Hospitals nationwide are grappling with staffing pressures, and the numbers paint a stark picture: the Association of American Medical Colleges (AAMC) projects a shortfall of up to 121,900 physicians by 2032. Amid this crunch, many facilities are turning to advanced practice providers (APPs)—nurse practitioners (NPs), physician assistants (PAs), and certified registered nurse anesthetists (CRNAs)—in locum tenens roles to keep care flowing. But how do these clinicians fit into the picture—and what does it mean for physicians, hospitals, and the APPs themselves? Let’s break it down.

The Trend: APPs Step In

From rural clinics to urban emergency departments, NPs, PAs, and CRNAs are increasingly filling locum tenens shifts. NPs manage routine care like follow-ups or chronic conditions, per the American Association of Nurse Practitioners (AANP). PAs support surgical teams or handle diagnostics, as noted by the American Academy of Physician Assistants (AAPA). CRNAs administer anesthesia for surgeries and emergencies, a role backed by the American Association of Nurse Anesthetists (AANA). This isn’t about replacing physicians—hospitals use APPs to complement teams, often freeing doctors to tackle complex cases or leadership roles. With flexible schedules and competitive rates, APPs offer a practical option for facilities stretched thin.

What the Experts Say

The role of APPs sparks debate. The American Medical Association (AMA) stands firm: patient care thrives under physician-led teams. Citing physicians’ 10,000–16,000 clinical hours versus NPs’ 500–720 or PAs’ 2,000, the AMA argues doctors’ training depth ensures unmatched safety and quality. The AANP counters with 50+ years of data showing NPs deliver high patient satisfaction and comparable outcomes, especially in underserved areas. The AAPA highlights PAs’ versatility, trained broadly to adapt across specialties. The AANA emphasizes CRNAs’ expertise, safely providing over 50 million anesthetics annually in the U.S. APPs, they argue, expand access without compromising care.

How Hospitals Are Making It Work

For administrators, APPs in locum tenens are a lifeline – not a takeover. Picture this: an NP handles routine follow-ups, a PA covers an overnight shift, or a CRNA manages anesthesia so a surgeon focuses on the procedure. It’s teamwork in action. Benefits include flexibility, cost savings (APPs often cost less per hour than physicians), and coverage in a pinch. Challenges? Scope-of-practice laws vary by state – CRNAs, for instance, work independently in some states but under supervision in others – and integrating APPs into physician-led workflows takes coordination. Hospitals that nail this balance keep care seamless.

What It Means for Clinicians

For NPs, PAs, and CRNAs, locum tenens opens doors—diverse experience, schedule control, and high-need roles like rural ERs or ORs. NPs might focus on primary care, PAs on surgery support, CRNAs on critical procedures. For physicians, it’s a mixed bag: many welcome the support to focus on complex work, but some worry about blurred lines. Still, physicians remain healthcare’s backbone, guiding teams and driving outcomes.

The Bigger Picture

As staffing pressures rise in 2025, NPs, PAs, and CRNAs are undeniably part of the locum tenens conversation. They’re not here to replace physicians but to support them – filling gaps as the industry navigates evolving needs. Whether you’re an administrator seeking solutions or a clinician weighing your next move, this trend is worth watching.

Have thoughts on APPs in locum tenens? Drop a comment below or reach out – we’d love to hear your take.

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