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A Physician's Guide to Locum Tenens
(Pros & cons of locums, negotiating contracts, finding opportunities & more)
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We are seeing more and more physicians considering being locum tenens physicians as an additional income stream, as a permanent career option, or even as a transition to retirement or a way to start cutting back clinically while developing an entrepreneurial venture or other interests. The flexibility that locums offers is attractive to many, along with the possibility of more lucrative pay for a day's work. It's important to understand the pros and cons of locums life, as it's not for everyone. It's also important to understand how to find the right locums recruiter if you choose to work with an agency, as well as how to negotiate a contract that protects you.
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In this guide, we'll help you determine whether locums is a good fit for you as well as discuss how to get started and succeed in locums.
Disclosure/Disclaimer: This page contains information about our sponsors and/or affiliate links, which support us monetarily at no cost to you. These should be viewed as introductions rather than formal recommendations. Our content is for generalized educational purposes. While we try to ensure it is accurate and updated, we cannot guarantee it. Rules/laws can change frequently. We are not formal financial, legal, or tax professionals and do not provide individualized advice specific to your situation. You should consult these as appropriate and/or do your own due diligence before making decisions based on this page. To learn more, visit our disclaimers and disclosures.
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Quick Links
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​Resources
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Resources
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PSG Locums Negotiation Database (You must be a member of our free group Physician Side Gigs to access.)
This database lists information about rates physicians are getting by location and specialty, details of locums gigs, experiences with different locums companies, as well as miscellaneous things like tips for maximizing points rewards
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Statistics on Locum Tenens Compensation for Doctors
Aggregate data on locum tenens compensation from our database including hourly pay rates, how physicians find opportunities and use locums companies or recruiters, and annual income.
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The Doctors Guide to Thriving in Locum Tenens
This course by one of our members covers the tools you need to successfully have a career as a locum tenens physician. It covers pros and cons of being a locums physician, being a 1099 employee, how to find opportunities either through agencies or hospitals, handling licensing and credentialing, housing, contracts, getting paid, malpractice, taxes, retirement accounts, and more! There is a money back guarantee, detailed here on our affiliate link.
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If you have a complex locums contract and need professional help reviewing and revising it, we have compiled a list of some group sponsors who have been positively reviewed by our members.
State Licensing
Email Jennifer Lincoln at Blue Shift Licensing at jen@blueshiftlicensing.com for 10% off of licensing and credentialing related services through our advertising relationship! They are experienced and have helped so many physicians and companies get their licensing completed efficiently.
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Visit our self-employed finances page to learn about how to structure your 1099 work, tax-advantaged retirement accounts available for individuals with self-employed income, and more.
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Tax Deductions for Locums Physicians Working as Self-Employed 1099 Independent Contractors
Common deductions doctors can often take for their locums work.
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Visit our taxes page to learn more about how to track and record your 1099 income and expenses, and what deductions are available to lessen your tax burden.
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Introduction
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Locum tenens translates to ‘take/hold the place of [someone temporarily].’ In the physician world, locum tenens means filling in for another physician to provide care to their patient base. This is typically a win-win situation for employers and physicians alike. Employers use locums physicians when they don’t want to turn away patients (and the revenue that is generated by those patients) while a physician is temporarily out or while they wait for a new full time employee. Common examples include injury, sickness, maternity leave, and lack of physicians to fill positions in a rural environment).
For the locums physician, they get the flexibility of being able to work as much or as little as they’d like (assuming they can find work), usually more money per day of work, autonomy to be their own boss and walk away from undesirable situations, and the ability to focus on being a physician without worrying about administrative tasks or concerns such as building a referral base.
Some physicians do locums as a side gig for extra money, whereas others do only locums. Maybe they want to cut back and focus on other things but retain skills, maybe they find they can make more money with locums, maybe they’re in transition between jobs, or maybe they just really love the perks of locums and are willing to give up some of the stability of a more traditional physician job.
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Is Locums a Good Fit?
