Recruiting “Temp Docs” a Key to Implementing Electronic Health Records

One of the most common complaints patients have with today’s health care system is redundancy. It seems that every time you go to the hospital or doctor’s office, you have to tell the same story to every physician, nurse or other health professional you encounter. Why can’t your medical records be on one easily accessible electronic folder, just like your financial records are when you go to the bank?

The answer is that soon they will be.

Hospitals and medical groups around the country are working hard to implement EHR – electronic health records – which health care experts hope will be the key to more efficient, cost effective, and better care. One reason health facilities are focused on these efforts is that the federal government is offering a considerable financial carrot for them to do so. These carrots will subsequently be followed by “sticks” for those facilities that do not transition from paper based to electronic health records.


This transformative undertaking has significant recruiting implications for thousands of health care facilities nationwide. Installing an array of electronic systems will of course require information technology expertise, and finding professionals with this expertise will have IT recruiters working overtime for the foreseeable future. However, the process also is affecting the staffing of clinical professionals such as physicians, physician assistants (PAs), nurse practitioners (NPs), and others.


EHR implementation entails major hardware and software changes that reshape how physicians and other clinicians interact with patients and significantly alters work flows. The process requires health care professionals to spend extra work time to learn effective ways to use EHR, and often there are steep learning curves.


As EHR is implemented, many clinicians report an increase in the length of time necessary to document patient encounters. Physicians often have a particularly hard time transitioning from jotting notes on a file to acting as “data entry specialists.” My personal primary care physician indicated to me that it takes him five times as long to order an e-prescription as it does a written one. Consequently, the number of patients seen per day decreases and facilities may lose patients who grow tired of the grid lock. Many clinicians are pulled off the floor during peak usage times for training, or are required to put in costly overtime during the months or even years it takes to make the transition. Studies have shown that in the initial six-month period following an EHR implementation, there is a decreased level of satisfaction among physicians, which can lead to turnover.


A creative solution to these challenges lies in the strategic recruitment of temporary physicians and other clinicians, who are known as locum tenens. One benefit of recruiting “temp doctors” is that they can maintain clinical services while permanent staff physicians focus on EHR training. Many facilities have attempted to train physicians or other clinicians while they perform their patient care duties. This can lead to poor understanding of the software and increased staff frustration. An alternative is to use temporary providers to maintain services while the permanent staff focuses exclusively on EHR training.


Many facilities reduce the number of patients, physicians and other clinicians are required to see during the “go-live” stage of EHR implementation. Typically, hospital and medical office practice managers will reduce patient schedules by 50 percent for one to two weeks after the go-live period and then by 25 percent for an additional several weeks. Some managers will request that an extra 15 minutes be added to each patient visit. This decreases pressure on the clinicians and can enhance quality of care, as providers are less rushed and distracted. It also can inhibit malpractice risks. However, productivity and revenue are lost as fewer patients are seen, increasing the overall cost of EHR implementation.


Recruiters can address this problem by using locum tenens physicians, PAs, NPs and other professionals to handle the patient overflow resulting from reduced patient schedules or expanded appointment times.


Just like every other field, health care is becoming more technical and more reliant on information systems for quality and efficiency. But it remains a people business, and recruiters are essential to providing the human element that allows care to take place.


Kurt Mosley is Vice President of Strategic Alliances with Staff Care and Merritt Hawkins, firms specializing in temporary and permanent health professional staffing that are a part of AMN Healthcare (NYSE: AHS). He can be reached at

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