The 50-Point Checklist For Your First Locum Tenens Assignment
/The 50-Point Checklist For Your First Locum Tenens Assignment
Below is a 50-point checklist organized into categories. Use it before you sign, during onboarding, and in your first week on site.
A) Pre-Decision: Is This Assignment a Good Fit? (1–10)
1) Define the assignment type clearly.
Is it inpatient, outpatient, ED coverage, procedure coverage, call coverage, or a blend?
2) Identify the “real reason” they need locums.
Recruitment gap? Seasonal surge? Leave coverage? Turnover? Expansion?
3) Ask for objective volume numbers.
Patients/day, consults/day, admissions/shift, procedures/day, RVUs/day (if relevant).
4) Understand acuity and complexity.
ICU coverage? trauma level? tertiary referrals? special populations?
5) Confirm support staffing.
APPs, residents, nurses, techs, scribes, case management, anesthesia (if procedural).
6) Clarify clinical resources.
Imaging access, IR availability, specialty backup, transfer pathways, on-call consultants.
7) Ask about EHR and documentation burden.
Which EHR? dictation tools? templates? expected note closure timeline?
8) Confirm schedule pattern and shift structure.
Start/end times, handoff expectations, weekend coverage, holidays, split shifts.
9) Confirm how call works (if any).
Pager vs in-house, response time, call-back triggers, expected frequency.
10) Ensure you’re licensed and privileged appropriately for scope.
If the site expects procedures or advanced skills, confirm privileges match reality.
B) Contract and Compensation: Protect Your Time and Risk (11–20)
11) Get a written scope of work (SOW).
A clear SOW prevents scope creep.
12) Confirm pay structure.
Hourly vs shift vs daily vs weekly, plus differentials for nights/weekends/holidays.
13) Define what counts as paid time.
Does paid time include sign-out, rounding, charting, required meetings?
14) Ask for guaranteed minimums if volume fluctuates.
Guaranteed hours/shift minimums protect you.
15) Nail down call pay terms.
Call stipend + call-back pay + minimum hours paid per call-back.
16) Clarify overtime.
If shifts routinely run over, ensure overtime language exists or rate adjusts.
17) Clarify cancellation terms.
How much notice? cancellation fees? guaranteed pay if canceled last minute?
18) Confirm malpractice details in writing.
Occurrence vs claims-made, limits, tail coverage responsibility.
19) Confirm expense coverage.
Travel, lodging, rental car, mileage, per diem, reimbursement caps and receipts.
20) Confirm payment timing and process.
Weekly/biweekly, timesheet approval, net terms, first-paycheck timing.
C) Credentialing, Privileging, and Compliance (21–30)
21) Build a “credentialing master packet.”
CV with month/year, licenses, board cert, references, immunizations, malpractice history.
22) Confirm state controlled substance requirements.
Some states require additional controlled substance registration beyond DEA.
23) Verify your DEA registration is appropriate for that state/location.
Multi-state work often triggers separate DEA registrations.
24) Confirm privileges match duties.
Procedure privileges, admitting privileges, sedation privileges as applicable.
25) Confirm prescriptive authority and eRx setup.
EPCS enrollment can be a bottleneck; start early.
26) Complete compliance modules early.
HIPAA, OSHA, workplace violence training, infection control, etc.
27) Confirm vaccine/health screening requirements.
TB, flu, COVID, MMR, varicella, hepatitis, fit testing if required.
28) Know facility bylaws that affect you.
Supervision rules, documentation rules, discharge processes, consult rules.
29) Confirm medical staff office timeline.
Ask: “What’s the typical credentialing time and what causes delays here?”
30) Get a single point-of-contact for credentialing issues.
You want one person who can unblock you fast.
D) Logistics: Travel, Housing, and “Friction Control” (31–40)
31) Confirm travel booking method.
Agency books vs you book and get reimbursed.
32) Confirm lodging type and location.
Hotel vs furnished housing; distance to site; parking situation.
33) Confirm check-in/check-out alignment with schedule.
Avoid paying out-of-pocket for extra nights.
34) Confirm rental car rules.
Class, insurance coverage, tolls, fuel reimbursement.
35) Confirm per diem or meal reimbursement.
If none, budget accordingly.
36) Confirm scrubs/coat/badge requirements.
Does the hospital provide? Do you need embroidery?
37) Confirm parking and access.
Parking passes, overnight access, call room access.
38) Get your EHR access before arrival.
Remote access, VPN, 2FA tokens—do this early.
39) Get a facility contact list.
Charge nurse, unit clerk, operator, OR desk, ICU lead, ED lead, IT help desk.
40) Confirm where to show up on Day 1.
Time, location, badge office, HR orientation, who meets you.
E) Clinical Workflow: Day 1 to Week 1 Execution (41–50)
41) Learn consult/admission workflow.
How are consults requested? who triages? what’s urgent vs routine?
42) Clarify escalation pathways.
Who do you call for help—chief, medical director, backup specialist?
43) Confirm handoff expectations.
Written sign-out? verbal? EHR tool? what must be included?
44) Confirm order sets and clinical protocols.
Sepsis pathway, anticoagulation reversal, stroke protocols, postop pathways.
45) Identify local “pain points.”
What commonly breaks? labs delayed? imaging bottlenecks? staffing gaps?