Fundamentally, locum tenens positions offer flexibility. Many physicians have turned to locums in recent years as a way to practice medicine on their own terms, without the contractual and physical obligations of traditional jobs such as set amounts of vacation, off duty charting and patient care responsibilities, and full time hours. Locums can be great for physicians looking to have more time that is fully 'off-duty,' those that want to be able to take months or more weeks off to travel, for those who have recently left a job and have a noncompete in their area, or those who want to maintain their medical skills or earn money as a physician, without the typical physician lifestyle. They also offer opportunities to spend more time on other interests or income revenue streams such as side gigs.
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In a locum tenens contractor position, you can work in different locations and experience various settings, as well as potentially make more money if you're willing to travel. Earlier in your career, this might offer an opportunity to figure out what local area you want to settle down in, or what kind of job you would want as your 'forever job.' A lot of these positions even offer benefits, such as a housing allowance and travel reimbursement, and many times, you will make more money for an individual day's work than you would in a permanent position. Some people also just really love the ability to tie the work to travel!
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They can help you decide if you prefer the larger hospital setting or a small private practice feel before settling into a multi-year contract with a facility. Similarly, locum tenens can offer a “try before you buy” approach. If you are interested in the opportunities a certain facility offers, but unsure of the work culture, it lets you see how the system operates before you find yourself locked into a contract in what could be a toxic work environment, which is a fast track to burnout. And if you are looking into eventually starting your own private practice, it can be an opportunity to explore different patient populations based on setting and help you decide where you may want to locate your future practice.
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Some less obvious benefits: locums can give you experience on different medical record systems and RCM systems which can make you more marketable as you will be more familiar with and find it easier to adapt to new systems for future positions. These short-term contracts also allow greater opportunities to network within the healthcare industry.
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With flexibility, however, can come instability. While locum tenens often offer better rates than a long-term position, income is not always guaranteed and the overall compensation package once benefits have been considered might not be as lucrative as it appears from just the rate. Depending on the market need for your specialty, you might have gaps in between contracts. If you have a family depending on a steady income stream, or you need stable income in your current financial situation, it might not be the best time to look into locum tenens positions. Many physicians on our communities have also expressed that it is harder for lenders to secure mortgages or other loans as you don't have guaranteed income.
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Working locum tenens positions requires you to actively hunt for new opportunities, especially if you need higher cash flow and more reliable income and can’t afford long gaps between contracts. You may end up searching to line up your next contract before you’re even halfway through your current one, depending on the length. This can take time you aren’t compensated for, which can lower your overall true “net” compensation if positions are difficult to find or take a long time to negotiate and credential.
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Speaking of credentialing, each facility will have its own credentialing and licensing processes. Depending on the size and efficiency of the facility, this process can end up a lengthy endeavor, which is why you’ll see it covered in the contract review section below. You'll typically require multiple state licenses to do a lot of locums, which can be expensive and hard to manage with each state's requirements. See our resources section above for a great resource if you need help with this.
And your time spent searching, applying, and negotiating contracts isn’t the only thing to consider when evaluating the compensation package. Long-term employment opportunities typically include a benefits package which can add up significantly. Certain benefits to weigh include: employer-subsidized health insurance (group plans are typically much cheaper premiums than you can get in the open market with an individual plan); paid time off, including sick time and vacation time; and employer-contributed or matching retirement plans such as a 401(k). Make sure you review the full compensation package in your locum tenens offer and assess a value to the missing benefits so you can make an educated decision on the offer overall.
Last, but certainly not least, if your locums position isn't local, you have to be okay with being away from family, friends, and all the other things in your life at home from time to time. Make sure that key players in your life are on board with the changes they'll have to make to accommodate your travel schedule.
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As with most things in life, there are pros and cons to everything, but hopefully this section helps you decide if locums life is right for you!
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Finding Locums Opportunities
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While certain specialties have a much more active locums workforce (namely those where the work is shift work), there are locums needs for every specialty. Similarly, while rural areas are often in the most need of locums physicians (and the pay in these settings tends to be the most competitive), there are locums positions in every city and setting.
