A View From the Hiring Side

Stacey Stanley, president of Dayton, Ohio-based Next Medical Staffing, serves on the board of directors for the National Association of Locum Tenens Organizations^® (NALTO^®). With a background in sales and other executive leadership roles, Stanley entered the healthcare staffing field as the co-founder of a traveling nurse business in 2003, and only five years later, she sold the second nurse staffing agency she founded Next Medical Staffing, a staffing agency working with physicians, nurse practitioners, physician assistants, CRNAs and traveling nurses. Since 2009, Stanley’s firm has seen notable growth in the physician locum tenens segment of her business. In 2015, she sold Next to Cincinnati-based Health Carousel and remains as division president of Next Locums and Next Travel Nursing.  

Here’s how she sees the locum staffing industry today:

Let’s start by talking about the overall growth of the locum marketplace – who wants locum talent today and why?

We’re in a very interesting time in the physician environment. We’re seeing significant change in practice models while doctors are evaluating their own options as well. At one point, the locum tenens physician was primarily a fill-in for a physician on leave or vacation. Today, they’re more likely to fill a vacant position as we’re seeing a greater shortage of physicians in this country. More than ever, you’ll see a hospital or practice viewing a locum as someone who might go from short-term or part-time locum work to full-time hire. That’s certainly not representative of every locum situation, but you do see more hiring environments evaluating locums as potential team members. That’s an interesting scenario for a physician who chooses to go full-time, part-time or occasionally in a locum role – depending on specialty and health care demand, there may be a range of career options and environments they can try on. 

Are there any physician specialties that are particularly sought-after in locum work?

The demand for locums is a mirror reflection of full-time physician shortages. Staffing agencies are competing for the same pool of professionals nationwide. Primary care – internal medicine, family practice and pediatrics – lead the way, while high-retirement specialties like pulmonology, psychiatry, orthopedic surgery show a significant need for short- and long-term locum placement. Shortages and other factors ranging from geography to experience in particular treatments and procedures generally mean attractive opportunities for locum physicians in those specialties.

If the locum environment is so highly competitive now, where are you looking for physician talent?

NALTO®’s standards of practice and ethics are high – depending on the specialty, our members want to recruit physicians who have documented and demonstrated success in their fields. So, many of us believe the future of the locum industry depends on educating future medical professionals that locum can be more than a part-time or late-career employment choice. Increasingly, we’re reaching out to residents and newly graduated medical students to talk about locum options once they reach certain employment and experience milestones. While we already know that newer physicians with some experience often seek out part-time or the occasional weekend locum assignment to ease the gap between starting salaries and medical debt, we’d like to create a broader discussion about how locum work could fit into other segments of a physician’s career.

We already know that younger physicians explore locum work in part because of the medical debt issue and late-career physicians often test locum as they transition into retirement, but are you saying locum may become an option for mid-career physicians as well?

There are no real statistics on this yet, but physician burnout is a real problem at all experience levels in medicine, and the way practice models are changing, we may be looking at a future where physicians plan their careers differently. Part-time or full-time locum work could provide an opportunity for career breaks or ways to explore new fields if doctors want to make a change. 

But it’s not just about career dissatisfaction – we’re seeing other opportunities for in-demand medical specialists to extend their reach in locum roles. We think telemedicine is going to be very interesting as a career path for locums. For example, as demand for mental health services increases in many communities, we’re seeing a significant shortage of psychiatrists. Telemedicine might be a way to extend or diversify the careers of current practitioners. 

If a physician is considering locum work, what should they ask their prospective staffing agency?

Healthcare professionals should feel comfortable asking a staffing agency any question that’s on their minds. But here are some of the major ones any qualified agency should be prepared to answer:

• Who are you? Many physicians hear about staffing agencies from direct contact or from peers, but it’s very important for prospective locums to understand a staffing firm’s history, their client relationships and the exact medical professionals they place¹. Some agencies place very specifically within specialties – know what the agency does best and which institutions they work with.
• What about my medical liability coverage? They should ask extensive questions about medical liability insurance, such as limits, reputation and rating of that coverage. They should also ask how that particular carrier works with locum physicians in terms of general customer service and in case a claim is filed.
• How will you compensate me and when? A physician should know the staffing agency’s payroll process and ask specific questions regarding timekeeping, guarantee of chart completion, timing for being paid, etc.  The physician should also understand the strictness of maintaining accurate 1099 status.  
• What about my credentialing, licensing and privileges?Based on specialty and assignments, prospective locums should confirm the staffing agency’s level of assistance in credentialing, licensing and privileges before they agree to any assignment.
• What about distance travel and housing? For overnight and out-of-state travel, it’s important to know how much assistance the agency offers in terms of negotiating housing or travel arrangements, what is reimbursed and what is not, and how to appropriately report reimbursed expenses. 
• What about the medical record issues onsite? EMR comfort and expertise is a challenge for any full-time physician working for years at a single institution. A locum can face enormous challenges in that regard, working on a wide array of medical records systems depending on where they’re sent.  It’s important for the staffing agency to be able to answer or refer basic questions about the medical record setup in any setting as it always carries an important role in medical liability protection. 

TAKEAWAYS:

• All career moves take planning. Take time to get to know the best locum staffing agencies in your specialty and target locations. Talk to trusted peers first, do your homework and interview the agency thoroughly before you decide to work with them.
• A staffing agency’s financial strength is key. Locum physicians depend on an agency’s ability to find quality assignments and pay on time. Ask specific questions about your compensation and any related financial record-keeping they provide on your behalf. 
• Investigate your agency’s medical liability carrier thoroughly. Ask the agency to provide proof of insurance and research the carrier to determine their financial strength and customer service. 

The best locum candidates want the best in medical liability protection – wherever they work. Healthcare staffing agencies of all sizes can count on ISMIE to provide solid coverage for professionals in all 50 states. 

1 - https://www.nalto.org/about/choosing-a-locum-tenens-firm/