Locum tenens ease dentist shortages to advance patient care

Employment of dentists is projected to grow 4% from 2022 to 2032, with about 5,100 openings each year, according to the US Bureau of Labor Statistics.¹ The hope is that many of these positions will be filled by new entrants to the field. The ADA predicts the number of dentists per 100,000 population will increase from 60.7 in 2020 to 67.0 in 2040.² And the Pew Research Center reported that the amount of US women receiving a dentistry degree has quadrupled since 1980, to 33%, up from 7%.³

While the number of dentists is on the rise, it’s still not enough to meet demand, and the industry continues to struggle with providing high levels of patient care in many communities. In some cases, it’s because the locations have a low number of providers—nearly 58% of people live in Dental Care Health Professional Shortage Areas.⁴ In others, a critical shortage of dental hygienists, dental assistants, and administrative professionals means that dentists are spreading themselves too thin, leaving patients underserved.

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While these challenges seem insurmountable, one solution that has been embraced by the medical profession can help. To address staff shortages, many hospitals and clinics employ trained and licensed locum tenens (locums) to temporarily serve in the absence of permanent physicians, nurse practitioners, and physician assistants.

Employing locum dentists to close gaps

Similarly, the dental profession can benefit from using locums and increasingly more practices and DSOs are receptive to the idea, especially to help close gaps caused by dentist shortages from planned leaves such as maternity or surgery, and in emergencies like illness or resignation.

However, there are also hesitations due to three main concerns—cost, recruiting, and integration. Here are some suggestions to address these familiar obstacles:

1. Rethink the financial impact

While compensation for locums can be higher than that of permanent employees, the cost of not having a dentist available to see patients is often significantly greater, not only to the bottom line, but to a practice’s reputation. Any temporary closure or reduced service level can compel patients to seek treatment elsewhere. Additionally, the remaining staff members often can’t afford to be out of work and off payroll when a dentist is unavailable. This could lead them to look elsewhere for a more stable position.

One way to mitigate cost concerns associated with hiring a locum dentist is through a competitive compensation arrangement. This is where DSOs, private practices, and health centers provide an incentive model that allows locums to earn more income based on productivity. This decreases financial stress by increasing efficiencies so the dental office can better meet the needs of existing patients and attract new ones to help build the business.

2. Focus on recruitment selling points

There are some challenges with recruiting dentists to become locums. On the business side, small private practices and some DSOs may not have the infrastructure, database, and recruitment channels to reach markets across the country. This is especially important as locums are typically recruited from outside the local area. This is often where partnering with an outside provider can be beneficial for opening up new talent pools.

From the dentist’s perspective, being a locum requires a willingness to relocate on a regular basis, work with a changing roster of colleagues and patients, and learn new protocols and procedures. The focus when recruiting for locum positions should be on highlighting the upsides to these experiences, including:

Flexible lifestyle: Being a locum enables practitioners to select assignments that meet their preferences. This may mean prioritizing locations, specifying the length of service, identifying a particular daily schedule, choosing a practice size, and more.
Professional growth: It’s an opportunity to live in new places and learn from different professionals that have treated a range of patient needs depending on the community and resources. This helps locums sharpen skills, improve decision-making, and build confidence.
Service opportunity: Many locums have a service mindset and experience tremendous satisfaction when they can help patients that lack adequate care. In turn, the locums are often not only respected, but embraced by a community that appreciates the additional resource.

3. Elevate the onboarding experience

Another struggle is how to integrate locums into the practice. The importance of this step should not be underestimated. Productivity, staff morale, and patient experience all suffer if time is not taken to acclimate a new dentist. It’s important to implement onboarding strategies that help ease them into the practice, while also ensuring the permanent staff and patients aren’t disrupted by the addition.

A few suggestions include:

Pre-planning: Arrange for office managers to coordinate with locums prior to the start date to discuss available equipment in the office and whether there are certain materials and tools the locum prefers.
Communication: From day one, explain the expectations for scheduling, treatment planning, and office procedures so the locums understand proper protocols. If they’re not aware, they may resort to prior knowledge from other assignments, which is not always transferable.
Standing meetings: Conduct brief team huddles of 15–30 minutes daily before the first patient arrives to strategize and create a game plan that optimizes the day to ensure positive patient experiences.
Community outreach: Introduce the locum to patients and the larger community. Assure patients there will be continuity of care and that all treatment plans and charting information will be shared with the locum (often done through the EMR system). Stress that while the locum may be temporary, they are just as qualified as full-time providers. Publicly welcome the locum to the community. Some practices will include their headshot and background on the website and even run an ad in the local paper.

Serving beyond leave replacement

While leave replacement is a critical reason for using locums, there are many other opportunities for them to serve in different capacities. For instance, they can:

Provide rural, underserved, and other communities with long-term, consistent dental care when there’s a lack of viable permanent candidates.
Act as traveling dentists for mobile organizations that deliver care to schools, nursing homes, large job sites, and prisons.
Handle patient increases which can occur in both large metropolitan areas and rural communities faced with a backlog.
Reduce the workload of the permanent workforce to optimize employee retention and prevent burnout.

Locums are also valuable for teledentistry initiatives, including virtual supervision of off-site staff, pre- and postvisits with patients, and routine oral hygiene instruction. Additionally, they can provide critical access to care during emergencies and deliver service “off hours.” Typical dental practices and clinics are open Monday through Friday from 8 a.m. to 5 p.m. Virtual offices that are open 24/7 help in two ways:

In an emergency, patients can connect with a locum, share their complaint with the provider, and receive temporary relief such as a prescription to treat pain until their regular dentist is available.
Workers that struggle to take time off or need to travel a long distance to see a provider can reduce the number of office visits, making it more likely they’ll not only get treatment, but engage in follow-up and ongoing preventive care.

Embracing a changing profession

The dental field is undergoing an exciting evolution with the goal of creating a better future for patients by employing new technologies, increasing awareness of oral health, improving the availability and flexibility of services, and advocating for preventive and personalized care. Employing locum dentists is just one example of how the industry can implement new and innovative practices and standards in order to meet these goals and open up new avenues for connecting with the community. Ultimately, this benefits all involved including providers, dental professionals, and the patients they’re dedicated to serving.

Editor's note: This article originally appeared in DE Weekend, the newsletter that will elevate your Sunday mornings with practical and innovative practice management and clinical content from experts across the field. Subscribe here.

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