There are two ways to approach finding positions - look yourself, or use a third party locums company or staffing agency that is searching for physicians on behalf of a healthcare facility. There are advantages and disadvantages to both of these situations.
Locums agencies often take a significant percentage of the rate paid by the hospital, with many companies taking 20-50%, so many people feel they may be able to negotiate better compensation on their own, without the use of a middleman. Many of our members have had success working directly with hospitals, and this is definitely something you should look into if you feel you have the experience and time to navigate this well. Remember that each hospital will have its own set of people you have to get to know, its own policies and procedures, and its own little nuances and headaches. That said, in addition to the better pay, you will have more control and autonomy over the circumstances of your position, as well as eliminate some conflicts of interest the locums company may have. These types of contracts directly with hospitals, however, can be hard to get, especially when you’re starting out and haven’t built up a network within the industry yet, or don’t have a business structure in place that the employer can easily work with.
Working with agencies definitely have some downsides. They are there to make a profit, so they may prioritize keeping the client happy over you. They may also encourage you to take a lower rate so that they get a higher margin on the rate the hospital is paying them. Once they've presented you to a potential employer, they will want a piece of everything, forever. They may call you incessantly about jobs you are not interested in. Make sure that if you work with an agency, you set expectations for what you want your working relationship to look like, and that you read the contract you sign with them carefully. Don't be afraid to ask for a different recruiter or change agencies if the one you're working with isn't a good fit.
On the flip side, there are real positives of working with locums companies. Depending on the locums company, they may do some of the heavy lifting in terms of negotiating rates, arranging for and paying for travel, helping navigate licensing and credentialing, collecting payments, covering malpractice needs, and more. If you work with them often, they may also cover your licensing fees and keep track of your requirements, expiration dates, etc to ensure you stay up to date with all the credentialing you'll have to maintain. They are also responsible for the payments and the timeline of the payments, which can take out the burden of tracking different pay periods and schedules if you work at a lot of different places. Locums companies also have lots of contacts around the country, and are constantly searching for opportunities and building relationships with employers, which means you don't have to. Hospitals may also prefer to deal with agencies, as they know the agency has policies and procedures in place that they've already vetted and agreed to.
Essentially, you have to decide how much you just want to "show up" versus be involved in the nitty gritty, and what the opportunity costs of being involved in the details are (for example, if you can work a few more days a month because you're not making arrangements or filling out paperwork, it may be well worth it to pay middleman fees). It may be that you have some contracts with known entities that you manage yourself, but use a locums agency for others. It may also be that you use a locums agency at first when you're getting your feet wet with locums, but then once you've figured out all the details, you switch to handling contracts yourself.
If you decide you want to reach out on your own, start by figuring out which hospitals are in the location you want to do locums in, and which ones of those offer the practice environment you want in terms of patient population, patient load, procedure requirements, and after hours responsibilities. You can then reach out to in house recruiters or medical staff offices you find on LinkedIn or on the hospital websites.
If you want to use an agency, many of our members have reviewed agencies and specific recruiters they've enjoyed working with on the Physician Side Gigs community and within our locums experience database.
Additionally, join our free locums jobs database for when physicians or companies come to us looking for physicians for these roles. We'll send you an email if something meets the criteria you specify (but we don't give your information to anyone else).
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Types of Locums Positions
Locum tenens positions can vary in length, structure, and terms. Here are some examples of the types of locum tenens contracts you may come across while exploring this type of employment.
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Fill-in contracts
This type of contract is used when the previous physician leaves a facility unexpectedly or in cases of emergency events. Due to the nature of these events, these types of contracts have little to no notice of availability.
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Short-term contracts
Short-term contracts typically last a few days to a few weeks. As mentioned above, these types of contracts cover instances such as when the normal physician is out for a conference, on scheduled leave, has jury duty, or took a vacation.
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Long-term contracts
Long-term contracts generally last a few weeks to a few months. Some can last up to a year. These types of contracts cover when the normal physician is out for situations like maternity leave or a sabbatical. Some facilities can also use long-term contracts as a contract-to-hire model for recruiting and evaluating physicians before bringing them on long term.
