Urology Locums, Upgraded: How Hospitals Get 24/7 Coverage and Continuity (and Why Urologists Prefer It)

If you’re a hospital executive, you’ve likely felt the pressure: specialty coverage gaps, rising referral leakage, and a community asking for more access closer to home. Nearly half of rural hospitals are operating in the red, and hundreds remain vulnerable to closure—an environment where every service line must pull its weight and every hour of coverage needs to make strategic sense. (Chartis)

If you’re a urologist, you’ve probably considered “urology locums” for flexibility and higher pay—but also discovered the trade-offs: travel, 24/7 call, minimal support, and little chance to build something lasting. Our own recent post outlined why many urologists are looking for alternatives. (VirtuCare)

This article challenges the default thinking about urology locum tenens coverage. We’ll show why the traditional model falls short for hospitals and physicians—and how VirtuCare’s integrated care model delivers 24/7 coverage coordinated with a staffed outpatient clinic, comprehensive services, and elective cases that drive outcomes and ROI.

What “urology locums” usually means today

Definition. Urology locum tenens typically means short-term specialist coverage to fill call gaps or stop‑loss scenarios. Schedules are reactive, travel-heavy, and often focused on emergencies and inpatient consults rather than building a durable local program.

Costs. Publicly posted rates and industry reports put urology locums compensation commonly in the ~$200–$290/hour range, with daily rates around $2,600—not including travel, housing, agency fees, onboarding, and handoff time. When coverage extends to nights and weekends, the true cost escalates quickly. (locumstory.com,AMN Healthcare)

Access realities. Even where hospitals buy call coverage, communities still struggle with urology access. More than 60% of U.S. counties lack a urologist, a maldistribution that fuels long travel distances and delayed care. (AUANews)

The downsides of traditional locum tenens coverage

Hospital leaders and physicians know these pain points, but it helps to name them clearly:

1. No continuity of care. Episodic coverage produces fragmented handoffs and short-term fixes rather than longitudinal management. Robust evidence links greater continuity to lower costs, fewer hospitalizations/ED visits, and lower mortality—benefits the typical transactional locums setup can’t deliver. (Annals of Family Medicine,AJMC,BMJ Open)
2. Emergency-heavy focus. When onsite time is spent almost exclusively on call, outpatient needs get deferred. Patients are triaged, transferred, or told to find an appointment hours away. Transfers and handoffs are recognized risk points for safety and quality. (Joint Commission)
3. Little collaboration or local infrastructure. Locums physicians “parachute in” without a consistent team, clinic processes, or EMR pathways tuned to urology. Everyone works harder for smaller gains.
4. Varying quality and variable workflow. Rapid onboarding, shifting sites, and inconsistent protocols create variability. Even superb physicians are limited without a system around them.
5. Not cost‑effective long term. Paying premium rates for reactive coverage doesn’t build durable capacity or revenue. You cover nights and weekends, but weekdays lack a clinic engine to drive diagnostics, procedures, and follow-up care that strengthen both outcomes and hospital finances.

The hidden costs of “coverage‑only” urology locums

1) Patient leakage drains hospital revenue.

Executives routinely estimate 10–30% of total revenue is lost to referral leakage when patients get work‑ups, procedures, and follow‑ups outside the system. In a 100‑provider network, leakage can translate to tens of millions in lost revenue annually. (webmdignite.com,Dialog Health)

2) Lost outpatient cases hurt the margin mix.

Hospitals are surviving on outpatient growth; 2024 analyses show outpatient revenue up 9% year over year and the main driver of margin stabilization. If you outsource urology to episodic call, you forfeit the very visits and electives that keep you in the black. (kaufmanhall.com)

3) The coverage price itself is steep—and opaque.

