Locums is an excellent way for physicians, nurse practitioners, and physician assistants to earn extra income, have more flexibility and control of their schedule, and experience working in many different clinical settings. It’s also an excellent opportunity to see the world — whether it’s rural South Dakota, sunny San Diego, or even beautiful and diverse New Zealand.
Once you have decided to accept a locums assignment, that’s when the fun — and a bit of work — begins. Here’s what you can expect once you’ve landed your assignment.
What travel is covered to/from my locum tenens assignment?
Generally speaking, a locum tenens agency will pay for certain travel logistics for your assignment, including standard airfare and a rental car. Here’s a short list of what you can typically expect.
- Airfare: Your locums agency will likely book and pay for your flight in advance between your preferred home airport and the closest airport to your short-term assignments. All that is asked of you is that you show up, check in (either online, in the app, or in-person), and get your boarding pass.
- Rental car: Car rentals are also typically paid directly by the locums agency. To pick up your car, you will report to the rental agency counter and provide a valid driver’s license. Then you can get the keys and hit the road.
- Mileage: Sometimes, you may decide it’s easier or more convenient to drive your car to the assignment. In that case, you can usually get reimbursed for the miles you travel at the IRS standard mileage rate.
What isn’t covered when you fly
So, are your travel expenses covered, or should you plan to be responsible for anything?
Other add-ons will usually be your responsibility to pay for, such as seat upgrades, in-flight services and meals, and alcoholic beverages — and let’s be honest; these things make being stuck in a flying tin can more enjoyable. But, as we all know, they’re no longer free. Wi-Fi access and early boarding are also not normally covered.
On the bright side, remember that as a 1099 contract employee, some travel-related expenses may be tax deductible. Save your receipts and consult your tax advisor to learn more.
So, how do I get to my locum tenens assignment?
Flying
Once you and your agency have found your ideal assignment, this is where the legwork begins — but not your legwork. At this point, your rep gets to work. If your assignment requires flying, they’ll work on securing a flight that accommodates your schedule and preferred airports.
The best part? In most cases, no money comes out of your pockets.
After you have landed at your destination and retrieved your bags, you can advance to the next stage of getting to your actual assignment. This may include hopping in a rideshare to a nearby hotel or heading to the rental car counter to pick up your vehicle.
Your locums placement agency will arrange all these logistics, immensely simplifying your travel planning and coordinating.
Driving
Depending on the distance to your destination, you might consider driving to your placement rather than flying.
Tenured locum physician Nicholas Kusnezov, MD, shares, “If driving is at all possible — even if it involves a 4- or 6-hour trip — it is tremendously more time-efficient and reliable than flights.” He also adds that driving your vehicle has its perks. “Driving ultimately gives you complete control of your time and avoids inefficiencies which develop from third parties — such as flight delays or issues with rental cars.”
Another perk of driving yourself? You can pack more bulky comforts from home, like books and sporting gear.
In these instances, keep tabs on your gas mileage and submit any gasoline receipts for reimbursement.
More considerations for flyers
Additional factors to remember if you plan to fly to your destination.
Window or aisle? Alert your rep
Remember, your agency rep is working to ensure you have the best flight experience they can get you. While you won’t be on the line with an airline representative, you need to let them know what your preferences are, such as:
- Window, aisle, or middle seat
- The time of day you prefer traveling: morning, afternoon, or evening
- What your airline reward numbers are
- Other special requirements
The staffing agency will probably give you multiple travel options, and once your flight is booked, you’ll receive a confirmation letter or email spelling out all the details.
How to leverage travel loyalty/rewards programs
You may wonder: I have frequent flyer miles and want to collect the points I earn. How will that work? Here’s the low down:
- Most staffing agencies will allow you to manage your rewards and collect reward points for any airline, car rental, or hotel program you belong to.
- If the agency is booking your travel, provide them with your relevant loyalty account numbers and brand preferences so they can be added to the reservation.
For even more advice on optimizing your points and miles earnings, turn to White Coat Investor, where Dr. David Rosen shares his tips on Travel Hacking for Students, Residents, and Those Entering the World of Credit Card Rewards.
Can I book my flight?
If you prefer to book your flight, most agencies will reimburse you for the cost — unless you feel the itch to fly first class and sip on some champagne, in which case the agency will usually only reimburse for reasonable and customary expenses.
How does travel booking work for your family?
Many doctors like to bring their families along and make the trip a working family vacation. Staffing agencies will often help with the travel arrangements for family members. However, you are usually required to pay for their airfare.
If you plan to use frequent flyer miles to cover the cost of your loved ones’ airfares, you’ll likely have to arrange that yourself.
Driving- and rental car-related logistics
Whether you’re driving to an assignment or need to get around town once you are there, there are considerations to keep in mind when using a car while on assignment.
Paying for your car rental
The staffing agency usually pays for car rentals, but sometimes, you may need to pay upfront and get reimbursed later. Be prepared to cover this expense at the onset. If this is not feasible, try to make sure the locums agency can pay the car rental agency directly instead.
Car rental insurance is usually paid for as well. If you choose to upgrade your vehicle, the staffing agency may only pay or reimburse the standard rental cost, while you’re responsible for the difference.
Tolls, parking, and fuel
Where there is travel, there is cost. You’ll encounter parking fees, toll roads, fuel costs, and insurance when driving on an assignment. You’re probably wondering if the agency will cover the cost or if you’ll need to be reimbursed. Short answer? Yes…to both.
