Imagine this: You’re midway through a complex joint reconstruction, and your colleague calls in sick. The OR schedule is already packed, and the hospital scrambles to find coverage. Enter the locum tenens surgeon-a specialist who steps in, often with little notice, to fill gaps in care. This scenario is no longer an outlier; it’s becoming a defining feature of modern surgical practice. The rise of the locum tenens specialist signals a seismic shift in how we deliver orthopaedic care, with profound implications for surgical excellence.
Traditionally, surgical careers were linear and anchored to a single institution. We trained to build deep, longitudinal relationships with patients and teams, mastering the nuances of our hospital’s culture and resources. The locum tenens model, often dismissed as a stopgap or a “gig” job, challenges this paradigm. It’s easy to write off locum work as transactional, but emerging data and anecdotal experience suggest a more complex reality. Surgeons are increasingly drawn to this flexible, portfolio-style practice, and healthcare systems are relying on them to maintain service lines amid workforce shortages and burnout.
Let’s dissect what this means for the fundamentals of surgery we hold dear.
First, continuity of care takes on a new dimension. Locum surgeons often inherit patients mid-course or manage acute cases without the benefit of long-term follow-up. This disrupts the traditional surgeon-patient relationship, which we know is critical for outcomes and satisfaction. Yet, locums bring fresh eyes and diverse experiences that can enhance decision-making. The challenge lies in balancing episodic intervention with seamless communication. Systems that integrate locums effectively-through robust handoffs, shared electronic records, and team-based care-can mitigate risks. We must rethink continuity not as a single surgeon’s domain but as a collective responsibility.
Second, technical adaptability becomes paramount. Locum surgeons operate across multiple institutions with varying protocols, equipment, and support staff. This demands a high level of surgical versatility and rapid assimilation of local workflows. The old model of mastering one OR environment no longer suffices. Instead, we must cultivate a mindset of continuous learning and situational awareness. This adaptability can sharpen our skills but also risks cognitive overload and errors if not managed carefully. Training programs should expose residents to diverse settings to prepare them for this reality.
Third, the economic and professional incentives driving locum tenens work reveal a nuanced landscape. Surgeons cite flexibility, autonomy, and financial benefits as key motivators. For some, locum work offers a way to escape administrative burdens or geographic constraints. For institutions, locums fill critical gaps without long-term commitments. However, this model can exacerbate disparities in care continuity and institutional loyalty. It also raises questions about credentialing, quality assurance, and integration into multidisciplinary teams. We must develop frameworks that preserve surgical standards while embracing this fluid workforce.
Our take is clear but layered: The locum tenens specialist is not a fleeting trend but a structural evolution in orthopaedic surgery. We should neither romanticize nor vilify this shift. Instead, we must engage with it critically. For trainees, this means cultivating adaptability, communication skills, and an understanding of healthcare systems beyond the OR. For institutions, it means designing processes that support locum integration without compromising patient safety or team cohesion.
Ultimately, surgical excellence in the gig economy hinges on embracing complexity. The locum tenens model challenges us to rethink continuity, adaptability, and professional identity. It forces us to confront the tension between flexibility and stability, between individual mastery and collective responsibility. Those who navigate this terrain thoughtfully will shape the future of orthopaedic care.
High-Yield Takeaways:
- Locum tenens surgeons disrupt traditional continuity but can enhance care through fresh perspectives if integrated well.
- Technical adaptability across diverse environments is essential; training must reflect this reality.
- Economic incentives for locum work reflect broader shifts in surgeon autonomy and institutional needs.
- Surgical excellence in this model requires balancing flexibility with robust systems for communication and quality assurance.
We stand at a crossroads. The locum tenens specialist is not just filling gaps-they are redefining what it means to be a surgeon in the 21st century.
