If you’re an ED leader weighing whether to bring in locum tenens providers for the summer, you’re probably asking two questions:
How much does locums coverage cost? What will it cost if I don’t use locums?
Answers to these questions depend on you. Consilium Staffing offers a framework for making that decision.
The Real Cost of Understaffing (What You'll Lose If You Don't Act)
1. Lost revenue from diverted ambulances
When your ED is over capacity, ambulances get diverted. Each diversion is a potential admission you don’t capture. You could lose a high-acuity patient and significant revenue with them.
2. LWBS patient loss and reputation damage
Patients who leave without being seen don’t just represent lost revenue. They leave poor reviews, file complaints, and tell their networks about the experience. In competitive markets, this directly impacts your facility’s reputation and patient acquisition.
3. Overtime costs that exceed locum rates
When you’re short-staffed, your existing team works overtime to fill the gaps. Depending on your market, overtime rates for emergency physicians and APPs can match or exceed locum rates without solving burnout or turnover in the first place.
4. Turnover replacement costs
Recruiting and onboarding a full-time emergency medicine provider typically costs between $40,000–$75,000 per hire. If summer burnout pushes two providers to leave, you’ve spent more replacing them than you would have spent preventing the problem.
5. Boarding penalties and throughput loss
CMS and commercial payers increasingly tie reimbursement to quality metrics, including ED throughput. Extended boarding hours hurt your scores and, in some cases, trigger financial penalties.
Locum Coverage Cost vs. Value
Locum tenens rates for emergency medicine vary by region, but have you considered comparing the ROI?
For costs, you can expect:
- Emergency physicians: $250/hour or more, depending on geography, shift type, and urgency
- Emergency medicine APPs (NP/PA): $95–$145/hour
What you get for that cost contributes to the ROI or value of using locum coverage.
You Gain:
- Fast capacity relief
- Flexibility based on volume
- Coverage during your highest-risk months
You Avoid:
- Recruitment fees
- Onboarding and training costs
- Long-term salary costs
- Benefits commitments
For most facilities, the break-even calculation is straightforward: if locum coverage prevents one FTE turnover or avoids 3–5 ambulance diversions per month, it pays for itself.
How Much Coverage Do You Actually Need?
Every emergency department has different needs, but they all provide access to care in their communities.
Don’t guess about the type of provider you need or the number of shifts you need filled. Use your own data to forecast summer volume and identify gaps.
Step 1: Pull Last Summer’s Numbers
Look at May, June, July, and August from the past 2–3 years:
- Daily patient volume
- Peak hours and shift types
- LWBS rates and average wait times
- Boarding hours
- Unplanned staff absences
Step 2: Identify Your Surge Weeks
Most EDs see volume peaks tied to specific events, like holiday weekends. Mark the weeks where volume historically exceeds your current staffing model’s capacity.
Step 3: Calculate Staffing Gaps
Ask the following questions:
- How many providers per shift do you need to maintain target wait times?
- Where are your current gaps?
- How many shifts can your existing team realistically cover before overtime becomes unsustainable?
Step 4: Build Your Locum Request
Based on the gaps you identified, tell your locum agency what you need.
Timeline: What to Do Right Now (And What Happens If You Wait)
"Credentialing and privileging timelines vary from critical access hospitals to large health systems. Our QA and privileging teams work hand in hand with yours to ensure documentation is complete, board dates are met, and providers start on time. "
The earlier you begin your search, the better prepared you can be when the patient volume surges.
Ideal Window: Start in February
- February: Submit locum request. Begin credentialing process
- March–April: Complete licensing, privileging, and facility orientation
- May: Locum providers ready before Memorial Day surge
- June–August: Full coverage in place for peak season
Result: You’re staffed before the surge hits.
Tight but Doable: Start in March
- March: Expedite credentialing and prioritize communication with agency
- April–May: Complete privileging under compressed timeline
- Memorial Day Weekend: Providers arrive as the holiday surge strikes
Result: You’ll be staffed through August most likely.
Crisis Mode Start in April or Later
- April–May: Credentialing unlikely to finish before peak season
- June–August: Operating short-staffed through the entire surge
Result: Using your existing team, expect higher overtime costs, higher LWBS rates, and higher turnover risk.
Consilium Staffs Emergency Departments Nationwide
The facilities that manage summer surges well don’t do it by accident. They work with a reliable, specialty-focused partner to secure the coverage they need.
“For the past decade, I’ve worked in Emergency Medicine at Consilium. Today, our devoted ER team partners with clients coast-to-coast—California to Florida—to provide trusted locum coverage in critical moments, leading with a servant mindset and prioritizing our clients above all else."
Emergency departments choose to partner with Consilium’s emergency medicine division because:
- We know your market, including provider availability, licensing timelines, and facility-specific credentialing requirements.
- We expedite where it matters. We reduce administrative lag by handling credentialing, licensing, and privileging coordination on your behalf.
- We fill the request, not just post it. Our proven track record in emergency medicine placements reflects our focus on this specialty.
If summer coverage is already on your radar, now is the right time to start planning. Consilium Staffing can help you think through your staffing strategy, supporting your team and protecting continuity of care during peak season. Schedule a consultation today.
