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The History of Locum Tenens in Healthcare


This month's blog post is a history lesson on how the locum tenens physician industry came to be.

Locum tenens is the practice of a physician filling in temporarily for another physician and has been around since the late 1970s. However, the origin of locums is not nearly this simple.

Born out of a CME need

The seed for what would become locum tenens came out of a need for rural physicians to receive continuing medical education (CME) training. Due to the limited number of healthcare providers in their towns, they could not take time off to attend training. At the time, Health Systems Research Institute (HSRI), an organization created to stem the tide of rural physician burnout in Utah, began offering a program called ROPE (Rural Outreach Physician Education) to bring physicians to the University of Utah for classes on how to improve their practices and CME. In addition to the training, the group also provided temporary physicians to work at the rural practices while the primary physician was training.

HSRI proved to be a success and was soon utilized in states outside of Utah. At the time, Yellowstone National Park needed to set up a healthcare system and called upon HSRI for help. One of their regular fill-in physicians, Dr. Alan Kronhaus, was tasked with setting up a system to bring senior surgery residents and attending physicians into the park for temporary assignments.

Success leads to a new industry

Kronhaus' success led to him partnering with fellow HSRI physician Therus Kolff to set up a service specifically for locum tenens. What started as a small company focused on filling regional needs soon started fielding calls from facilities and physicians around the country.

Kronhaus went on to form KRON Medical and Kolff started Comprehensive Health Systems. Years later, the two companies came back together when Comprehensive Health Systems, which had changed its name to CompHealth, purchased KRON Medical. Today there are hundreds of healthcare staffing companies focused on offering locum tenens services and more than 40,000 physicians working locum tenens.

A need for standards and guidelines

As locum tenens grew, many in the industry recognized the need to set professional standards and guidelines for locum tenens physicians. As a result, the National Association of Locum Tenens Organizations (NALTO) was created. According to the NALTO website:

"The National Association of Locum Tenens Organizations was established in 2001 to create and enforce strong industry standards and practices for our profession, stressing honesty, objectivity, integrity, and competency. Our goal is to set clear and effective parameters of behavior for all individuals affected by the industry, including both physicians and clients."

Nearly 40 years after those first physicians provided CME coverage in rural Utah, locum tenens is now a multibillion dollar industry that continues to grow. NALTO estimates that 75 percent of all hospitals now utilize locum tenens to augment their permanent staff. Locums are also used for gap coverage, starting new lines of service, and many are still used for the original purpose of offering patient care in rural communities that truly need it.

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