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Cruise ship medicine is a popular locums gig that physicians explore. Learn more about being a cruise ship doctor.
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Part-time positions
These locum tenens positions offer fewer hours than full-time contracts, and can be dictated by availability during certain times of the day or on certain days.
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Rotational contract
These contracts work on a specific number of weeks on/off schedule.
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Telemedicine contracts
Unlike a traditional locum tenens position based at a specific facility’s location(s), telemedicine contracts offer even more flexibility than traditional contracts. They can be offered as any of the other types of contracts mentioned above. They may also be presented on a project basis for a specific healthcare initiative or program.
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Hybrid contracts
Hybrid contracts blend traditional on-site care with telemedicine services.
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Locum Tenens Contracts
Ready to start your first or next locum tenens position? We see question after question come through our communities asking about locum tenens contract review and how best to negotiate the proposed contracts. Though they are valuable skills for any physician to have, we don’t learn them during schooling or residency.
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First, you want to make sure the locum tenens position and related contract align with your needs and expectations. While not every part of a contract is negotiable, several parts are, and stepping up to the negotiations table can help you secure the best agreement, especially rates. You don’t know what’s negotiable until you ask. And don’t automatically accept their first hard line of “non-negotiable” as it might be their way of trying to push their standard contract as is.
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Below are common areas to review and negotiate for your locum tenens position. If your contract is complex and you need a professional to review it, check out our contract review attorney database to find someone who will work with your best interest in mind.
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Master services agreement
If you are working with a third-party staffing agency, they likely have a master services agreement (MSA) in place with the hiring healthcare facility. This agreement governs the terms under which the staffing agency and the healthcare facility work together. When this agreement is in place, the staffing agency may ask for you to sign this agreement before offering you a locum tenens position or before you can be placed with the healthcare facility.
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When a MSA is in place, specific terms of the particular locum tenens placements are then supplemented by addenda, statements of work, work orders, etc.
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Terms and the evergreen clause
When working with a staffing agency that has a MSA in place, you want to check the terms of the overall agreement you are making with the staffing agency, independent of your locum tenens placements. Some terms contain an evergreen clause that automatically renews the contract for a specific period unless one of the parties provides notice to terminate. This type of clause allows the agreement to remain in effect indefinitely.
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When reviewing the MSA provided by the staffing agency, you want to make sure you know your rights to terminate the agreement, especially if the staffing agency is not providing you locum tenens opportunities as desired. You also want to check what the notice requirements are to terminate the agreement, as well as what the termination options are.
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Pay and payment terms​
The rate is the most commonly negotiated part of a contract. The rate is typically set by an hourly amount or as a per diem paid by shift or day. Ensure that the contract specifies rates for routine hours, overtime, and in on-call situations. Consider shift differential as well when negotiating rates, depending on the proposed work schedule outlined.
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When working under an evergreen clause with a staffing agency, you want to consider an inflation adjustment as well, which may be stated as an “escalator.” This allows the rate to increase automatically by a certain percentage each time the term renews.
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Don't hesitate to negotiate a fair and competitive rate that reflects your skills and experience. The first offer given is rarely their best offer, but you will not receive a higher compensation package if you don’t advocate on your own behalf. No staffing agency or healthcare facility will outbid themselves to secure your services.
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You should review actual payment terms as well, as they can range widely. We've seen people not get paid for months. Specify when you will get paid for each component of your compensation, including reimbursements or installments, if applicable.
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Travel and accommodation​
If an assignment requires travel, negotiate travel arrangements and reimbursement details. Some organizations may impose limits on how much they will reimburse for expenses such as housing, meals, and transportation. Make sure you negotiate and clearly outline these limits. Another point to discuss under travel is whether they will provide transportation or if you are responsible for making your own travel arrangements.
