Physician coverage has long been one of the most pressing challenges facing oncology programs. For decades, the default solution has been straightforward: when a physician vacancy occurs or volumes increase, hire a locum tenens physician to maintain access and keep the clinic operating.
That model made sense in a healthcare environment built around fee-for-service reimbursement, where success was measured primarily by patient volume and the number of services delivered.
Today, however, the economics of healthcare are changing. CMS is sending increasingly clear signals that reimbursement is moving away from simply paying for services performed and toward rewarding organizations that demonstrate value, accountability, quality, operational efficiency, and improved patient outcomes. In that environment, the traditional locums model begins to reveal significant limitations.
A Model Built for Yesterday’s Healthcare Economy
The fundamental problem with the locums model is not the physicians themselves. Locum physicians provide an important service and often help organizations maintain access during periods of transition. The challenge is that the model was designed for a reimbursement system focused on individual encounters rather than enterprise performance.
CMS is steadily redefining what it means to deliver value. Recent proposed rules emphasize quality reporting, AI governance, documentation integrity, care coordination, operational efficiency, and total cost of care. These priorities reflect a healthcare system that increasingly rewards sustained organizational performance rather than isolated clinical transactions.
Temporary physician coverage addresses one operational issue: filling a schedule. It does not necessarily improve the broader performance of a cancer program.
Coverage Is Not the Same as Transformation
Locums physicians help maintain patient access, but they are generally not engaged to redesign workflows, optimize treatment planning, improve scheduling efficiency, strengthen multidisciplinary collaboration, enhance documentation processes, or reduce unnecessary costs.
Modern oncology programs face challenges that extend far beyond physician availability. Radiation oncology, medical oncology, infusion services, pharmacy, imaging, navigation, prior authorization, revenue cycle, and supportive care are becoming increasingly interconnected. Small inefficiencies in one area often create financial and operational consequences throughout the entire oncology service line.
Value-based reimbursement increasingly rewards organizations that improve these systems over time.
Temporary staffing, by design, is rarely positioned to accomplish that objective.
Accountability Cannot Be Temporary
Another limitation of the locums model is accountability.
CMS continues moving toward reimbursement models that emphasize longitudinal quality measures, patient outcomes, documentation accuracy, resource stewardship, and coordinated care. These initiatives require continuous physician leadership and long-term ownership of organizational performance.
A temporary assignment naturally limits that accountability. Once the contract concludes, responsibility for quality metrics, workflow improvements, strategic initiatives, and operational performance returns entirely to the organization.
The future of value-based oncology depends upon sustained leadership rather than episodic coverage.
Rising Costs Demand Greater Returns
Healthcare economics have changed dramatically over the past decade.
Locums physicians frequently represent one of the highest labor expenses within a cancer program after agency fees, travel, housing, credentialing, and premium compensation are considered.
Under historical fee-for-service reimbursement, these costs could often be offset through increased patient volume.
Today’s reimbursement environment tells a different story.
Cancer programs are increasingly being asked to demonstrate measurable returns on every investment they make. Hospital executives are no longer asking whether physician coverage can be obtained. They are asking whether those investments improve access, quality, workforce stability, operational efficiency, financial performance, and patient outcomes simultaneously.
Temporary physician staffing generally addresses only one of those objectives.
The Physician’s Value Extends Far Beyond Presence
Perhaps the greatest misconception embedded within the traditional locums model is the assumption that a physician’s primary value is simply being physically present to provide patient care.
That perspective is increasingly inconsistent with modern oncology.
The value of an oncologist is not measured solely by the number of patients seen during a clinic day. It is reflected in clinical judgment, multidisciplinary leadership, protocol development, mentorship, quality improvement, stewardship of healthcare resources, physician collaboration, governance, strategic planning, and the ability to improve outcomes across an entire cancer program.
Reducing physician value to physical presence alone diminishes the true contribution physicians make to healthcare organizations.
Physicians are not interchangeable labor units whose value begins when they walk through the clinic door and ends when they leave.
They are leaders of highly complex clinical systems whose decisions influence patient safety, operational performance, workforce development, financial sustainability, and long-term organizational success.
As CMS increasingly rewards coordinated care, documentation integrity, quality improvement, and responsible resource utilization, physician leadership becomes more valuable—not less.
The question is no longer:
“Was a physician present?”
The question increasingly becomes:
“Did physician leadership improve the quality, efficiency, outcomes, and sustainability of the cancer program?”
That represents a profound shift in how physician value should be measured.
Building Institutional Knowledge
Another challenge with traditional locums coverage is the limited opportunity to build institutional knowledge.
High-performing oncology programs depend upon standardized workflows, multidisciplinary communication, consistent clinical pathways, operational governance, and continuous process improvement.
Temporary coverage rarely creates the continuity necessary to establish these systems.
Sustainable improvement requires physicians who understand the organization’s culture, participate in operational decision-making, mentor clinical teams, and help shape long-term strategy.
That type of leadership compounds in value over time.
Temporary staffing, by definition, does not.
CMS Is Rewarding Infrastructure
The proposed 2027 CMS rules continue to reinforce an important trend.
Whether discussing AI governance, care coordination, documentation quality, total cost of care, site-neutral payment policies, or value-based reimbursement, CMS is increasingly rewarding organizations that build durable clinical infrastructure.
Healthcare is shifting away from paying for isolated services and toward rewarding organizations capable of consistently delivering efficient, coordinated, high-quality care.
Infrastructure—not transactions—is becoming the competitive advantage.
Organizations that invest in stable physician leadership, integrated care teams, operational excellence, technology, analytics, and governance will be better positioned for the reimbursement environment that continues to emerge.
The Future Is Partnership, Not Coverage
The next generation of physician engagement will likely look fundamentally different from traditional locums staffing.
Rather than purchasing physician time alone, cancer programs will increasingly seek comprehensive clinical partnerships that combine physician expertise with operational leadership, quality improvement, workforce development, technology integration, virtual supervision, data analytics, governance, and enterprise accountability.
These models create value long after an individual clinic day ends.
They strengthen organizations rather than simply filling temporary vacancies.
A New Definition of Physician Value
The future of oncology reimbursement is increasingly centered on outcomes rather than activity, leadership rather than labor, and long-term performance rather than temporary coverage.
Locums physicians will continue to play an important role during transitions, emergencies, and recruitment periods. They remain a valuable tool when used appropriately.
However, they should no longer be viewed as the long-term strategy for building sustainable oncology programs.
CMS is signaling that the future belongs to organizations capable of demonstrating measurable improvements in quality, efficiency, access, and total cost of care.
Meeting those expectations requires something far more valuable than physician presence.
It requires physician leadership.
As reimbursement evolves, the organizations that thrive will not simply ask, “How do we cover the schedule?”
They will ask a far more important question:
“How do we empower physicians to lead the transformation of cancer care?”