Is Locum Tenens a Good First Job for Physicians?

Many graduating residents find themselves at a crossroads. They have been exposed to traditional physician roles in academic or community medicine but are not sure what type of role would suit them best. Others may know the kind of job they want but not the location or type of facility.

It is for this group of graduates that locum tenens positions may provide a solution. These roles are less frequently encountered by residents but may provide the experiences or lifestyle some graduates desire.

What is locum tenens and how does it work?

You can find locums positions for many specialties. But as an example of how it works, let's focus on emergency medicine. Let's say a hospital doesn’t outright employ their emergency physicians. Instead, they outsource to Staffing Company X. Staffing Company X is contracted to provide the physicians and manage the practice while paying their doctors an hourly rate. Now, let’s say that for some reason Staffing Company X is temporarily unable to provide the physicians. Perhaps many emergency physicians with the company retired or left at the same time. Maybe the emergency department expanded in size and more coverage is needed urgently. Maybe there's a huge seasonal variation in patient volumes and more doctors are needed, but just for that season. Whatever the reason, Staffing Company X will be temporarily short of providers. Staffing Company X needs to fill the schedule, or they risk losing their contract with the hospital.

Enter locum tenens companies. Locum tenens literally means “place holder.” These companies provide temporary solutions to fill positions until the existing company can permanently fill them. Staffing Company X contracts with the locums company to provide physicians. As a locum tenens physician, you work (through a 1099 contract) with the locums company.

Your contract with the locums company is usually for a distinct period of time. It may be for something like eight shifts per month for six months. You negotiate with the locums company and because this is a temporary and urgent need, you can often command a competitive pay rate. If the hospital is far from your home, the locums company will often pay for travel, hotel, a rental car, and sometimes a food stipend. The locums company will facilitate your negotiations with the primary staffing company as well as assist with licensure and credentialing.

It's temporary

A graduating resident who has a fear of committing prematurely to a role or location can assuage those concerns by taking a position that is, by definition, temporary.

For example, I was considering moving to a new region of the country. This is an area I had vacationed in but otherwise had no real knowledge of. It would have been a big move for me and my family and a new way of life – not a decision that I wanted to make frivolously. I found a locums job in the region. It was not at the hospital I would have wanted to work in, but close enough to get a feel for the people and life there. The contract was for 72 hours of work a month for four months. During that time, I was able to learn a significant amount about healthcare in that area. I learned about these schools and the predicted future and reputations of surrounding facilities from the people who actually live there. This is information that would have been very difficult to glean indirectly from the Internet.

By taking a locums job, I was able to explore what I needed to without a commitment, was paid more than I would have been paid locally, and gathered information critical to my decision to move.

Rounding out a new practice

It is not uncommon for residents to find partial work in the region of their residency through connections made during training. There is a peace of mind in staying close to home when one already has a house, friends, and a life where they trained. But by the same token, some residents may feel like they haven’t spread their wings as an attending physician. Having unique, independent experiences is what forges a new practice and staying too close to home can limit that opportunity.

Here, locums provides another solution.

Since many locums jobs are also part time and the schedules are often condensed into blocks, a graduating resident may find balance through locums. For example, six shifts a month for six months would allow a resident an opportunity to increase their income temporarily, keep their local position, and network while expanding career horizons.

While continuing to foster local relationships, locums allows new physicians to practice their style independently and grow in a new environment. The new facility and region will also expose graduating residents to new ways of solving old problems and round out their personal practice.

Sounds great- what's the catch?

 Locums has definite positives but there are a few negatives to consider.

The main concern is that locums is temporary and may lack stability. Your contract may only last as long as the hole exists. If the primary company can fill it, they will. It is possible for them to fill it with you (if you choose to do this), but the positions can be unpredictable.

Also, you are the lowest member of the hierarchy. The hospital and staffing company want to keep the locals happy – people who remain dedicated and have much more skin in the game than you do. You’re coming in from outside and often getting paid more to do the same job. Accordingly, you may not always be well-received. You also may wind up with a schedule that is undesirable. Just remember that you are a guest of a guest when you’re working locums.

The “exciting location" and " paid travel" often touted by locums ads are major positives of working locums. The catch is that your travel is limited to the days you’re working. The locums company will arrange your travel after your schedule is published by the local institution. If you’re scheduled M-F, 7a-7p, you’ll fly in Sunday night and fly out Friday night, never really getting to see the area outside of work. The way around this is to ask the locums company (before you sign anything) whether it can be arranged for you to stay longer than your shifts, but at your own cost. ie, if you pay the difference for the hotel and car, can it be arranged that you stay a few days more? I’ve worked with two locums companies and both were able to accommodate this request.

Lastly, it is important to remember that locums could be perceived as not being as committed. Your resume will look like you hopped from place to place for several years. If you decide to settle down in one place after working only locums for a while, expect to have to explain your work history and provide any references. One solution to this is to keep a stable, local job while doing locums to illustrate your ability to maintain long-term work while figuring out the next steps of your life.

Locums positions are a unique blend of novelty and flexibility which make colorful additions to a burgeoning medical practice. Though they all require a bit of planning and strategy, they do solve problems commonly encountered by graduating residents and should be considered along with the more traditional options.

Browse locum tenens opportunities from HospitalRecruiting's clients here: https://www.hospitalrecruiting.com/jobs/Physician-Jobs/Temporary/