7 tips for overcoming fears about locum tenens

Illustration - doctor curious about locum tenens

Considering taking on some locum tenens work? Here are 7 tips about working locum tenens shared by experienced locum tenens physicians.

Although the prospect of working locum tenens may be intimidating, many veteran locum tenens physicians immensely enjoy the lifestyle and freedom that locum tenens provides.

But is it right for you? How does a physician get started? What are the essentials to know?

You have questions, and we have the answers!

1. How does working with an agency make the locums process easier?

Emergency medicine physician Dr. Rip Patel started working locums nearly a decade ago. He recommends working with a locum tenens agency instead of trying to do it solo, at least at first. “They make sure that everything is set up on time, such as travel and housing arrangements. This way you’ll be all set before you start your first shift.” Now that he has some regular assignments where he likes to keep working, he mostly sets up contracts himself.

Illustration - Dr Pellegrini quote about LT agencies

Another doctor, Dr. Joan Pellegrini, a trauma critical care physician, agrees about working with an agency you like. She recommends sticking with one or two instead of multiple agencies, since the agency learns your preferences, skills, schedule, and work history. “They’re going to help you get licensed and credentialed, and they know exactly what paperwork needs to be done. I tend to do most of my critical care through one company, but trauma through another.”

2. How to choose an assignment that’s right for you

So how do you even go about choosing a locum tenens assignment? Well, first, consider what you want. A weekend shift? Extra money over the holidays? Are you looking to try out a different type of facility from where you usually practice? Do you want to try to tie in some travel where the assignment is located?

These are the types of questions to ponder so you can talk with the agency recruiter about opportunities. After that, consider the specific assignment.

Board-certified pediatrician Dr. Trevor Cabrera says that before he takes an assignment, his favorite question to ask is, “Why does the facility needs a locum provider in the first place? If it’s for a simple maternity/paternity leave or a staff member who has transitioned to another job for a personal reason, I’m less dissuaded. I am very wary if there’s a history of running through one provider after another. Do other locums still work there who I can speak to?” Doing some due diligence upfront, he says, helps ensure a better fit and a better experience.

Illustration - Dr Cabrera quote on assignments

Dr. Cabrera recommends finding assignments that are the best match for your preferences, “like location, practice style, and schedule availability.”

PHYSICIAN’S TAKE: How I choose a locum tenens agency

3. What should I consider when looking for housing?

It’s the agency’s job to line up logistics like transportation and housing as part of the contract. When working with your recruiter, give the housing location some thought.

Illustration - Dr Kusnezov quote on housing

Board-certified orthopedic surgeon Nicholas Kusnezov, MD, who has had years of experience as a locum tenens physician, says, “For me, the most important factors when selecting locum tenens housing are: proximity to the facility; proximity to other locations such as points of interest, restaurants, outdoor recreation; quality of the housing; amenities such as an on-site gym or spa; and accommodations where you can earn loyalty points.”

These all matter, he says, in how much you’ll enjoy the assignment overall.

4. How can I make handling locum tenens paperwork simpler?

Yes, there is a lot of paperwork involved in locum tenens. The good news? You can streamline the process by being organized, says experienced locum tenens Dr. Trevor Cabrera.

 “The IMLC (Interstate Medical Licensure Compact) helps to create an abbreviated path to obtaining a new medical license. However, the IMLC doesn’t completely get rid of the paperwork,” he points out. So, it makes sense to preemptively start working on some licenses early for locations on your bucket list.

Experienced locum tenens physician Dr. Marye McCroskey offers additional ideas for tackling locum tenens paperwork. First, she says, maintain your CV in Google docs and update it every time there’s a change. “This allows for a quick response to job openings.”

References are another key to success, as each locum tenens opportunity requires them. “Every place you take an assignment, obtain references,” she says. “Try to get two names from each place you go.”

