Locum Tenens for Hospitalists

I fell accidently into becoming a locum tenens Hospitalist.

I was very unhappy with my previous job and decided to leave and relocate closer to family in another state but as is with many things, life happened. The license process took longer than I thought and I accidently discovered locum tenes.

When I first started out, I didn’t know anyone working in this field. My education was self taught if you will and my experience has been great. Those who have looked into this field are aware of the many companies out there in this sector of medicine.

The hardest part is finding a good company and a good representative for yourself.  Some people are dissatisfied under a ‘contract’, others want the opportunity to travel and some just enjoy the additional income.

Whatever the reason maybe, it is becoming popular and if you’re going to do it, make sure you do your research. Information on locum tenens was scarce online when I did my research so I started out with a lot of phone calls.   

Once you find a company and a representative that you like, you will establish your requirements and preferences. This varies from your hourly wage to job requirements like procedures or geographical locations etc.

Most companies will give you general information about sites, however, they will not provide exact names of facilities. The reason for this is that they do not want you to go to these sites and make your own agreement. Financially, they will lose out.

Additionally, they will often require some form of commitment from you signed before providing you with specific site information. After you are vetted by a company and presented to a hospital, you will undergo a telephone interview. Rarely will you ever have an onsite interview.

Based on my experience, here is some advice to guide you by.

  • Choosing a company.  
    • Start off by visiting The National Association of Locum Tenens Organizations. It has a list of members who follow an industry standard. Some Tenens companies are not part of NALTO and there are a slew of reasons. An example is with your CV; companies who are not members don’t have any restrictions in passing out your resume/CV which can affect who you work for at a later date.
    • If you are focusing on a geographical region, find out if the company has sites in your region. Companies can have sites nationally and not necessarily in your region of interest. This can hinder you in the future if Company ABC got you a particular state license /DEA as they expect you to fulfill several shifts to “pay off”, the license and this might mean more travel than you prefer.
  • Choosing a representative. Go with established organizations and with referrals from colleagues first.  
  • If you are going through a referral, you will already have an individual to work with and will likely know of their reputation. Otherwise, if you are calling based on an email/phone call you received, do not be shy in asking how long your representative has been working in the field.
  • There is a high turnover with the reps and if you are new to this, you will want to go with an experienced representative.
  • Your rep benefits from your satisfaction so many will be wonderful to work with however, some can be assertive and maybe looking out for themselves first. 
  • Choosing a site. Ask your representative why a tenens is required at the new facility.
  • Know why you are needed and if it is an environment you want to be at. Sites need replacement typically if someone is off for medical or personal reasons, remote geographical region, and transition within the organization or limited availability of staff.  
  • Typically, if they require locums, I interpret it as a loose brick in their foundation and the reason, is sometimes obvious but not always.
  • Regardless of the reason, make sure that it is a good fit for you as well. Ask about site requirements regarding your job such as running codes, cross coverage, day/night shifts, subspecialties that are NOT available, ICU coverage, and procedures.
  • In remote areas, not all specialties are available and review your comfort level before taking on such sites. Larger companies typically have more resources and more options as well.
  • Malpractice Coverage. Ask about malpractice coverage as not all companies offer the same.
  • Most will have tail but not occurrence coverage. I suggest that you take the time to contact the insurance company and go over your coverage with an agent.
  • Errors can be made in the paperwork and I personally had it happen to me.
  • Duration. Decide whether you want a site for weeks or months and inform your representative from the get go.
  • It is difficult to learn everything including the site layout, culture, staff and EMR frequently. 
  • Talking to Other physicians: Ask your representative to speak to other physicians who they work with.
  • This can help you identify information that might be most important to you about your representative and/or the site that you are interested in. This is really beneficial.
  • Wage. Determine your worth and set a minimum hourly amount.  Your options may be limited based on your geographical region, the necessity and the services you will offer.
  • Remember, these facilities and locum companies need a physician so do not undersell yourself. Regardless of what you get paid, the locum company has an hourly fee they charge the hospital so in reality your wage affects the company.  
  • The fee is usually in the $200-$400 range for hospitalist, but can go higher depending on the circumstances.
  • Wages are usually higher if you are going to cover ICU’s, procedures, nights or work in remote areas.
  • Orientation. Before you begin your shift, you should receive at least 1 day of orientation.
  • Make sure that you receive an itinerary of this in advance. Some sites are not organized and you don’t want to be thrown into a location with no training or orientation; it has happened!
  • Also, get access to the EMR on your personal device so that when you are done with a site, you can sign documents remotely.
  • Otherwise, be prepared to be hounded and/or your wages held until you complete documents.  
  • Taxes/Health Insurance. You are now responsible for health coverage. As for taxes, you will be taxed as a 1099 self employed  and not as a W2 employee.
  • Get a good account and don’t squeeze your pennies for one!

I have enjoyed the travel and have learned a lot about various health systems.

I’ve met some interesting people and seen some amazing places along my journey. Each new site has it advantages and disadvantages and equally can be frustrating.

But, in the long run, I think it will help in defining your career goals.

-Lavaniya Beesley, MD


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