Going Loco

[suckstobeme]

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So, I've been seeing a trend on this forum- people are more interested in going full time locums (ie "Going Loco", as I like to call it). I've been thinking about it, too actually. Although I'm more or less happy with my current situation, I'm just one bad management decision away from quitting at all times, and I think my current back up plan would be full time locums. I was wondering if I could get input from you guys about some of the nuts and bolts of how this works- specifically, if I could get some answers to the questions below. I think there's a real lack of knowledge amongst some of us newer attendings regarding how locums works- and that paucity of information only seems to be helpful to the companies that hire and manage locums. I would really love it if we could get a bunch of locums docs or those who have experience with it to post. (I think you are reading a sticky thread in the making.)


1) I know there are locums compaines out there that hire docs and connect them to facilities that need docs. What's their average cut of the pie? What would be considered acceptable and what would be excessive?

2) Is it feasible to do locums without one of those companies? If so, how do you handle your malpractice stuff and credentialling stuff without them? What other stuff would you think about?

3) Are there any companies you think are particularly good? Any to absolutely avoid?

4) Are there any contract provisions you absolutely insist upon? For example, do you insist on occurrence based malpractice vs claims made?

5) Any rules of thumb regarding how much you expect to be paid? (X pts/hr= $Y/hr)

6) OK. So there's a locums opportunity on the table. How do you know it's right for you? How do you do your due diligence? What are the red flags? Do you ever visit the site before signing on or call the department director to get a vibe?

7) What makes someone a great locums doc? (Would be especially interested to hear from those who hire locums.)

 

[Groove]

So, I've been seeing a trend on this forum- people are more interested in going full time locums (ie "Going Loco", as I like to call it). I've been thinking about it, too actually. Although I'm more or less happy with my current situation, I'm just one bad management decision away from quitting at all times, and I think my current back up plan would be full time locums. I was wondering if I could get input from you guys about some of the nuts and bolts of how this works- specifically, if I could get some answers to the questions below. I think there's a real lack of knowledge amongst some of us newer attendings regarding how locums works- and that paucity of information only seems to be helpful to the companies that hire and manage locums. I would really love it if we could get a bunch of locums docs or those who have experience with it to post. (I think you are reading a sticky thread in the making.)

1) I know there are locums compaines out there that hire docs and connect them to facilities that need docs. What's their average cut of the pie? What would be considered acceptable and what would be excessive?

Most make $40/hr at a minimum on top of what you make. What is considered unreasonable is a matter of perspective. The hospital needing emergency staffing for their ED is willing to pay top dollar. My last job was paying upwards of $360/hr for each physician from a staffing company when we were in need of providers if what I heard was true. The physician was likely getting around $225 or $250/hr in that particular case. That is a somewhat more extreme example.

2) Is it feasible to do locums without one of those companies? If so, how do you handle your malpractice stuff and credentialling stuff without them? What other stuff would you think about?

Generally, the staffing company "wins" the contract to provide extra staffing. If you go outside of them to seek "temporary staffing" for your ED, you violate that contract and can get in trouble i.e. sued.

3) Are there any companies you think are particularly good? Any to absolutely avoid?

I'm only familiar with Weatherby as far as "pure locums" is concerned and I had a positive experience with them, but you have to realize and be ok with the fact that they are making a lot of money off you. That being said, if you tell them on the front end that you won't accept anything less than $00-225/hr.. They will find you many jobs for that exact amount. Is the hospital paying $275/hr for your services or $350/hr? You'll never know.

4) Are there any contract provisions you absolutely insist upon? For example, do you insist on occurrence based malpractice vs claims made?

Most provide claims based with tail.

5) Any rules of thumb regarding how much you expect to be paid? (X pts/hr= $Y/hr)

I would not work for less than $200/hr and you can expect to make probably $225/hr. You have to haggle with them. They will always low ball you on the front end.

6) OK. So there's a locums opportunity on the table. How do you know it's right for you? How do you do your due diligence? What are the red flags? Do you ever visit the site before signing on or call the department director to get a vibe?

I never visited. Get all the info before hand and ask all the important questions that you need to inform yourself. Show up and work your first shift. If there are deal breakers, call your agent and tell them to fly you back home and find you new work. I've know more than one guy that would do this if a job didn't pan out. I would too if the situation called for it although I never had to and it certainly is not an uncommon occurrence with a locums company. Alternatively, it's not uncommon for a hospital to "let go" a locums provider if they are providing poor patient care or there are significant issues.

7) What makes someone a great locums doc? (Would be especially interested to hear from those who hire locums.)

Single. Desire to travel. Seek maximum flexibility and mobility. (Need to routinely take 2-3 weeks off in a row or take a month off twice a year, etc.. ) Want to check out other parts of the country? Putting off making a decision about practice location/type? Other than that, I don't know.

I honestly don't know too many people that do locums full time for a long period of time. I haven't met anyone that's done it for more than say 2-3 years though I'm sure there are some around.

Cautions:

You are working EDs where they have difficulty maintaining providers. These are undesirable locations or hospitals. There are inherent risks associated with that. Bad hospital? Bad reputation among the public? (I.E. Are you likely to get sued?) Malignant/Dangerous working environments? Bad nursing? You roll the dice with every gig.

Flying around and living in hotels gets old. Quick.

 

[Old_Mil]

You are working EDs where they have difficulty maintaining providers. These are undesirable locations or hospitals. There are inherent risks associated with that. Bad hospital? Bad reputation among the public? (I.E. Are you likely to get sued?) Malignant/Dangerous working environments? Bad nursing? You roll the dice with every gig.

This. There are a lot if lousy jobs out there and if a facility can't keep adequate staffing there is usually a reason (bad location, bad malpractice, bad management, low pay)

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