Then, organize the references. “I have two reference docs. One is an ongoing, open list of all the physicians and coworkers I have ever asked to be a reference and all their information (cell number, office number, email, etc.). The second is a list of three colleagues I am ready to use for my next reference cycle. You will find over time that some people genuinely do not mind doing this for you, and you can call on them repeatedly. Others are not good about getting paperwork done, so choose carefully.”

Both Dr. McCroskey and Dr. Cabrera advise you to keep a personal information file in the cloud with the commonly requested information, such as driver’s license, medical licenses, passport photos, immunization records, respirator fit testing, etc., along with diplomas, CPR certificates, procedure logs, and CME — and keep it updated.

RELATED: Guide to Contract Negotiation

5. Here’s how you can ensure a smooth locums onboarding process.

So what does onboarding look like for a locum tenens? Think about your onboarding for a full-time permanent gig, but shorter.

The onboarding process includes a wide range of activities. You’ll need to know where to show up for work — which, if you’re working with an agency, your recruiter should make clear to you so you can have it mapped out ahead of time. And you’ll need to familiarize yourself with the electronic medical record and meet your coworkers — and you’ll want to allow time for all of this.

“It is best to have at least 48 hours to settle in before your assignment starts,” says Dr. Colin Zhu, DO, board certified in family practice/OMT and lifestyle medicine. “But this may not be the case with every assignment. Sometimes they give you just 24 hours to settle in before you start. Use that time to familiarize yourself with the facility and ensure you have enough time to learn their EMR before you see patients.”

Illustration - Dr Zhu onboarding quote

Once you start the assignment, ensure you’ll have time to learn the EMR before you start seeing patients. “Your familiarity with the EMR will determine how long your onboarding with the computer system will be,” Dr. Zhu says. Make sure there is time build into your assignment for this, he urges.

Then be sure to set up your work area before you see patients. Plus, “Confirm how patients will come in and out of the office and verify who your medical assistant/nurse will be and how you will work with them during your assignment,” Dr. Zhu adds. All of these will help you get up to speed as quickly as possible.

LEARN MORE: How to prepare for a locum tenens assignment

6. Ways physicians make taxes for a 1099 employee easier

As a locum tenens physician, you’re considered an independent contractor and will receive a 1099 rather than a W-2 at the end of the year. Some highlights: Taxes are not automatically taken out of your compensation; you must pay your own quarterly payroll taxes; and, as mentioned, you can deduct business expenses.

Dr. Pellegrini and Dr. Patel both prefer to get help from professionals for their taxes, especially since they have income from more than one U.S. state.

As Dr. Patel points out, “I have an accountant. Just like I’ll call a handyman to fix something at my house, I’ll hand my accountant my salary report, and we’ll discuss how much I’ll give in taxes each quarter.”

Illustration - Dr Patel accountant quote

LEARN MORE: 7 tax benefits of being a locum tenens

7. How does medical malpractice work for locum tenens physicians?

How does malpractice insurance work for a locum tenens? That depends on the way the contract is written and the coverage offered by the agency with whom you work.

For example, locum tenens agency CompHealth obtains a claims-made professional liability policy for each locum physician with limits of $1 million per occurrence and $3 million aggregate. Sometimes, the healthcare organization that contracts with CompHealth for their locum tenens services provides their own malpractice insurance. Additionally, as with some other agencies, CompHealth supports their physicians when a malpractice claim arises.

Illustration - Dr Pellegrini malpractice quote

In short, be sure you know the type of coverage and its limits and the type of support you’ll get if a claim arises.

Dr. Patel and Dr. Pellegrini both stress how important it is to thoroughly investigate what malpractice insurance the locums agency offers. Then ensure that you’re fully covered. Dr. Pellegrini recommends, “Know what type of malpractice coverage you’ll get, its limits, and the type of support you’ll get if a claim arises.”

“I think it’s good to work with a bigger agency that will be able to support you and back you if things come to that,” Dr. Patel adds.

Keep learning

These tips directly from physicians should help cover some of the basics, but if you have more questions, keep reading stories by locum tenens doctors — or reach out to an agency. If it seems like locums might be a good fit for you, we’re here to help!

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