If you’re driving — whether your car or a rental — you’ll usually be reimbursed for
- Fuel costs (rental cars only)
- Mileage (for your car, at IRS mileage reimbursement rate)
You are not reimbursed for the following:
- Toll fees
- Gas for rental
- Speeding/parking tickets
- Car insurance for your own car
Never forget to save your receipts.
Personal use
If you choose to rent a car, some rules for personal use usually apply:
- Staffing agency-provided rental cars are intended for use while on assignment and for reasonable personal use when you’re not at work.
- If you plan to arrive early for your assignment or are staying longer for vacation or other personal activities, you should return the rental car, rent another on your own, or make arrangements with the agency to pay the difference.
Insurance considerations and risks
Whether the staffing agency pays for the rental car or you get your own, getting insurance is best. Some agencies even carry secondary policies that cover the deductible, but certain activities can negate your insurance coverage:
- Driving the car to another country, such as Canada or Mexico
- Driving with an invalid driver’s license
- Driving under the influence
- Using the vehicle for an unintended purpose, such as driving on an unpaved road
Consider the season and terrain
If you are used to driving along a grid and have an assignment up in rural mountain areas, or if you’re picking up an assignment in New York state during a snowy winter, adjust your rental car plans.
“If you ever work in the Northeast, Midwest, or any mountainous areas in the winter, you better be prepared. The key here is to have a reliable car that would make your driving seamless,” says hospitalist Vlad Dzhashi, MD, also known as the Locum Tenens Guy.
Dr. Dzhashi recommends choosing only an all-wheel drive sports utility vehicle or truck in wintry conditions. Ideally, the car will also have special seasonal tires.
For those seeking international locum tenens placements
Pack like a pro
Airlines limit the amount of luggage you're allowed to check, and sometimes weight restrictions. Be sure to look at each leg of your flight: if you're switching to a carrier with a lower limit, you might get hit with additional fees. Pack to the lowest common denominator across carriers.
Pack as lightly as it feels comfortable to you. Plan to purchase large toiletries in the country rather than packing that liter of shampoo. Wear your heaviest shoes and jacket on the plane. If possible, stick to one checked bag; your future self will thank you.
Ever wonder how locum tenens pros pack for their assignments? This veteran locum shares his packing tips:
Manage your money wisely
Check to see if your bank has branches at your travel destination. This may mean more access to in-network ATMs or other support.
Savvy international locum tenens workers call their banks and credit card companies to tell them what days they’ll be traveling and what locations they intend to visit. This should help you avoid (most) hiccups when accessing your money abroad.
To that end, have a backup plan. Bring some U.S. dollars as emergency currency and more than one credit card (store them in two different spots on your person). Snap a pic of your credit cards before traveling; though a lost or stolen card is guaranteed to be a hassle, it'll be easier to manage if you have a copy of the card.
Be mindful of how often you pull money from an ATM, as you may get dinged with international ATM fees. Do one better by bringing a card that reimburses ATM fees or doesn’t charge for out-of-network withdrawals.
Grab a SIM card
If you have an unlocked smartphone, plan to get a SIM card at the airport upon arrival or in town shortly after settling in. If adding a SIM card to your existing phone is not an option available to you, consider going the route of buying a basic phone in the country. This will help you stay in communication with your placement and agency rep.
Additional safety risks and considerations
Use taxis and rideshares safely and look like you know where you're going. This means you should use (and hide) your phone strategically to avoid cell phone theft.
Be mindful of the culture and traditions of the country you are working in so that you may be more likely to blend in and be seen as respectful. While wearing your favorite watch or fancy jewelry can be nice, bling might draw unwanted attention, so it's better to leave the Rolex at home.
Travel day advice for locum tenens physicians
Get travel protections
Pediatrician Dr. Trevor Cabrera, a veteran locum tenens physician, refers to his personal Locum Tenens Checklist ahead of each assignment to streamline his preparations. One step is “Emergency Travel Planning.”
“Having emergency roadside assistance is always a good idea for a flat tire, and sometimes travel protection can be beneficial for flights.”
Keep your medical equipment TSA-compliant — or check it
Refer to the Transportation Security Administration’s website to learn what items are cleared for carry-on hand luggage versus checked baggage. Most items will be eligible to be brought on the plane, but they must be disclosed to the TSA officer as you go through security. That said, not all items are allowed.
In general, carry on anything you can't afford to lose. Examples of items typically accepted in your carry-on include a stethoscope, reflex hammer, pen lights, and tuning fork.
Vlad Dzhashi, MD, recommends TSA PreCheck for those with frequent locum tenens assignments. “If you fly more than a few times a year, TSA precheck is a MUST. You don’t have to wait in lines going through security checkpoints, and you’ll have extra time before your flight since you can come to the airport as late as one hour before your flight’s departure.”
Know the rules: U.S. Department of State for advice for Americans traveling abroad.
Stay in touch with your rep
Nicholas Kusnezov, MD, offers this travel advice: “Whenever traveling, always make sure to keep the locums agency, specifically your representative and travel agent, apprised of any delays, cancellations, or issues that arise during transit. This ensures that the company can not only troubleshoot travel issues in real-time as they arise, but they can keep the destination hospital in the loop regarding any delays instead of them finding out last minute and scrambling for coverage, and make sure you have an after-hours contact number.”
Now it’s time to hit the road!
Working with a staffing agency can make your travel to, from, and during your assignment smoother and simpler than if you were left to your own devices. Don’t ever hesitate to ask your agency’s provider representatives to clarify anything that may be unclear. Their goal is to make your locum tenens travel experience as simple, painless, and comfortable for you and your family. Finally, remember that these are general guidelines for locum tenens travel, and every agency will have its policies and procedures for handling locum tenens travel. Bon voyage!