Building a Physician Bench Before a Vacancy Hits

A rural clinic loses its only pediatrician in March. A few months later, an emergency department learns in early December that one of its doctors will be on medical leave straight through the holidays. Different situations, same first question from leadership: how fast can we fill the spot?

The honest answer is "not very fast." Physician hiring comes with credentialing, licensure and payer enrollment, and each of those has its own waiting period. Even so, plenty of HR teams still plan as though a physician leaving is a rare event nobody could have seen coming. It isn't. Doctors retire, relocate, burn out and go on leave all the time, so the smarter move is to plan for it ahead of time.

The hidden cost of "everyone pitch in"

When a physician leaves, the usual fix is to divide the workload among whoever is left. It looks cheap, and it feels like teamwork. In reality, one vacancy often becomes two.

The people who agree to extra call shifts tend to be your most dependable doctors. They say yes because they care about their patients and their colleagues. But after a few months of added nights and weekends, morale drops, and those same people start replying to recruiters. You end up wearing out the very physicians you can least afford to lose.

Coverage and recruitment are different jobs

Many organizations lump temporary coverage and permanent hiring into one project. They work better apart. Coverage answers a short question: who is seeing patients next Tuesday? Recruitment answers a longer one: who will build a practice here over the next ten years? When you run them side by side, the daily operation stays steady and the search isn't rushed into a bad hire.

Locum tenens as a plan, not a panic button

Some leaders see temporary physicians as proof that recruiting failed. That's a mistake. Many well-run facilities build locum tenens doctors into their staffing model on purpose, using them for interim coverage while the permanent search continues. A look at current Locum Tenens Jobs listings shows how common these assignments have become across specialties and settings.

What separates a plan from a panic is timing. A locum physician can't see patients until privileges are granted, and credentialing can take weeks. If you pre-credential a small group in your highest-risk specialties, that delay is gone before you need them. Over time the group turns into a real bench: doctors who already know your EHR, your nurses and your referral patterns. A few may even end up joining permanently.

How physicians get found now

Physician recruiting has always worked backwards. Most doctors aren't browsing job boards. Recruiters contact them, and the doctor replies only if the specialty and location already fit what they had in mind.

That's slowly shifting. More candidates now type out what they want in plain words, something like "outpatient family medicine, four-day week, within an hour of the coast," and let an AI job search engine return matches. Keywords count for less. Clear, specific descriptions count for more.

So the posting itself matters. "Board-certified internist, competitive salary" gives a search tool almost nothing to work with. A listing that covers the call schedule, patient mix, support staff, community and growth path gives it plenty. If you can't describe what the job is really like, the right physician may never see it.

Making the case to finance

Finance teams often turn down flexible staffing because they assume a locum physician's daily rate costs more than a salaried hire. That comparison leaves out what understaffing really costs.

A fuller picture includes the visits and procedures that never happen, patients who go to another system, and overtime paid to the doctors covering extra shifts. It should also include the cost of recruiting and onboarding a replacement if one of those doctors burns out and leaves.

Industry averages help, but numbers from your own organization's last vacancy persuade far better. HR teams that write those figures down will have a much stronger case the next time the topic comes up.

Where temporary coverage goes wrong

When a locum assignment goes badly, the physician is rarely the cause. Three problems show up again and again.

1. Starting too late. If you wait until the schedule already has gaps, credentialing, license checks and contract review all happen under pressure.
2. Treating the doctor like a visitor. Temporary physicians who arrive without enough information or system access spend their first days sorting out logistics instead of seeing patients.
3. Skipping the debrief. Few organizations record how an assignment went. Without notes on fit, productivity and staff feedback, the next booking starts from scratch.

Don't forget the basics either. State licensure, malpractice coverage (including who pays for tail coverage), and the contract's cancellation and conversion terms should all be confirmed before the first shift, not after.

Where to start

You don't need a system-wide overhaul. Pick the one specialty where a sudden loss would hurt most, say a thinly staffed emergency department, and ask three questions:

• Where does credentialing usually stall, and could any of those steps be done in advance?
• Which interim options, such as locum partners, telehealth or neighboring facilities, could be running within two weeks?
• What did the last vacancy in this specialty actually cost, and has anyone written it down?

Quiet months are the right time to do this. A bench thrown together in the middle of a crisis is just a scramble with a nicer name. If you are revamping your recruitment funnel or updating your candidate application packets, starting with a standardized ATS resume template helps streamline initial screenings before physicians even reach the interview stage.

The aim is simple. When a pediatrician gives notice, it shouldn't set off a round of desperate favors and tired colleagues. It should lead to one phone call to a locum physician who is already credentialed, already knows the nurses, and can start the week the vacancy opens.

John Kendrick writes about healthcare staffing and workforce planning. He is a recruitment professional with a passion for talent acquisition, hiring strategies, employer branding, and career development.