Physician transitions are not always clean. Even when a departure is planned, the operational impact can ripple through scheduling, access, quality workflows, patient experience, revenue integrity, and your staff morale.

When the transition involves a coverage-critical specialty — radiology, emergency medicine, hospital medicine, or other services that support downstream care pathways — the stakes rise quickly and timelines compress.

Ben Stajduhar, senior vice president of business development at Jackson Physician Search, described this dynamic based on work the firm did in conjunction with LocumTenens.com at a rural hospital in Colorado. The “discomfort” of contract talks with an external group felt like the organization was “being held over a barrel” — a familiar scenario when essential coverage is concentrated in a small number of clinicians or a single contract agreement.

Transitions become more manageable when leaders treat this situation as an operational change rather than a recruiting fire drill. In practice, that means:

1. Understanding the operational risks of transition, especially in coverage-critical specialties;
2. Using interim coverage intentionally as a bridge; and
3. Planning permanent hires in parallel so it supports stability, community investment, and sustainable coverage.

This article explores a framework you can apply to any medical group, including organizations that rely on coverage-sensitive services (e.g., imaging, anesthesia for surgery centers).

Start with operational risks, not a job requisition

When disruption hits, the instinct is to fill open shifts as fast as possible. Speed matters, but it can also lock organizations into a “temporary” model that is expensive, fragile, or misaligned with longer-term goals. Before you decide how to staff, work to find your hidden capacity and then clarify what is truly at risk. In coverage-critical specialties, this typically involves:

• Access and throughput (delays, backlogs, reduced clinic capacity)
• Clinical risk and continuity (handoff gaps, inconsistent coverage expectations)
• Service line viability (impact to ED flow, procedures, or diagnostic turnaround time)
• Financial exposure (premium staffing costs, missed charges, delayed billing, payer credentialing problems)
• Reputation and trust (clinician confidence, patient satisfaction, staff morale).

This is where transition management builds on effective recruitment. Recruiting becomes one of several coordinated workstreams rather than the single lever leaders pull.

• Learn more about how physician transition management comes together by attending “From Chaos to Coverage: Managing Physician Transitions for Long-Term Team Building” at the 2026 MGMA Operations Conference, April 12-14 in Charlotte, NC.

Preparation before a transition happens

Many transitions feel sudden because organizations act only once a relationship is already unstable. A practical preparation step is to treat physician arrangements, especially in coverage-critical specialties, like a risk-bearing contract that requires routine review. This can include imaging coverage, anesthesia coverage for surgery centers, specialty call coverage arrangements, or reliance on a small number of providers with no redundancy.

In these scenarios, build a consistent process of “risk sensing”:

• Review contract terms and termination timelines 12 to 24 months before renewal.
• Look for indicators: Is there persistent scheduling friction? Coverage disputes? Service complaints? Repeated quality/turnaround concerns?
• Confirm that credentialing and payer enrollment processes can move quickly if needed.
• Agree internally who owns decisions in a disruption (CEO, chief operating officer, service line leader, medical director, etc.).
• Pre-identify a staffing bridge approach (e.g., locum tenens, regional partners).

When disruption hits: A transition management checklist

The first three days will set the tone. Your objective is coverage continuity with minimal additional disruption. That requires rapid decisions and understanding next steps.

1. Stabilize the coverage model: Confirm the minimum safe coverage requirements (hours, call, on-site needs)
2. Launch parallel workstreams: Your interim staffing work (locum tenens, internal coverage, or partner coverage) can happen alongside efforts to search for a permanent hire, as well as credentialing and payer enrollment for all new clinicians. Throughout, make sure you communicate updates and expectations with your existing clinicians, staff, and leadership.
3. Reduce variability: Coverage is not just having a provider present; it is the reliability of workflows centered on that provider. Especially in imaging and similar areas, clarify expectations for turnaround times and coverage handoffs. Use daily huddles until stability improves.

Interim coverage as a bridge

Interim coverage can support continuity during transitions, but leaders sometime hesitate to use locum tenens because they assume it is only for short absences. Amy Otto, director of enterprise solutions at LocumTenens.com, said: “Usually people don't want to engage locums for transition management because they think locums is only for vacations or when someone is out on maternity leave” or otherwise filling a small gap in coverage.