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Scheduling
Scheduling and hours should be set prior to the locum tenens assignment. Clarify your expected schedule, including not just standard hours/shifts, but holidays, weekends, and on-call responsibilities. Negotiating for a schedule that aligns with your desired work-life balance is a great way to help prevent burnout, especially for longer term contracts.
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Discussing the patient load is also important prior to starting an assignment. Ensure it is a reasonable expectation on the facility’s behalf, allowing you to deliver quality care without undue stress.
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Contract dates and location
Consider the length of assignments carefully. If you prefer shorter contracts for more flexibility or longer contracts for more stability, discuss your preferences with the staffing agency or the healthcare facility. Make sure the terms of the contract clearly state the start and end dates.
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Also check that the contract clearly defines the locations covered, especially if the facility has multiple ones.
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Licensing and credentialing
Different facilities will have their own licensing and credentialing requirements. If you need to obtain additional licenses or credentials for the assignment, discuss who will cover the associated costs. Make sure to check if there are any terms associated with the payments that could result in charges to you if the contract should terminate early. It’s also important to know what support is provided throughout the licensing and credentialing processes. Negotiate any necessary assistance to expedite the licensing and credentialing procedures. The contract should clearly state what happens if the facility takes longer than expected. Check out our resources section above for help with the licensing process.
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Malpractice insurance
Ensure that you have adequate malpractice insurance coverage during your contract. Discuss whether the facility provides coverage or if you need to secure your own policy. When at all possible, negotiate for them to cover you. Most locum tenens malpractice insurance policies provide $1 million per claim and $3 million aggregate total coverage limits for a one-year policy term. Make sure the contract clearly outlines the policy limits and terms. If the coverage provided is claims made coverage, see if you can get tail coverage added and covered by the facility. Tail or nose coverage is expensive if you have to pay for the coverage yourself.
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Exclusivity
Check the contract for any verbiage that prevents or limits you from working with other facilities, staffing agencies, or employers in the area, as well as limits on other locum tenens contracts or other work while under the terms of the agreement.
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Cancellations and termination
You want to make sure somewhere in the agreement you are protected in case they cancel, as you've already set aside the time and made arrangements accordingly.
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Review the contract termination clause carefully. In particular, discuss the notice period required for both parties to terminate the agreement and any potential penalties or obligations that may arise. Pay attention to the without cause and for cause/for good reason terms, as they may determine the rest of your rights. A without cause clause means either party can terminate the assignment for any reason or no notice at all. A specified period is usually defined and advanced written notice is generally required. The standard period is thirty days. Shorter clauses can help you leave a bad situation quicker, but also offer you less stability as the facility works under the same guidelines.
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A for cause clause means the facility can terminate the assignment, sometimes immediately or after a “cure period.” These clauses are almost always drafted with the facility’s best interests in mind, not yours. When the contract includes vague phrases such as “failure to perform duties to reasonable satisfaction,” you want to ensure that the facility is required to give you written notice and a “cure period” to correct.
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Buy-out terms
A situation may arise, especially in a long-term contract, where the healthcare facility may want to convert the locum tenens assignment into a permanent job placement. The terms of such an arrangement should be clearly discussed and defined within the contract.
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Boilerplate clauses and force majeure
These terms can be lumped together and look like the double sided, tiny print of a medication guide. You may be tempted to skim this portion of your contract, but it’s important to do your due diligence up front. No one is going to protect you better than you will.
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One particular section to read multiple times and understand here is the force majeure. This section dictates how you can protect yourself in case you can’t complete the assignment due to circumstances beyond your reasonable control. If a force majeure clause is not included, you might find yourself held liable for a breach of contract, which can lead to thousands in monetary damages. It is not always a standard clause included in locum tenens contracts because it protects you, not the facility, so it’s important to review and discuss as part of your contract negotiations.
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Also look out for an indemnification clause or hold harmless wording. This typically protects the facility instead of you, and we're seeing it more frequently in physician contracts.
