Locum Tenens Coverage: Your Hygiene Hole Costs More Than You Think

Locum Tenens Coverage: Your Hygiene Hole Costs More Than You Think

Locum Tenens Coverage: Your Hygiene Hole Costs More Than You Think

When your hygienist calls out sick, you have three options: cancel that schedule (lost $2,000-$3,500 production), work it yourself (burns your doctor time), or call a locum agency. Locums charge $55-$75/hour, which sounds expensive until you price the alternative.

Losing $2,800 in production over canceled hygiene costs you $1,800-$2,100 after overhead. A locum at $65/hour for 8 hours costs $520. You save $1,300 in that day alone.

The math changes for planned absences. A 10-day vacation without coverage costs $28,000 in lost hygiene production. Locum coverage costs $3,900. But here's the trap: booking locums requires 4-6 weeks lead time in busy markets. Miss that window and you're paying premium rates or canceling.

Smart practices budget 2-3% of annual revenue for planned locum coverage (vacations, maternity, sabbaticals) instead of absorbing the production hit. For a $1.5M practice, that's $30K-$45K annually. Counterintuitive? Yes. Until you realize unplanned cancellations already cost you that much without a safety net.

Build the locum relationship now. Pre-credential them. Test them with one easy day. When you need them, you're ready.

Source: DSO Staffing Solutions and Locum Tenens Economics (2025)

OPERATOR MATH

Let's break down the annual cost of NOT having locum coverage ready.

Your hygienist gets sick 4-6 days per year (industry average). Each unplanned absence: $2,800 lost production × 65% margin after overhead = $1,820 lost profit per day. At 5 sick days annually, that's $9,100 in lost profit.

Add planned absences: 2-week vacation (10 working days) + 2 continuing education days = 12 days. Without coverage: 12 days × $2,800 = $33,600 lost production × 65% = $21,840 lost profit.

Total annual cost of no coverage: $9,100 (sick days) + $21,840 (planned) = $30,940 in lost profit.

Now compare to a locum strategy: Pre-credential 2 locums ($0 cost). Book them for planned absences: 12 days × $520/day = $6,240. Emergency coverage for 3 of the 5 sick days (2 you can reschedule): 3 × $520 = $1,560. Total annual locum spend: $7,800.

The savings: $30,940 (lost profit without coverage) - $7,800 (locum cost) = $23,140 net annual gain. That's a 296% return on your locum investment. The 2-3% revenue budget isn't expense - it's protecting 1.5% of net profit.

THE TAKEAWAY

Action items for the next 30 days:

1. Contact 2-3 locum agencies in your market this week. Get their rate sheets and lead-time requirements. Ask for references from practices similar to yours.

2. Pre-credential one locum now (license verification, malpractice, background check). Budget 2-3 hours of admin time. Don't wait until you need them.

3. Test your preferred locum with one easy day - a light Friday or a day when your regular hygienist is available for backup. Pay the $520 to validate quality before the emergency hits.

4. Build the annual budget line: Calculate 2.5% of gross revenue, earmark it for locum coverage. For a $1.5M practice, that's $37,500. Track actual spend monthly.

5. Document your locum protocols: Which patients are good test cases, your preferred scheduling approach, how to introduce the locum to patients. Make it repeatable so your front desk can execute without you.