WHEN IT COMES TO working locum tenens, one of the biggest questions most physicians have is this: Will they be able to find regular work? But the consensus among physicians who work locum is that there’s plenty of work out there. When Elizabeth Noel Lumpkin, MD, started working locums 12 years ago, there were not a lot of jobs in her home state of Washington. But a locum agency she contacted quickly found her a job in Ohio, and the anesthesiologist hasn’t run into any lack of assignments since.
“People always think that there is a scarcity of jobs when you are a temporary worker,” Dr. Lumpkin says. “That’s not the case in locum. In 12 years of doing this, I have never been without work. Sometimes you might end up taking jobs you don’t love, but you can always find work.”
“I turn down an average of about two jobs a week.”
Because of the nationwide physician shortage, she notes, there are “hundreds or thousands of jobs available, depending on your specialty. I turn down an average of about two jobs a week, and that’s just in my own specialty. If you are a hospitalist, an emergency medicine physician or psychiatrist, there are even more jobs.”
Shaun S. Berger, MD, who has worked as a locum pediatrician and pediatric hospitalist for more than a decade, says that a good physician with a reasonable attitude should have no problem. “If you’re a quality person, you’re not burning bridges,” Dr. Berger says. “So you’re going to keep getting hired.”
Should you go through an agency?
How do you find locum assignments? While Dr. Lumpkin used an agency for her first locum assignment, she often finds new assignments herself. “Sometimes it’s just a matter of picking up a phone or texting or e-mailing someone and asking if they see any need for locum down the road,” Dr. Lumpkin says. “The jobs are often there. Just asking can yield jobs that are not ever posted on a job board or listed with an agency.”
But Christopher Noel, managing partner at Integrity Healthcare Locums in Sarasota, Fla., says it can be a challenge to have a sustainable career as a locum if you’re arranging everything yourself. “You are doing the credentialing piece yourself,” he says, “you’re coordinating the travel yourself, you’re taking care of your own malpractice, you’re planning your next assignment so it begins when your current one ends.”
Dr. Berger agrees that agencies make working as a locum easier, even if they do keep a percentage of the wages you earn. “Agencies make sure your travel is arranged, that you’ve got the proper insurance, and that your paperwork and credentialing is in order. You may be able to make a little more money arranging work yourself, but that isn’t always the case.”
“The best match is not always the highest paying job.”
He also notes that agencies have sometimes been able to negotiate a higher pay rate than he could have done on his own. And “as a new physician,” he explains, “you’re probably not going to make that happen yourself.”
Finding a wide variety of assignments
A good locum agency can help you not only find a high paying locum gig, but the one that best fits your needs. As Mr. Noel points out, the two may not always be the same.
“The best match is not always the highest paying job,” Mr. Noel says. “You might have something in a rural area that pays well, but do you want to be out in the most rural of hospitals where you are the only provider with limited subspecialty support to back you up?” Instead, “you might be better off taking a job with a larger hospital. A 300-bed community hospital with lots of access to subspecialty support may pay only $5 or $10 less an hour.”
Many physicians work with more than one locum agency just to make sure they see a wide variety of assignments. “I have my name in the hat with multiple agencies,” says Paul Birinyi, MD, a neurosurgery fellow who also works locum. “It is up to them to market me and figure out where I fit in. I have new assignments come across my desk every few days, so it’s just a matter of seeing which ones match my schedule.”
Questions to ask
Whether you’re looking for locum assignments yourself or with an agency, make sure to ask lots of questions. “Get a clear idea of what’s involved with the assignment,” Dr. Berger says. “As a pediatrician, they may tell me that I need to attend deliveries. You want to know if that means attending every C-section or just high-risk ones. You get a lot less sleep going to every C-section.”
Other key questions he says to ask include the call schedule, hours, and whether doctors need to provide in-house call vs. call from a hotel or an apartment. And “are there residents you’re teaching, and who is doing the notes? There’s a big list of questions to ask, and some are very specialty-specific. Think about how call has varied among the rotations you’ve done as a resident.”
Veteran locum physicians also say that it helps to be organized. Digitally scan your license, credentialing and other materials so you have the materials on hand. “When someone wants a copy of your license, CV and diploma,” Dr. Berger says, “you can send an e-mail from your phone. You might get the job before someone else because you replied quickly.”
And finally, working locum requires physicians to think ahead. Mr. Noel says that in most cases, it can take about 60 days to get physician credentials. “If you’re finishing your residency in June, you need to begin the process in April.”