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Negotiating Locums Contracts
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We aren’t lawyers, we’re physicians. We’re used to arguing with patients to take their pills, not with hospitals over what to pay us. But it’s worth stepping out of your comfort zone to ensure you make the best deal for yourself. Negotiation is an expected part of the process and a collaborative endeavor. The healthcare facility’s goal is to get care at the best cost for them. Your objective is to make sure you protect yourself and that the facility properly compensates you for your time and expertise. If negotiating isn’t your super power, here are some tips to prepare yourself when reviewing and negotiating your contract.
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Approach the negotiation discussions with professionalism, clarity, and respect
You are a physician, but you are also a business professional. This is a business deal you are negotiating and signing with the staffing agency and/or healthcare facility, and you have to protect your business. If they try and use your altruism against you, respectfully point out that while you love what you do, you know your worth in the space and expect compensation that is commensurate with that. Communicate your expectations, needs, and desires, as well as any non-negotiables you may have, up front.
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Know your worth
This can be difficult, but it’s worth the time and effort to research, especially for long-term contracts. Speak to colleagues you have that are practicing in the same or similar area and have similar job responsibilities. Remember, when comparing temporary, contract, and full-time positions, you need to consider the entire benefits package—or lack thereof— as well as exact responsibilities when comparing rates for the different types of opportunities. Remember to take into account expectations while you're not physically at the hospital (on call responsibilities, overtime, etc.). You also need to compare and weigh your expectations when it comes to other factors, such as scheduling, travel reimbursements, and time off when determining your desired overall agreement.
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We have worked to compile a database to help physicians find comps and know their worth. Learn more about:
Then explore our free locums salary and compensation database for doctors to help you compare relevant data points to your location and specialty.
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As part of knowing your worth, it’s important to understand your value in the current market as well. Shortages in the physician labor market have empowered employees with more negotiating power in the last few years than in previous decades. The shift in the labor force is uncharted territory, and employers are still trying to navigate it. They tend to shift back to the default position they’ve had for years. Don’t forget you have leverage. Just make sure you don’t abuse it or overplay your hand. Remember to be professional and courteous. Be prepared to justify your requested rate and other benefits. Explain how you came to your desired rate based on your qualifications, experience, and the specific demands of the assignment. If you can provide examples of similar assignments where you earned a higher rate, bring those to the negotiations table as well.
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Clearly articulating your qualifications, experience, and any unique skills or certifications that make you valuable is a great way to not only know your own worth, but to communicate it to the other party. Emphasize how your particular expertise and skill set can benefit the healthcare facility, especially if you can offer specialized knowledge.
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Know your goal and deal breakers
Come prepared with your desired numbers after reviewing as many relevant comps as you can find. The likelihood of the company coming back and agreeing to all of your requests in the first round of negotiations is possible but not probable, so it’s important to know your deal breakers as well. What is the middle ground you are willing to compromise to when it comes to not just the rate, but all the overall terms of the governing contract? It is important for you to sit with this question and come up with your requirements prior to starting the negotiation process.
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Researching the healthcare facility offering the assignment can also help you understand your negotiating power, as well as possible roadblocks you might encounter during negotiations. Listen to their perspective and understand their budgetary constraints. By demonstrating that you understand their needs, not just your own, you can approach negotiations in a collaborative manner that aims to find a mutually beneficial solution. And remember, collaboration is key. You are asking the employer to come to the bargaining table. Be willing and expect to do the same. A collaborative and respectful approach is much more likely to result in a successful negotiation.
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Learn negotiation tips, tactics, and strategies all physicians should know and use.​
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Credentialing and Licensing
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Credentialing
The point of the credentialing process is to confirm your identity and qualifications before you begin your new locum tenens contract. It can be the most frustrating part of doing locum tenens contracts, especially since you don’t have much control over the process. Being prepared can help make the process as smooth as possible. Here’s a list of documentation to have ready that you will likely be asked to provide during the credentialing process.
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Basic personal information
Have your personal details together such as your full legal name, contact information, date of birth, and Social Security number. If applicable, keep an original or certified copy of any change of name documentation.