Posted and reported rates show many hospitals paying $4,000–$5,000 for a 24‑hour call day in procedural specialties (sometimes more in high‑acuity or short‑notice scenarios), while some urologists are offered less than $2,000 per 24‑hour equivalent for weekend call packages. Meanwhile, industry insiders peg common agency markups at 30–50% between the hospital’s bill rate and the physician’s pay rate. Translation: large non‑clinical margins for middle‑men. (DocCafe,ZipRecruiter,Student Doctor Network,physiciansidegigs)

Why “no continuity” is the most expensive line item

Continuity isn’t just a patient‑satisfaction metric; it’s an outcomes and cost lever:

• Systematic reviews associate higher continuity with lower mortality, fewer hospitalizations/ED visits, and lower total costs. That’s the opposite of episodic, coverage‑only staffing. (BMJ Open,BioMed Central,AJMC,JAMA Network)

In short: paying top dollar for coverage while forfeiting clinic continuity and elective cases is a double hit—high expense + lost revenue.

A better path: integrated Urology Locums through VirtuCare

VirtuCare reimagines “urology locums” by pairing 24/7 coverage with a coordinated outpatient clinic, staffed and standardized, so coverage time translates into durable access, elective cases, and measurable results. We outlined the clinician lifestyle benefits of this model in a recent piece, but here we’ll go deeper on the hospital integration that makes it work. (VirtuCare)

What’s different

• 24/7 coverage that’s coordinated—not just call. Yes, we can provide round‑the‑clock coverage. The difference is that our on‑call urologists are embedded in a clinical model tied to a local APP-led clinic and clear care pathways, so nights/weekends link back to proactive outpatient workups and scheduled procedures.
• APP‑led clinic, urologist‑directed. We help you identify and train a local NP/PA, standardize order sets and templates, and run a weekly clinic that feeds your OR. Teleurology is evidence‑supported for many urologic conditions when integrated with proper triage and follow‑up. (European Urology)
• Elective cases stay local. We stand up regular OR time for bread‑and‑butter urology (stones, BPH, etc.), so your community doesn’t have to drive hours—and your hospital doesn’t lose the case. Recent partnerships show hospitals publicly leaning into this model to expand access.
• Team-based continuity. Patients see the same clinic team. Supervised teleurology visits and local APP follow‑ups knit the journey together. Evidence shows teleurology can safely manage many conditions when integrated thoughtfully. (European Urology)
• Standardized handoffs. Shared EMR templates, standing orders, and preference cards reduce variability and risk across shifts and sites—addressing a well‑documented point of failure in traditional handoffs. (Joint Commission)

Bottom line: We don’t just “plug a hole.” We build a urology service line that happens to include 24/7 coverage.

Why continuity + comprehensiveness matter

Continuity isn’t a feel‑good extra—it changes outcomes and costs. Systematic reviews associate continuity with lower mortality, fewer hospitalizations/ED visits, and lower total costs of care. In practical terms, that means fewer avoidable transfers and better long‑term management for conditions like BPH, stones, recurrent UTIs, and incontinence. (BMJ Open,Annals of Family Medicine,AJMC)

And when you combine continuity with comprehensiveness—a clinic that can evaluate, order diagnostics, perform in‑office procedures, and schedule OR time—you keep care local, capture downstream revenue, and rebuild community trust. (Chartis)

The economics for hospital leaders

Traditional urology locums was built for stopgaps, not sustainability. You pay premium day rates to cover call, but the value leaks out the door: no clinic, no elective pipeline, no loyalty.

VirtuCare’s integrated model flips the script:

• Access drives revenue. A consistent clinic and scheduled OR time generate recurring top‑line revenue from visits, ancillaries, and outpatient cases rather than just costs for call coverage. Many rural hospitals are leaving this on the table. (VirtuCare)
  
• Fewer transfers, less leakage. Keep patients local with structured teleurology + APP coverage and a traveling surgeon for monthly blocks. Transfer only the truly complex cases. (VirtuCare)
  
• Predictable costs, scalable model. Coverage and clinic scale up or down with demand. You’re not over‑committing to a full‑time hire that may be impossible to recruit.
  

In a challenging rural landscape—where margins are thin and closures are still happening—investing in a system that creates durable specialty capacity makes far more sense than paying indefinitely for episodic call. (Chartis)

What this looks like in practice

A typical month for a VirtuCare partner site:

• Daily: APP‑led clinic with remote urologist supervision for new consults, testing, medication management, and post‑ops.
  
