

“Even if you have a heavy load, you know you’re going to be with your patients. You’re not going to be pulled out for some meeting or something like that,” Dr. Freundel says. “That’s what I went into medicine for—to be with my patients.”

Locums have also reported that—even though their stays are temporary—they generally feel connected to their patients and can spend more time with them.

“People will say you can’t establish relationships, but I’ve found that’s totally untrue,” says hospitalist Dr. Lee Green. “I’ve established a lot of strong relationships. I think being a locum makes me a better patient advocate because I know the only thing that really matters to me is the quality of patient care.”

Want to know how Weatherby vets its providers? Read 6 ways Weatherby ensures quality locums.

Frequently asked questions

Are locum tenens physicians as safe as staff physicians?

In a JAMA study of Medicare hospitalizations from 2009 to 2014, 30-day mortality was 8.70% for staff physicians and 8.83% for locum tenens physicians. The authors found no significant difference.

What does research say about locum tenens and readmissions?

In the same JAMA study, 30-day readmission was 22.80% for patients treated by locum tenens physicians and 23.83% for patients treated by non-locum physicians.

Do locum tenens physicians cost hospitals more or less?

Findings are mixed. The JAMA study found higher Part B spending and a longer stay (5.46 vs. 5.21 days). A single-hospital Toledo study of hospitalists found shorter stays and an average savings of $1,339 per hospitalization. The studies used different populations and settings.

Are locum tenens physicians as productive?

In an emergency physician study published in Annals of Emergency Medicine in 2025, locum tenens physicians were less productive than staff during their first 100 shifts at a site (1.7 vs. 1.8 patients per hour). Returns, admissions, length of stay, and procedures did not differ statistically.

Weatherby Healthcare can provide you with quality locum tenens physicians, PAs, and NPs to provide coverage at your healthcare facility. Give us a call at 954.343.3050 to learn more.