Healthcare Staffing Spend Is Down 6% - But Surgeon and Oncologist Locum Pay Is Up. Here's Why

Staffing Industry Analysts projected healthcare staffing revenue would fall about 6% in 2025, to roughly $39.4 billion — a real correction after years of pandemic-driven growth. Read as a single headline, that sounds like relief for any employer budgeting staffing spend for next year. It isn't, at least not evenly. The same data shows the locum tenens segment specifically grew 15% in 2024, with pay for specialties like surgery and oncology continuing to climb even as the broader market cooled.

Two different markets, one headline number

The 6% decline is concentrated where the pandemic-era premium was least sustainable — travel nursing rates that spiked in 2021 and 2022 have largely normalized as crisis-level demand faded and health systems rebuilt internal float pools and internal resource pools to cover routine gaps. That's a real, durable cost reduction, and it's the part of the market driving the aggregate number down.

Specialty physician coverage is a structurally different problem. Surgeons and oncologists aren't in short supply because of a temporary crisis — they're in short supply because of the same long training pipelines and capped residency slots behind the broader physician shortage. That scarcity doesn't correct when travel nursing rates do, and it shows up as locum tenens pay for those specialties continuing to rise even while overall industry revenue contracts.

What this means for next year's budget

• Don't apply a blanket "staffing costs are down" assumption across every role — benchmark by specialty and role type, not against the industry-wide average.
• Expect routine nursing and allied health coverage costs to keep trending toward pre-pandemic norms as internal resource pools mature.
• Expect surgical and oncology locum coverage to keep commanding a premium, and build that into multi-year specialty coverage budgets rather than assuming it follows the broader correction.

DirectShifts benchmarks locum and per diem rates by specialty, not by industry average — talk to a clinician partner about what a realistic 2027 budget looks like role by role.