Locum Tenens Hiring: Tips from the Pro

John S. Daniel

President of NALTO^®

VP, Alliance Recruiting Resources

In any other field, locums would be described as freelancers. Can you speak to the qualities that physicians or other medical professionals should have to become a success in locum work?

The single most significant factor to being a successful locum tenens physician is the quality of the physician. Clinically speaking they should be sound, flexible with their schedules and a team player.

What differentiates staffing agencies from one another? Do small shops and larger ones handle different types of placements? If so, what separates them?

Smaller agencies may serve more limited specialties, whereas larger agencies tend to provide physicians in all specialties. However, quality physicians are available to all agencies regardless of size. Small or large, being able to listen and determine the needs of the client is what sets you apart.

Are you seeing any particular trends emerge in the locum contracting process? Are there certain pay/work environment demands locums have now that they didn’t have 3-5 years ago?

Our observation is that physician needs and requests have remained fairly stable over the past three to five years. Routinely, doctors stay aware of compensation and want assurance that they’re getting market rates on assignments. We’ve also seen physicians trending away from client-covered medical liability terms on individual assignment contracts. Most of the meaningful shifts we’ve seen in the locum tenens contracting process have been on the client side. These include indemnification requests for provider errors, indemnity requests for data breaches, the ability to withhold payment for incomplete patient records, requests for telemedicine coverage, requests for longer payment periods ranging from 30 to 60 days, and requests to add a client as an “additional insured.”

What has changed in your approach to locum recruitment in recent years? What’s getting easier or harder about finding the best healthcare professionals and why?

The business of sourcing and recruiting qualified locum tenens physicians has always been competitive and will continue to be even more so in the future. We’ve seen the number of agencies grow significantly over the last 5-10 years and that’s helped NALTO^® (National Association of Locum Tenens Organizations^®) grow. The internet has also been a factor – through websites, online listings and social media, news about locum openings and opportunities travels much faster than it used to. Finally, the locum career option is better known – 15 years ago, the concept had to be explained to both physicians and hospitals alike. Today, there’s much more awareness. So that’s made the business easier in a sense.

What’s harder? Simple supply and demand. The well-documented physician shortage is coming at a time when an aging population needs doctors – too many needs out there and too few people to fill them.

That said, we NALTO^® firms recruit quality professionals who are the right match for all parties involved. Lives are at stake, and we firms take that responsibility seriously.

Are there particular types of practice environments doctors are leaving right now to become locums?

In recent years, we’ve watched physicians leave private practices to either become employed physicians or become full-time in locum tenens professionals in practice settings. We’ve seen this accelerate for a number of reasons, including:

• Rising overhead in building and maintaining a practice;
• The number of hospital systems aggressively acquiring medical practices and physician groups;
• Reimbursement cuts – particularly since the passage of the Affordable Care Act;
• Practice-related regulatory requirements, such as MACRA; and
• Rising Electronic Medical Record (EMR) investment and other practice technology costs related to metrics reporting.

Yet we’ve also seen hospital-employed physicians turn to locum tenens because they would like to “practice without politics” – meaning, they show up, provide exceptional patient care and finish their day. They have full professional autonomy, decide which assignments to pursue, and don’t have to worry about any administrative hassles.

How and when do you start identifying potential locum candidates? Without giving away competitive information, has that process changed in recent years?

We never stop procuring candidates and we work very hard to build relationships with quality professionals so we’re ready when a job order is produced. We begin by emailing candidates and start phone calls and texting within 48 hours of receiving an opening to fill. In recent years, digital communications have become the primary way to reach locum candidates – it’s a more efficient way to share details than traditional phone calls.

What are you most optimistic and/or concerned about for the future of the locum staffing industry?

I’m definitely optimistic about continued growth in the locums market, but concerned about certain clients using technology solutions to find candidates instead of hiring experienced staffing agents who know their physician talent and the territories where they’ll be needed. We believe greater dependence on technology will reduce customer service levels for clients and doctors. And while continued consolidation of healthcare systems will make these institutions stronger, we’re finding many of these larger organizations are restricting the number of locum staffing companies they work with, or going with the lowest-cost agency. We think such decisions make it tougher to locate the right professionals needed by hospitals and practices in a timely fashion, which often ends up costing more.

For locums working close to home or halfway across the country, having a constant in medical liability coverage becomes very important. That’s ISMIE – physician-led in all 50 states.