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Professional references
You will likely be asked for multiple references during the credentialing process. Compile a list of professional references, including: names; specialty; contact information; and the dates you worked with them. References should be physicians or other professionals in the healthcare industry who you have worked directly with that can speak to your clinical skills and character. The more people you have who have already agreed to provide references for you ahead of beginning credentialing the better, as it gives you more options to pick from when you need to reach out.
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It can take a while to get reference letters pulled together, especially if the facility has a preferred format or other requirements, so starting on the references right away can help prevent any delays to the credentialing process and gives your former colleagues time to get the reference letter done without you having to pester them.
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Curriculum vitae (CV)
Have an update to date CV (resume) that highlights your professional experience, training, current certifications with expiration dates, and any publications or other relevant information. Your CV is often your ticket to show where you shine, so make sure you take the time to make it an organized and professional tool to highlight your accomplishments and unique talents and experience. This should be done before you start searching for locums positions, as it’s a great tool to have during negotiations. Update your CV at the end of every assignment or position and when you renew your training, certifications, etc. to save yourself time researching and remembering everything when you’re against a start date deadline.
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Employment history
Create a list of your past employment history, including dates at that facility, position(s) held, and contact information for references (for your own reference). This helps verify your professional background and work experience. Make sure there are no large gaps in your work history. Gaps in employment are red flags for employers. If you took a sabbatical or have a gap in your employment history, make sure to explain it up front, don’t wait for them to ask you about it.
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Education and training records
Keep copies of your med school diploma and transcripts, your residency and fellowship certificates, and records of any other relevant education. Include information about the institution, date of completion, and your specialty training.
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Professional licenses
Have copies of your active medical licenses for all the states in which you’re licensed to practice (this includes both your permanent licenses and any temporary or locum tenens licenses you may have).
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CME documentation
The healthcare facility will likely have a minimum continuing medical education (CME) requirement. (Some states do too for licensing, so make sure you check ahead if considering getting licensed in a new state.) Keep certificates or transcripts together and easily accessible. It’s also a good idea to have a record of the course you took, the number of credits you received, the organization who presented it, and the location of the course. Getting this organized early will help prevent a mad scramble come credentialing time.
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Immunization records
These records should be up to date and readily available. Healthcare facilities typically request your records for diseases like the flu, tetanus, hepatitis B, and tuberculosis. While others immunizations are not as common, it’s still a good idea to keep all of the records together. You never know when a situation may arise on assignment, and the facility needs other records for specific cases.
Board certifications
Have copies of your board certifications or letters verifying your certification status.
Life support certifications
Have copies of your current certifications, such as basic life support (BLS) and advanced cardiac life support (ACLS).
Professional association memberships
Keep a list of your current memberships to professional organizations, medical societies, or specialty-specific associations.
Malpractice insurance
Hopefully, you can negotiate in your locum tenens contract for the facility to cover you under their malpractice insurance. If malpractice insurance is not covered in the contract, you will need to provide proof of your personal coverage. Have the policy details, limits, and expiration date on hand and ready.
DEA registration
If you are registered through the DEA (Drug Enforcement Administration) for controlled substances, keep a copy of your DEA certificate or verification letter on hand.
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Keeping an organized list of all your expiration dates, with reminders for renewals, will not only help you with the credentialing process, but it can help you prevent a mad scramble at the expiration deadline when life might be pulling you in multiple other directions.
You should also be prepared to undergo a background check as part of the credentialing process. Have information on hand for any disciplinary actions, legal issues, or criminal history. If you know from previous experience that something is going to get flagged, it’s better to be upfront.
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Licensing
Every job will require you to have a license, and each state has different rules for getting licensed (such as requiring an address in the state in order to apply or specific CME course requirements). This is an important factor to research and assess when weighing your locum tenens options, especially for states you haven’t previously worked in before.
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Selecting a few different states you really love working in will be less of a headache than jumping around the country and trying to get licensed in a new state with each assignment. It will also cut down on the time required in between assignments (timelines for licensing can vary state to state and can take a while), during which you won’t be making income.