46) Set documentation boundaries early.
When do notes need to be done? same day? 24 hours? avoid “charting forever.”
47) Confirm follow-up responsibilities.
Who follows pending labs/imaging? who communicates results after you leave?
48) Clarify discharge and outpatient follow-up process.
Avoid becoming the default for long-term follow-up you can’t provide.
49) Learn the facility culture fast.
Who really runs flow: charge nurse, hospitalist lead, ED lead, anesthesia lead?
50) Debrief and refine after week one.
What slowed you down? Fix with templates, workflows, and clearer boundaries.
What to do if something feels unsafe or scope creeps
Locums physicians often feel pressure to “be helpful.” Helpfulness is good—until it becomes unpaid, undefined, or unsafe responsibility.
If scope creeps:
Refer to the written SOW and contract
Escalate early to the medical director + agency/hospital contact
Propose a structured fix (“Happy to do X if we remove Y / add support / adjust pay”)
Document key communications professionally
Your goal is not conflict—your goal is safe, predictable coverage.
The “first assignment playbook” (simple timeline)
4–8 weeks before start
license + credentialing packet complete
EHR access initiated
travel plan established
contract scope finalized
1 week before start
schedule confirmed
contact list received
orientation location/time confirmed
malpractice certificate confirmed
Day 1
meet lead nurse/unit flow leader
learn workflow + escalation pathways
identify templates/shortcuts
confirm call expectations
Week 1
build efficiency
set boundaries
document and close charts daily
assess whether assignment is sustainable
Part 2 — 2,500-Word FAQ: First Locum Tenens Assignment (Doctors)
1) What is locum tenens work for doctors?
Locum tenens is temporary physician work providing coverage for hospitals, clinics, or health systems. Assignments may include inpatient care, outpatient clinics, procedures, call coverage, or combinations of these.
2) How do I start locum tenens as a physician?
Start by defining your scope preferences, selecting an agency or direct contracting approach, building a credentialing packet, getting state licensure lined up, and choosing a first assignment with clear scope and reasonable support.
3) What is the best first locum tenens assignment?
For most doctors, the best first assignment has predictable shifts, clear scope of work, strong staffing support, and limited call (or clearly defined call). Avoid vague “full coverage” roles as your first experience.
4) How long does credentialing take for locum tenens?
Credentialing timelines vary by facility, specialty, and completeness of your paperwork. Delays often come from missing documents, unclear work history, reference delays, or facility medical staff office backlogs.
5) What is included in a locum tenens contract?
A locums contract usually covers scope of work, schedule, pay rate, call terms, malpractice coverage, travel and lodging, cancellation terms, and payment timing.
6) What does “scope of work” mean in locum tenens?
Scope of work defines what you are expected to do clinically: clinic, consults, procedures, admissions, rounding, call, supervision, and administrative responsibilities.
7) What should be in a first locums scope of work document?
It should list shift times, patient volume expectations, call details, procedures required, staffing support, documentation expectations, and what is excluded.
8) How does locum tenens pay work?
Locums pay can be hourly, per shift, per day, or per week. Some roles include call stipends and call-back pay. Pay timing depends on timesheet approval and payroll schedules.
9) What is guaranteed pay or guaranteed hours?
Guaranteed hours means you’re paid a minimum amount even if volume drops or the facility cancels cases early. This protects your income.
10) What is call-back pay?
Call-back pay compensates you when you actively work while on call. Good contracts include minimum paid hours per call-back event.
11) Do locum tenens doctors get malpractice insurance?
Many locums assignments include malpractice coverage, but you must verify policy type (occurrence vs claims-made) and who pays for tail coverage.
12) Should I choose 1099 or W-2 locum tenens?
Many locums roles pay 1099; some offer W-2. The best choice depends on taxes, benefits, your financial setup, and administrative tolerance.
13) Do I need my own DEA registration in each state for locums?
Often, DEA registration is state-based and multi-state practice may require separate registrations. Confirm with facility credentialing and compliance for your specific situation.
14) How do I manage taxes as a 1099 locums physician?
Track income and expenses carefully, set aside money for estimated taxes, and work with a CPA familiar with multi-state physician income.
15) What are common red flags for first-time locums?
vague scope
heavy call with unclear compensation
weak staffing support
lack of clear escalation pathways
unpaid onboarding and heavy documentation expectations
last-minute travel chaos
16) What should I pack for a locum tenens assignment?
Common essentials: licenses/IDs, hospital credentialing info, scrubs/coat if needed, stethoscope, dictation mic (if used), and backup authentication devices for EHR access.
17) How do I avoid burnout on my first locums assignment?
Choose a manageable assignment, limit heavy call early, close charts daily, clarify boundaries, and schedule recovery time after intense blocks.
18) Can locum tenens lead to a permanent job?
Yes. Many hospitals use locums as a bridge while recruiting. A successful assignment can become a working interview for a permanent role.
19) What if the facility changes expectations after I arrive?
Refer to your scope of work, escalate to the medical director and agency contact, and renegotiate or clarify expectations quickly. Do not accept unsafe scope creep.
20) What’s the bottom line for first-time locums doctors?
Success comes from clarity: define scope, protect call terms, confirm malpractice coverage, control travel friction, and choose stable facilities. Your first assignment should be designed for smooth operations—not maximum intensity.