Locum tenens: How to get started, what to expect

The prospect of undertaking something new and different can be intimidating, even for the most confident among us. Think back to when you first considered the possibility of optometry school. You probably asked yourself questions like: How does the process work? How hard is it really? Where do I begin? Who can help me figure this out?

Fortunately, launching a career in locum tenens isn’t nearly as challenging as getting into optometry school, but like stepping into any unknown territory, having reliable information can relieve the minor anxieties associated with change.

Do your research first

If you’re interested in practicing locum tenens, National Association of Locum Tenens Organizations (NALTO) board member Andrea Hernandez says the first step is to identify agencies you want to associate yourself with. “If you know someone who’s been doing locums, perhaps someone who has come through your facility, talk to them about their experience,” said Hernandez. Find out which companies they’ve worked with and what they liked and didn’t like about each one. A list of more than 60 NALTO member firms is available on the organization’s Web site, www.nalto.org . This is also a good place to research agencies that have agreed, as NALTO members, to voluntarily adhere to a set of quality and ethical guidelines.

Hernandez recommended taking time to research and interview several agencies before making the decision about which ones to work with. “Be sure to talk directly to the person who would be representing you if you signed on with the company,” she said. “Get to know the people, not just the company. Get a feel for their breadth of knowledge about your specialty. You need to feel confident that they have a good grasp of the industry so that they can partner with you and help you guide your locum tenens career,” she said.

Affiliating with three to five agencies is a smart move, especially if you plan on locum tenens as your full-time career. “You’ll have more opportunities with greater variety,” said Hernandez. One critical factor to consider when choosing an agency is the quality of the liability insurance it provides. Make sure that it’s from a highly rated company and that it includes tail coverage.

Organizing the paperwork

Once you’ve chosen your companies, you’ll be asked to submit all the standard documentation required for credentialing, including a current CV, copies of licenses and certificates, and references. “Have people lined up who have agreed to be your references. The industry standard is to list three colleagues you’ve worked with within the past 2 years,” said Hernandez.

Each agency will ask you to sign an independent contractor agreement. This outlines your working relationship and confirms that you are a free agent rather than an employee. This means you will receive 1099 tax forms, as opposed to W-2s, and that you are responsible for paying your own income taxes. “The independent contractor agreement is a blanket contract and not attached to a specific assignment. For each assignment, you’ll get a separate confirmation letter that outlines specific details. Some agencies require that letter to be signed each time and some don’t,” said Hernandez. Assignment letters cover the location, length, hours, call duties, housing, travel details, and compensation associated with each assignment.

When you’re ready to begin considering locum tenens assignments, be clear about exactly what you want in terms of where you’d like to work, what type of services you will provide, and for how many weeks or months you’re willing to be away from home during a given year. “This will help your agency representatives call you about assignments that match your criteria,” said Hernandez. Plan ahead if you're going to work in a state where you don’t currently hold a license. Licensure rules vary from state to state.

Setting the ground rules

“Once you’re contacted about assignments, it’s important to be organized by keeping a logbook that tracks specifically which agency called you and the details of the assignment, including the practice name and service dates,” said Hernandez. This is because it’s not uncommon for more than one company to have the same assignments to offer. “If company A calls you on Monday with an offer to work at ABC Practice for the month of June and company B calls you on Tuesday about that same assignment, you’re obligated, if you accept, to go with company A,” she said

There isn’t usually much negotiation when it comes to compensation. “The initial registration process will cover that,” Hernandez said. Factors that influence pay include specialty, geographic location, and the duties associated with the assignment.

In most cases, part of the process of considering an assignment will include a phone interview with someone at the practice. “Practitioners usually speak with a practice manager or another practitioner,” she said. This is your opportunity to ask about details such as patient volume, on-call expectations, and the practice philosophy of the hospital or clinic.

If an assignment involves inpatient care, the hospital will go through a credentialing process just as if you were applying for permanent staff privileges. “It’s essential for doctors to get that paperwork turned around quickly,” said Hernandez. “Agencies can help move the process along, but some things the doctor has to do him or herself.”

The first few days on site are critical to the overall success of an assignment. Ask in advance what kind of orientation you should expect, and make sure you’re comfortable using the electronic medical records system and that you understand the essential policies and procedures of the hospital or practice before you begin patient care duties.

You’ll receive a timesheet to fill out and submit directly to your agency. “Find out what the payment schedule is,” Hernandez said, adding that most companies offer direct deposit for their locum tenens practitioners.

Once you’re established with locum tenens agencies and working assignments on a regular basis, keep your CV current and send updated credentials (e.g., renewed licenses) to each company. In addition, stay in touch with your agency representatives.

“Send a quick e-mail letting us know where you are, for how long, and what you’ll be looking for next in terms of work,” said Hernandez. “This way we won’t be calling you when you’re not available, but we can be on the lookout for your next assignment based on when you will be ready.”ODT