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Our list above for credentialing is a great primer for what you will want to have ready for licensing in a new state. A few other items to have pulled together include a government-issued ID, such as your driver’s license or passport, and a current (last few months) professional photo in case the state requires it for your license.
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See our resources above for help with licensing from a trusted partner that many members of our group have used.
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Succeeding in Locums
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Success in locum tenens requires preparation, professionalism, and flexibility and starts before your assignment does.
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Preparation
Before you start, familiarize yourself with the healthcare facility you’ll be working at. If scheduling permits, arrive a day early or stop by the night before. While online resources can be helpful to give you the lay of the land, obviously seeing it in person and getting familiar with the layout, parking, and other key areas will allow you to avoid getting lost on that first day, as well as come up with the questions you want to ask during your orientation to start off smoothly. If you can’t get there early, reviewing the facility’s website can help. Websites also often list key personnel as well (often with pictures), which can give you an idea of who you will be working with.
If you are relocating for your assignment, take some time to research the area. Google Maps can help estimate travel times from your housing to the facility. Plan for a longer commute than it estimates on the first day, which will give you time for unexpected delays and a buffer period if parking is difficult. There will likely be lots of hiccups/orientation the first day, so you’ll want every minute you can get to try and stay on schedule.
Make sure you also have your contact’s information readily available. If your contact doesn’t mention an orientation ahead of time, request one to help get acclimated. Not only will this make your first day less stressful, but it will make you look better when you’re prepared. You may also want to ask them for a list of key contacts or numbers you’ll need to do your job, systems you’ll be using and login/passwords, and any other access information you will need. It will be easier on you if it’s all in one place than figuring it out as you go.
If you’re relocating to a part of the country or another region of a large state, make sure you’ve accounted for any climate differences. Also, if this is your first locums assignment, take some time to track the things you use in your daily life over a period of a few days, so that you don’t forget to pack them. Although you can probably get most things at the location, it can be really annoying trying to get a prescription filled or having to constantly run out to get things you forgot.
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Professionalism
A lot of this may seem like common sense, but many of us are used to working in environments where everyone knows us. You will be making a lot of first impressions on every assignment you go to, whether it’s with colleagues, administrators, or patients, and you want that to be a good one.
Being kind and helpful goes a long way in creating a positive work culture with others, which can not only make day-to-day life easier, but can be useful when you’re looking for references for your next assignment. The better the impression you leave on the staff, the more likely they will be to want you back for another assignment. Reputations spread quickly through the healthcare industry. If you have a bad one, you’ll find it difficult to land the locum tenens positions you want. Be neat, both in your work area and in your appearance.
Stay up to date with medical advances and guidelines in your specialty so that you can be efficient and effective. Not only do reputations spread, but they can linger from the physician you’re filling in for or the previous contract physician you replaced. Being able to outperform your predecessor will go a long way in building your own reputation.
Be organized with patient records and your time as well. Managing your time and prioritizing tasks can make you more efficient, which will help you stand out in a temporary assignment. Having patient records and paperwork organized will not only make your job easier. It will help those you’re working in conjunction with. This applies even to your time card. Make sure you know by the end of your first day who has to sign off on your time card and make sure you submit it before you leave at the end of your assignment, or by the required deadlines within longer-term contracts.
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Flexibility
One of the selling points of locum tenens positions is the flexibility they afford for your lifestyle. Embrace that aspect when approaching your assignment. The ability to adapt and assimilate to different work settings, structures, equipment, procedures, and personalities is a key feature in a successful locums doctor. Remember you are on assignment for a particular purpose–to fill in temporarily. You aren’t here to change their system. Be willing to adjust your normal approach to fit the needs and desires of the facility. And be receptive to feedback. Your attitude is coupled with your reputation.
Be open to learning from your colleagues and other staff. Taking the time to learn their standard workflow will help you adjust quicker. As you become a more seasoned locums physician, a way to demonstrate your knowledge is to incorporate best practices and procedures you’ve learned from other facilities, so long as you come at it with a helpful and professional approach. Find opportunities to show your interest in the facility and their success, not just your personal success in your assignment.
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