• Weekly: OR days for elective cases (e.g., endoscopic stone, BPH procedures, and other bread‑and‑butter cases), handled by our traveling surgeon.
  
• Always‑on: 24/7 call coverage is available when contracted—integrated with the same protocols, handoffs, and clinic follow‑up so ED encounters don’t become dead ends. (VirtuCare)
  

This continuity supports quality and safety while addressing a key risk area: handoffs between shifts and care settings. (Joint Commission)

Quality, governance, and support (the “VirtuCare difference”)

• Run by a urology team. We are built and led by practicing urology clinicians, not generalist staffing brokers. That’s how we vet colleagues with excellent reputations and align incentives around continuity and outcomes. (VirtuCare)
  
• Operational playbooks. From referral management and clinic workflows to preference cards and order sets, we bring the infrastructure that makes quality and efficiency repeatable—addressing the very handoff risks that undermine traditional coverage. (Joint Commission)
  
• Marketing that fills the clinic. We help you stand up a visible service line—public‑facing pages, community outreach, and referring‑provider education—so the clinic is busy from week one. (That’s why our partners highlight access gains when launching with us.) (fairfieldmemorial.org)
  

Why urologists prefer this version of urology locums jobs

Urologists want flexibility without burnout. VirtuCare offers a clinical home—not just an assignment:

• A real team: You’re not parachuting in solo; you work with trained APPs and shared protocols.
  
• Choose your mix. Telehealth clinics from home, in‑person clinic days, and scheduled OR blocks—not just midnight consults.
  
• Competitive pay without the chaos: Focus your time on higher‑value care, not travel logistics or uncoordinated consults. (See our explainer on why this beats traditional locums.) (VirtuCare)
• Lifestyle preserved. Many roles avoid 24/7 call entirely; when we do provide hospital call, it’s supported by protocols and a coordinated clinic so you’re not just reacting.
  

If you’ve tried traditional locums and felt like a permanent visitor, this is different. You get flexibility and the satisfaction of building something that lasts.

FAQs (for executives and urologists)

Isn’t teleurology just a COVID workaround?

No. A systematic review in European Urology found telehealth applicable to a wide range of urologic care when integrated with appropriate triage, exam needs, and follow‑up. In rural systems with good clinic protocols and APP support, teleurology expands access safely. (European Urology). Our model combines the best part of telemedicine (remote guidance and knowledge) with the best parts of in-person care (human touch, familiarity).

Can you really deliver 24/7 coverage?

Yes. We staff round‑the‑clock coverage when contracted, but the crucial difference is that coverage connects to an outpatient clinic and scheduled elective time. Night/weekend encounters loop back to the clinic for definitive care rather than becoming serial handoffs. (VirtuCare)

How is this more cost‑effective than traditional locums?

Traditional urology locums often purchase time, not capacity. You pay premium rates for reactive coverage and lose revenue to transfers and leakage. Our model converts coverage into capacity via a running clinic, elective OR blocks, and continuity—capturing downstream revenue and improving outcomes. (locumstory.com,AMN Healthcare,Chartis)

What about workforce realities—is there enough urology demand?

Yes. Urology workforce shortages and maldistribution are well documented; over 60% of U.S. counties lack a urologist, with rural communities most affected. That means pent‑up demand for access, diagnostics, and procedures—if you build the right model. (AUANews)

Next steps

• Hospital executives: Are you ready to turn coverage into capacity? Let’s assess your market opportunity and build a pro forma. We’ll map visit volumes, OR blocks, and downstream revenue, then design an implementation plan for a clinic launch in months—not years. (VirtuCare)
  
• Urologists: Explore flexible urology locums jobs without the chaos—telehealth clinics from home, coordinated teams, and elective cases that keep you clinically sharp. (VirtuCare)
  

Ready to rethink urology locums? Use the contact form on our site or email our team at [email protected] to start the conversation.