The Pros and Cons of Locum Tenens
Let’s be honest, we have all contemplated locum tenens work. There isn’t a doctor I have interacted with who hasn’t had a moment of reflection, the age-old question, “Is the Grass Greener?” Maybe you are in residency, and a couple months working on Hawaiian island or remote Alaska seems like an adventure you can wrap your head around. A reasonable transition until you settle into family life and join a practice. Perhaps you are 5-10 years into practice, and certain aspects of your work aren’t exactly as you planned. Could you do it better on your own? Or maybe you are at the tail end of your career, kids already out of the house and you are looking for a bit of a change, a step down before retirement, focusing on the aspects of practice you think are getting lost amongst paperwork, prior auths, and meetings. Wherever you are in your career, today we break down the big points of locums work. The items that must be addressed before making a decision if locum tenens is right for you. So let’s get started with the broad strokes and we will break each of these down in future posts.
FREEDOM!! Scream it like William Wallace did in Braveheart. It feels that good. Freedom to define where and how you practice. Freedom to choose how much you work, how much call you take and where you decide to practice. Let’s not forget, you are the one who spent 10 years in medical school and residency. Shouldn’t you be the one to decide how the next step in your journey looks? We think so, its why we do locum tenen’s work. We think everyone should spend winters in Aspen and summers in Hawaii. However, all freedom comes with a price, and the price can depend on several factors. While there are always certain specialties with opportunities in highly desired areas, others are often limited in where you can go. It is important to know whether your specialty has availability. Anesthesia, emergency medicine and hospitalist positions are easy to find, but want to do pediatric allergy, it’s a little bit more difficult.
Ok, so let’s say you happen to be a hospitalist, and the opportunities are more plentiful. The stars don’t always align. Just being in a highly desired specialty in the locums world won’t ensure you land the position in the exact location you want. You will need to be a little flexible and strategic. Yes, there are hospitals in San Francisco and New York looking for doctors to fill in, but there is no guarantee that location will always be available. Once you decide that your field will allow you to pursue locums, and most will, you need to get a feel for exactly where the positons typically are and if that will fulfill your goals.
Finally, the freedom to define exactly the way you want the practice medicine. Yes, you can find positions that limit the aspects of practice you want to avoid. No call- easy to find. Shift work and clock out, many hospitals want you now. Emergency coverage only- the list is long. However, hospitals aren’t looking to pay you to golf or ski. Most have requirements that need to be fulfilled. Although you can do it your way, locums isn’t a paid vacation.
This is by far the biggest question I get when interactive with doctors contemplating locum tenens work. I get it, we all dream about setting up shop in some amazing location, but are they really going pay me to do it and how does the typical locums pay system work?
Take a deep breath here, locums work is designed to pay you for your work at a rate set ahead of time. How does it work? The rate and details of the contract is negotiated with the hospital or practice ahead of time by the locums staffing agency who is handling the position. Typically, the contract will pay a daily rate for a defined amount of work. In addition, any extra work (call or after hours) will be rewarded with an hourly rate for any additional work. Let me give you an example. Hospital “A” needs a Cardiologist to cover its health system while they recruit someone new after the old doctor left or retired. They contract with a locums company to find someone fast. The hospital agrees to pay $1200 for an 8 hour day of hospital consults and/or clinic coverage. They also will pay $150 dollars an hour for any direct patient care beyond the 8 hours of work if you agree to take call coverage at night and on weekends. Cover for 2 weeks and not get a single call, you walk away with $16,800. Add in 3-4 calls in the 2 week period, each taking 2 hours, and you add in an additional $1200 for you extra work. At the end of the 2 weeks, the Cardiologist walks away with $18,000. Be aware, you will not have access to the billable charges, these will go to the hospital.
That’s a simple breakdown, but it holds true for the vast majority of positions. The benefit of being a locum tenens doctor is you are in demand. The rates aren’t set in stone and are usually negotiable. I have found hospitals and practices willing to pay more for immediate needs and longer contracts. The details of how much you are paid will depend on the demand for your specialty, the location, and the work volume expected of you.
How does the payment get to you? The hospital pays the locums staffing agency. That agency takes a small cut to cover the licensing, credentialing and privileging, as well as pay their employees. Most locums staffing agencies have a quick and easy system of logging your hours and typically have a 2 week pay cycle. Every 2 weeks you log your hours worked and they simple cut you a check. Its relatively easy.
Your time is your most valuable commodity, if you are considering locums you probably already understand this point. The duration of each position will vary, but there are some industry norms and typical groups of doctors who take advantage of locums work. The length of the assignment will depend on the reason why your service is needed. Many doctors use locums to make some extra income, taking 1-2 week positions on vacation time. These opportunities are plentiful and are used by thousands of doctors every month. Typical this is covering for the doctor in that community who is on vacation or dealing with a short term leave of absence. Longer assignments can be secondary to a medical or maternity leave of the current doctor, and can last anywhere from 1-3 months. However, the most common long term positions are used by hospitals to fill a need while searching for a permanent practitioner. This can lead to both opportunity and frustration. Most doctors complete there 6 to 12 month term without issue. However, some contracts give the hospital the ability to cancel your contract early if they find a permanent doctor to fill your temporary spot. While infrequent, this hiccup can be both frustrating to your quality of life and your wallet! On the other side of the coin, there always exists the possibility that you love the job and want to stay forever. You will have to finish your locums agreement before this can be discussed but many doctors use locums to transition into a permanent position, a bit of a test drive before buying the car!
Locums offers many doctors the opportunity to practice where they want, for the pay they think they deserve and to leave when they are ready to move on. Read on to learn more if locum tenens is right for you!