In transition management, the framing changes. Otto described it this way: “When we go about recruiting for transition management, we look at clinicians as project-based, not necessarily locums.” The project mindset matters because it leads to clarity on the length of time clinicians are needed, continuity of care, onboarding requirements, and the transition to long-term, permanent staffing. Good transition management turns disruption into stability. 

Coordinated transition support can also reduce complexity for practice leaders. In the rural Colorado example, Jackson Physician Search and LocumTenens.com organized the response through one coordinated call, rather than multiple briefings and parallel conversations. In time-sensitive transitions, a shared view helps when teams must coordinate interim coverage, recruiting, credentialing, scheduling, and stakeholder messaging at once.

A consultative transition management model differentiates itself through deliberate cross-coverage between interim and permanent staffing partners — preserving continuity of care, protecting team morale, and preventing operational whiplash. It goes beyond simply filling shifts to stabilizing systems, recognizing that even small workflow inconsistencies in coverage-critical specialties can lead to scheduling backlogs, billing delays, or patient dissatisfaction.

Operational safeguards

Credentialing and payer readiness are part of continuity. Otto emphasized starting early to protect revenue integrity: “We proactively begin the payer credentialing process … so clients don't have to rely on the Q6 modifier,” with the goal of ensuring organizations are able to maximize reimbursement. 

Onboarding must also be structured. Otto described a high-touch approach that reduces friction and helps clinicians integrate into workflows quickly: “We have a customer care team that ensures that the right clinicians are in place at the right time with clear and consistent expectations, consistent workflows and strong communication. For administrators, the takeaway is to define workflows, documentation expectations, and service line priorities for interim clinicians the same way you would for a permanent hire — on a compressed timeline with the help of a partner with in-depth experience in providing intentional stabilization with minimal disruption.

Reality-based role design

A common failure in transitions is designing a coverage plan that ignores what must happen on-site. This is especially important in radiology, but the principles apply elsewhere. Georgia put it plainly: “Radiology is so volatile right now.” While remote coverage can improve speed, “you have to have someone on site,” in part because procedures such as paracentesis and thoracentesis need to be done on site, along with certain breast imaging needs.

As a broader principle, separate what can be centralized or virtualized from what requires physical presence, then design the interim and permanent models accordingly. Many transitions become expensive because the interim coverage plan is mis-scoped — either paying for on-site presence unnecessarily, or relying too heavily on remote coverage that cannot meet key clinical demands.

Permanent hiring: Recruit for stability and fit

Interim coverage only works if you are building toward a durable end state. Coverage decisions affect recruitment by shaping the organization’s reputation, clinician confidence, and the practicality of onboarding new permanent physicians into a stable environment. Georgia described the importance of deep upfront assessment: “With any client, we like to get boots on the ground and go profile the entity thoroughly,” including spending time with leadership and clinical stakeholders to understand what the role looks like from the inside.

Role definition should include: clinical scope that matches the market; schedule realities (including call); governance expectations and decision-making structure; what “community investment” means for the organization; and a clean interview and selection process that doesn’t drift over time.

The goal is to recruit for staying power, not just speed — especially in rural and smaller markets where stability and relationships are part of the care model.

In the rural Colorado example, leadership needed a plan that maintained coverage while transitioning toward a stable, in-house model. The response paired interim locum tenens with a parallel permanent placement strategy across coverage, credentialing, onboarding, and recruiting. The core principle was consistent: treat the bridge as a structured project and build around a defined outcome rather than waiting for “stability” to arrive on its own.

Building a transition blueprint

Coverage-critical transitions benefit from a staged plan, regardless of whether the setting is hospital-based or ambulatory.

1. Proactive risk sensing: Stajduhar acknowledged that many of these transitions occur reactively rather than through planned changes. Leaders should review key contracts early (possibly a year or two before they term), “pulse the relationship,” and explore alternatives before negotiations become a crisis.
2. Stabilize with an intentional bridge: Define minimum safe coverage and the right blend of on-site and remote support. Start credentialing and payer enrollment early. Establish a communication plan that keeps clinicians and staff aligned while the permanent search progresses.
3. Convert to continuity: Begin permanent recruiting early, grounded in cultural profiling and a streamlined interview process. Use tight feedback loops to refine the candidate profile and strengthen the organization’s story in the market. As permanent clinicians come on board, ramp down interim coverage in a controlled way to support knowledge transfer and preserve team cohesion. Avoiding a coverage gap is only one small part of transition management. Done well, it creates the operational runway to stabilize services while building a team that can deliver continuity, community investment, and long-term sustainability.