When it comes to physician vacancies, it’s not if but when. Whether due to a physician retirement or general turnover, it’s rare that an organization can successfully fill the role during the standard notice period. This creates vacancies, and with the worsening physician shortage and roughly one in five practicing physicians already 65 or older, it’s fair to say that every health system will deal with them from time to time. The vacancies may be inevitable, but how you respond is not. And that response determines how much it costs you far more than the vacancy itself.
As Regional Vice President of Jackson Physician Search, I work with healthcare organizations across the South dealing with current or impending vacancies. By the time most organizations partner with a physician recruitment firm, they have often already spent a few months trying to fill the position on their own. If we’re lucky, when my team joins the effort, we still have a little time before the physician officially departs, but more often than not, the organization is already feeling the impact of the vacancy. If it’s not yet hitting the bottom line, they are experiencing it in the form of increased patient wait times and overworked physicians picking up the slack.
It’s a clear pattern. Recruitment rarely becomes a priority until a crisis forces it. Physician staffing gets treated as discretionary spending, deferred until the clock ticks down to the inevitable vacancy. That’s the vacancy trap: not the opening itself, but the reactive scramble that follows, which almost always steers organizations toward the two most expensive options…while the more cost-effective third option is there for the taking.
Three Responses, Very Different Costs
When a physician leaves, a health system really has three choices. Two of them feel manageable in the moment but quietly drain resources over time. The third takes foresight, and while it requires an investment, it consistently costs the least in the long run.
Option one: leave the role open and absorb the loss. This is the invisible option, because nothing shows up on an invoice. However, an empty schedule is anything but free. A single physician easily brings in six figures in revenue every month through direct care, and the referrals that flow across service lines account for more. A vacancy means that revenue is lost, and those losses compound as wait times stretch, patients seek care elsewhere, and referral patterns shift. The physicians who remain may absorb some of the extra load, but their resulting fatigue becomes its own retention risk.
You can estimate the lost revenue created by your specific vacancy with our Physician Recruitment ROI Calculator.
Option two: bridge with locums. Locum tenens coverage has a real and appropriate place; sometimes you need it to keep the doors open. But a short-term fix has a way of becoming a long-term line item. The costs run higher than most leaders expect, and the drawbacks go beyond the invoice. A revolving door of temporary providers can erode continuity of care and, over time, your reputation in the community. Credentialing each locum for privileges and payer plans slows the revenue cycle, and while some may think locums is a good way to “try out” a potential candidate, the buyout provisions in most locum contracts can make converting a strong temporary physician into a permanent hire cost-prohibitive.
Option three: have a proactive strategy already in place. This is the only response that breaks the cycle, and it’s the one many organizations ignore. Not because it doesn’t work, but because it requires investment and intention before there’s an urgent need.
What Proactive Recruitment Actually Looks Like
Proactive recruitment isn’t a vague aspiration. It follows a clear strategy, and it starts with treating physician staffing like capital planning rather than a reactive line item. It begins with ongoing workforce analysis: mapping the age distribution of your medical staff, tracking turnover by specialty, and weighing how community demographics and local growth projections will impact the need for care. Predicting departures and areas of growth allows organizations to plan for recruitment long before notice is given. Whether that plan includes partnering with a physician recruitment firm or simply posting the job and building a database of potential candidates, the organization can avoid or at least minimize the length of vacancies with this proactive approach.
Other ways to be proactive include nurturing relationships with former applicants, engaging residents and fellows (especially those rotating through your facilities), and hosting grand rounds or CME symposiums. Anything you can do to build your reputation and visibility among physicians without an overt recruiting pitch will help to build your pipeline. My colleague, Tara Osseck, did a deep dive on shifting from reactive to strategic physician recruitment, and it is certainly worth a read.
Where a Search Partner Fits
Building internal pipeline capacity is powerful, but no in-house team can maintain relationships with every physician in every specialty nationwide. That’s just one way a permanent search partner can help. A true partner functions as an extension of your organization, only presenting candidates who are aligned on culture, clinical fit, and timing. A good partner can also advise on what’s happening in the broader market in real time. They see specialty-level shifts in supply-and-demand before they surface in national benchmarks and can advise on the best position.
The strongest organizations don’t choose between these approaches. They build internal pipeline capacity and keep a trusted search partner on hand for the hard-to-fill or urgent searches that require a broader reach or unique perspective.
The Math Always Favors the Proactive
Physician turnover is an inevitable part of healthcare workforce planning. While no organization can eliminate every vacancy, preparing for potential transitions before notice is given can help minimize disruption and create more options when the unexpected happens. A proactive recruitment strategy can help organizations respond with greater clarity and flexibility, rather than making critical decisions under the pressure of a vacancy, lost revenue, or the need for costly temporary coverage. Investing in that preparation can also deliver a proven ROI. Planning ahead does not eliminate uncertainty, but it can provide a stronger foundation for navigating what comes next.
Are you ready to start planning? The team at Jackson Physician Search has the experience and expertise to help you build a winning strategy before you need it. Reach out today.
