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Is This the Perfect Time to Try Locum Tenens?

A physician traveling to a locums assignment
anyaberkut/123RF.com

As facilities restructure to satisfy the new normal, positions are opening up. And the more I’m contacted by recruiters trying to fill those positions, the more I see just how many and how varied those positions are.

With all of this opportunity, one can’t help but ask oneself: Is this a good time to try something new? 

Enter locums

Locums, short for “locum tenens”, is essentially a temporary physician. The term itself means “place holder” and refers to a physician who is contracted, usually on a temporary basis, to plug a scheduling hole until a permanent physician can be hired.

Staffing companies that specialize in locums positions are easily discoverable online. I have worked with one of the larger companies for locums gigs in two different states. The process went as follows:

  1. The locums company credentialed me and began the paperwork for any additional state licenses I would need.
  2. Locums company played matchmaker between me and hospitals in regions I was interested in. (This is the step where I would negotiate my rate with the locums company.)
  3. Once a hospital was agreed upon, the locums company presented me to that hospital, which would have to approve me in order to work there.
  4. Once accepted, the locums company facilitated the credentialing paperwork with the hospital and whatever local staffing company usually staffs that ED.
  5. Once credentialing and licensure is done, start submitting availability to work.
  6. Locums company arranges and pays for all licensure, travel, lodging and rental cars.
  7. Start working until the contract you’ve negotiated ends!

The Good

Limited obligation: I never signed a contract requiring me to work longer than six months.

In times like these, when you’re asking yourself whether you want to leave for good or just need a break, the opportunity for a temporary change is perfect. I agreed to cover a set amount of hours each month for a set period of time and when those months were done, I had no obligation to return.

By doing locums, I was able to explore new opportunities without having to commit.

Experience a new region: You may not get a locums job specifically in the hospital you’re interested in, but you can almost certainly find something in the region.

There are locums opportunities all over the country and in various parts of the world. You aren’t stuck with the same geography—if you want mountains, ocean, desert, urban, rural—you can check it out without having to move there.

A temporary assignment in a region you’re interested in can tell you a lot about what you need to know—schools, other hospitals, crime, entertainment. The people you’ll work with have all of the information you need to help make a decision about whether you want to live in a new place.

Experience a new setting: We get tired of the same old thing—the same broken processes, the same roadblocks. By working in a new system, you get a fresh look at situations that have become your norm. 

Working in locums will let you know whether the problem is really your hospital. You’ll apply your medical skills in new ways, with different populations and get a fresh perspective on your career.

Flexibility: I’ve enjoyed a good deal of flexibility in scheduling with locums. If I said I couldn’t work on certain days, that was it. When the contracts ended, they ended; there was no difficulty in completing work at one hospital and moving on to the next phase.

The Bad

The schedule: I would get the days off that I wanted— but the actual shifts themselves (or combination of shifts) were almost never good.

Remember, you’re in the mix with people who work there full time; people that are committed to working there through whatever event led to the need for locums in the first place. You are temporary, fungible and often expensive; administration wants to keep the main people happy.

Regardless of the hours I gave for availability, I wound up with the least desirable shifts—almost exclusively nights, swings, and weekends.

On one hand, this was expected. But on the other hand, only working at night makes exploring a new place nearly impossible to do during the day. This meant that if I wanted to stay in the new area longer than the days I was scheduled to work, I’d have to coordinate lodging and pay the difference in car rentals out of pocket.

Travel: This starts out sounding fun—you get to go to a new place for a few days at a time. But after months of having to pack everything, fly or drive a few hours away, work a stretch and then fly back, it began to lose its charm.

If you’re thinking of moving to a new place, it helps to look at “travel assignments” as an investment. You’re traveling now to keep yourself from making a bad move in the future.

New systems: A new system can take a while to learn. If you have a six-month locums assignment, you may not really understand how things flow until halfway through that contract.

But learning new systems is a skill; you start to ask better questions sooner in the process. In the meantime, it can be frustrating and potentially risky.

There’s a reason they’re hiring locums (and it’s not always good). Sometimes hospitals are expanding rapidly, or their volumes grew unpredictably, and they need new doctors fast. This would be good reason that a hospital needed to hire locums.

But sometimes it’s not a great place to work. It’s understaffed. They don’t have working processes; they’re changing ED groups and need coverage between. They can’t keep people. Everyone’s leaving for a different hospital or the system is broken —those hospitals hire locums as well.

This is information you can gather during the early stages of selecting a hospital. Do your homework as well—online information, social media, or word of mouth can help you learn why a position is open in the first place.

You’re not always welcome: Locums doctors sometimes get a bad reputation. They are sometimes paid at a higher rate than the people who work there full time. Some locums providers are perceived as having “no skin in the game” positions and are therefore less eager to see patients than their colleagues.

You never get a second chance to make a first impression; dispelling these myths requires being a good team player and good worker. It’s just important to remember that not everyone will be excited to see you.

Verdict

Locums can provide a great opportunity for you to explore new jobs without risking your current stability.

Having done it, I can honestly say that I’d work locums again in the future. To me, the benefits outweigh the risks in general, but if you know what the risks and downsides are, you can enter the locums arena with even less to lose.

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About David Beran, DO

I am a practicing emergency physician with academic and administrative roles. I work full time as a medical director but am exploring multiple non-clinical avenues for my medical and public health degrees. Aside from blogging on www.theprescientdoc.com, I work in file review, consulting, research and expert witnessing.

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