Hospitals and health systems are spending more than ever on locum coverage. For urgent gaps, locums are important. But for many organizations, locums have quietly become the default instead of the exception. The numbers show this approach does not make sense.
Six Weeks. Twelve Weeks. Thirty Four Weeks.
Six Weeks. Twelve Weeks. Thirty Four Weeks.
- Six weeks: A psychiatrist at $320 an hour costs $12,800 a week. After six weeks you have spent $76,800. That is the same as the one time fee for a permanent hire. You have spent the money but you still do not have a long term solution.
- Twelve weeks: Even if you you pay the entire placement fee of a permanent hire up front, the cumulative cost of locum coverage will catch up in only 12 weeks. From here on, every week of locum coverage is more expensive than a permanent provider on a cash flow basis.
- Thirty four weeks: At thirty four weeks of full time locum coverage you have spent the same as the entire first year cost of a permanent provider. That includes salary, benefits, and the fee. Every week after that is overspend, and you still have no one in place the next year.
The Hidden Costs You Do Not See on the Invoice
The hourly rate on a locum invoice is clear. What you do not see are the ripple effects inside your organization.
- Onboarding and credentialing over and over. Each new locum provider has to go through the same process. That means time, paperwork, and delays.
- Lost provider relationships. Patients notice when they see a new face every few months. Trust and continuity suffer, which can affect patient satisfaction scores and retention.
- Institutional knowledge walks out the door. Every locum who leaves takes with them the understanding of your systems, team, and patients.
- Leadership distraction. Each new gap pulls executives and managers back into the weeds of staffing instead of focusing on strategy and growth.
Locums solve the short term need, but they add hidden costs that build up fast.
Why Permanent Hires Pay Off
Permanent hires do more than balance the budget. They strengthen your organization across the board.
- Consistency in care. Patients know their provider, and providers know their patients. That improves outcomes, satisfaction, and trust.
- Stability for your team. Nurses and staff can only adapt to so much turnover. A permanent hire lowers stress and helps retain your existing people.
- Predictable budgets. With a permanent hire you know the salary, benefits, and fee. Locum costs can spike without warning, and even small extensions blow through budgets.
- Cultural alignment. Permanent providers join your mission. They take part in committees, quality initiatives, and long term planning. Locums rarely have that buy in.
- Future pipeline. Building a team around permanent hires reduces last minute emergencies. You are not scrambling to cover holes because you already have stable capacity.
Rethink the Default
Locums will always play a role. The smarter move is to know your break even point by specialty, run permanent and locum searches in parallel, and use locums only when the need is short term.
Bridge Health is service agnostic. We work in both permanent and locum recruiting. Our role is to put the economics, timelines, and realities in front of you so you can make the right call. Sometimes that means locum, sometimes permanent, and often a mix of both. Our job is to help you spend smarter and build the right team for the long run.
The Real Cost of Locum vs Permanent Staffing in 2025
