Locums…is it true what they say? How do you choose the right company?

Locums…is it true what they say?  How do you choose the right company?

Usually by the time you’ve practiced for a while you will start to get emails from locums company representatives asking if you would be interested in locums work.  For residents, odds are at least one of your attendings has worked for locums company at one time or at least considered it.  The first time I heard of locums was during my third year of residency.  One of our attendings mentioned it as a good option to explore different practices before committing to a final hospital or location.  In my first year of practice, I received a random email from a larger locums company, I filed it away at the time.  I was happy and I didn’t have the time for additional clinical responsibilities.   But, when I decided to revisit locums, I went back to that email.  It was as good of a place to start as any.  Things to consider:

1. Big Company vs Small Company. There are a multitude of companies out there.  From my experience, the bigger companies are consistent, they have great support staff and usually work hard to maintain a favorable reputation with their facilities.  Their representatives are available 24 hours a day for any issues that may arise while you’re on assignment or traveling to an assignment. This  also means they have more standardized (and possibly lower) pay rates.  Small companies will have less support staff and therefore less overhead.  They may offer higher pay rates, but you may have to be a little more flexible.  As with anything else, each company may have local or regional preferences, may work with government facilities or be geared toward clients that are seeking temporary to permanent positions.
2. You are a contract employee of the locums company. You will have to complete credentialing application for each locums company, in addition to each facility you apply. As with any company, pay frequency may be weekly, bi-monthly or monthly.  You may receive paper checks or direct deposit.  Make sure you confirm with the company.
3. If you are seeking employment within a small geographical area, then you may want to research which companies place more physicians in that particular area and plan to sign up with at least 2-3 companies.
4. All companies generally offer to cover transportation to and from the site, including ground transportation to the airport, airfare and baggage costs. They cover or arrange lodging and rental car if needed.
5. They may or may not cover additional state medical licenses, DEA applications and/or controlled substances certificates.
6. They do not cover meals.
7. They do not cover health care benefits or other benefits usually associated with full-time employment: disability insurance, retirement investments or CME reimbursements.
8. Malpractice. They cover your malpractice while on assignment.  You will receive a copy of your malpractice coverage agreement when you start each assignment.  You will be responsible for your tail if you need it when leaving your current practice situation.
9. If you have the time, talk to a few companies and build a rapport with a representative in your specialty area before you commit. Explain your reason for pursuing locums, what length of assignment you prefer, where and how you would like to work. This relationship will be very important as you move forward.  Remember that the representatives talk with each other and facilities talk to multiple locums companies.  Your reputation is important.  It can help you get or keep an assignment, be asked to return to an assignment, be considered for a permanent position or negotiate a higher pay rate.
10. Be very clear with the representative if you would like to be “presented” to an organization. There are rules as to how often you can be presented to the same organization.  This detail can get tricky if you’re working with more than one company.  Once the company has your CV, it is possible that they can present you even if you’re not credentialed with them.  I now only send my CV to companies after I am confident that I plan to work with them.

I started with one company.  One of the larger ones.  For me it made sense to sign up with a company that had a solid reputation and great online resources.  Most locums physicians that you meet along the way, will tell you that if you do locums long enough you will add on additional companies.  One doc told me at one time he was up to 9!  I just added my second company, a smaller physician run company.  I imagine I will add a third next year.

Take homes:

• Ask around. See which companies have the best reputation in the area(s) that you want to work.  Forge a relationship with a representative before accepting your first assignment.
• Be clear about the type, location and/or length of assignment you are looking to find.
• Do not let the representatives talk you into anything you’re not comfortable with doing. There will be another assignment.  You are in control.
• Use this opportunity to build the life you want to live!

Resources:

https://www.nalto.org/

http://www.medpagetoday.com/KevinMD/41085

http://www.kevinmd.com/blog/2013/02/year-locum-tenens-physician.html

http://journal.practicelink.com/career-move/career-move-locum-tenens-physician/