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Choosing a locum assignment: What to ask and what to avoid

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Experienced locum pediatrician Dr. Trevor Cabrera shares what questions he asks when choosing which locum tenens assignment he’ll take.

When choosing to work locum tenens, it’s important to know what you’re getting yourself into. You want to avoid pitfalls or unsafe assignments, and you’ll want to find assignments that are the best match for what you’re looking for — like location, practice style, schedule availability.

While locum physicians shouldn’t expect that every job will be a perfect fit, there are things you can look for and questions you can ask to help triage the best place for you. Each provider and client relationship will be different, but with the following tips, hopefully the best connection will be formed — and can lead to longevity and establishment of a long-term assignment.

The obvious things to think about

Location  

Over time, my questions on location have changed. While I started out being open to any location in the country, I’ve now come to question details such as how far a facility may be from a commercial service airport or where the nearest referral hospital is. If I’m working a job that’s not inherently in-house, are there things to do around the town or within the call radius when I’m not working? Maintaining a balanced life and hobbies is important — I love the stories of locum providers who take advantage of different assignment locations to spend time at the beach, or hiking, or birdwatching until they get called in. 

Rate

I’m very careful after a couple of bad experiences to proceed with caution when I’m offered an “all-inclusive” rate. Depending on the acuity of the population, the regular hospital census, and my clinical duties, I’ve often tried to negotiate a contract that doesn’t leave me feeling taken advantage of. In some cases, it might be worth it to take the “all-inclusive” if the volume is low enough, but you can only figure these things out by asking. It’s exhausting to feel undercompensated and overworked. Don’t be greedy but know your worth.

Clinical duties and safety

A no less-important consideration is to clarify the facility’s scope of practice. Certain procedures and duties are standard, but others may be optional. Being asked to work in high-acuity, busy settings without backup can lead to safety issues. The responsibility for safe care extends not only to the patients but should also be a question to ask for the sake of the staff.

The less obvious things to ask

My favorite question

I always ask why the facility needs a locum provider in the first place. If it’s for a simple maternity/paternity leave or a staff member that has transitioned to another job for a personal reason, I’m less dissuaded. If there’s a history of running through one provider after another, I am very wary. Do other locums still work there that I can speak to?

Additionally, the reputation of previous locum physicians can leave a bad — or good — taste in the eyes of a facility. Places with good or no experience with locums have always been the most eager to give me a chance and be welcoming. But if the title of locum tenens has been tarnished by a prior provider, I have unfortunately found myself a bit ostracized, not a result of my own behavior at all.

Availability of consultants and other providers

As a primary specialty, I often find myself in need of consultant help. Tied in to how near or far the nearest referral facility is, it’s a good thing to know that providers interact well across specialties in case it’s needed. After working in multiple facilities across the country, I have developed some great professional relationships with providers in other specialties. We’ve been able to help each other out in a pinch, something that is invaluable as a temporary worker. To this day, I know I can still reach out if needed.

Ultimately, you won’t know if a new job is a right match until you show up and wait it out, but hopefully asking these questions of the facility can help to make finding a good fit easier and more consistent. After all, if it’s not the perfect fit, you can always move on.

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