The subtotal in Table 29-1 assumes the candidate is sourced, interviewed, signed, licensed, credentialed, and relocated all within 120 days in order to avoid any gap in physician coverage for your program. Depending on the desirability of your location and the availability of candidates interested in your location, this 120 days may be achievable. However, for many practices, 120 days is sadly only a dream. Some hospitals cannot even get hospital privileges granted in 120 days! If your remaining physicians cannot absorb the patient volume once their departing colleague is gone, the practice will be faced with locum tenens coverage that could cost up to $2,000 per day! For every month the position is unfilled, the practice must pay $60,000 in locums fees. It is easy to see how the $87,000 can quickly become $147,000 or $207,000. The cost of turnover is high! And this table does not even begin to try and calculate the cost of decreased collections (when locums docs are used or while the new doc is getting up to speed on the billing software, etc). Furthermore, losing an experienced hospitalist who has positive working relationships with your primary care physicians and a working knowledge of the hospital may further compound the financial impact and adversely affect the smooth functioning of the service.