Locum tenens is a Latin term meaning “place holder”. While most of us are familiar with traveling nurses, fewer may understand the role of the traveling (or temporary) physician. Locum tenens physicians work in hospitals, clinics, and private practices when regular full-time staff is unavailable (such as for illness), on sabbatical, or more hands are needed to get the job done. Some providers enjoy the challenges and rewards that come with traveling to new places – meeting new people, trying out a new city, or testing the waters in a different work environment before accepting full-time employment. How much you make on an assignment will vary depending on the type of degree or specialty you have, the work setting, and what percentage is being taken by your middleman, or locum tenens agency.
Locum tenens physicians tend to make slightly less than full-time employees do unless they are willing to work overtime – in which case the earning potential is much higher. If you choose to work with a locum tenens agency, pay for a specific job is negotiated between the facility looking for a provider and the locums agency. The agency charges the facility a set fee and takes a cut. Some agencies will list pay ranges by specialty on their websites. Examples for an 8-hour shift included $600-$800 for OB/GYN services, $1,300-$1,400 for neurosurgeons, and $720-$880 for family practice. Most agencies pay rates that are comparable to one another so it does little good to shop between them.
Because most agencies pay providers as PRN (as needed) contractors, no taxes are taken from your paycheck and you may need to set aside a significant chunk of your money to pay Uncle Sam at the end of the year. There is no 401(k) matching as compared to full-time employment and no health or retirement benefits. However, some locum tenens agencies do pay malpractice insurance, travel and housing expenses but make sure to ask. Some experts warn that malpractice insurance may be inadequate and additional tail policies may need to be purchased. According to an article published in the American College of Physicians, “30% of locum tenens practices provided only basic claims-made malpractice insurance without tail coverage. Of course, this would be totally inadequate for a situation that is, by definition, temporary. A malpractice tail must either be negotiated as part of the locum tenens agreement or purchased separately.”
Even with these downfalls, some providers consider locums work positive because there are very little or no administrative duties, no haggling with insurance companies, and no chasing patients for payment. You gather your paycheck at the end of your two weeks and either continue your assignment or move on to the next.
You do have some wiggle room to negotiate pay for a locums contract. Because rates are based on supply and demand, pay rates may go up and down depending on how many physicians there are to fill positions, or if a job has been particularly hard to fill. If you are willing to work longer hours or stay in a location for an extended period, you may be able to negotiate a higher pay rate. Keep in mind that as the physician you have the final say in what job you take.
Very few providers find benefit in finding their own locums work outside of an agency, and it boils down to convenience. Agencies handle the negotiations, locate housing (often on short notice) and handle insurance and licensure logistics –factors that can be time consuming and frustrating for busy physicians. Most providers also lack enough network connections to find steady work outside of an agency and find this route most beneficial and the least stressful.
Locums work can be a great alternative to full-time employment and can help providers build skills while deciding when and where they will put down roots. There are plenty of benefits and plenty of drawbacks to the field and each will have to be considered before tackling a locums assignment.
By Rachel Ballard RNC, BSN
Rachel Ballard is a certified registered nurse and owner of the medical writing company iHealth Communications. iHealth teams with healthcare leaders to create written content that boosts revenue and builds relationships. Learn more about Rachel on Google+