Locum Tenens

The Latin term Locum Tenens (LT) means “place holder.” In medicine, it often describes a position to fill a vacancy for a physician who is temporarily absent, or it may be a slot at a short-staffed health care facility. Sometimes it is a placement at a clinic or hospital in a location without a large enough patient base to support a full-time position. LT work can be in a clinic, a hospital, or a combination of both. It has been reported that over 90% of health care facilities use LT in some form often during peak patient periods.   

According to a recent survey of a major LT staffing company, there are about 50,000 LT physicians in the US. While most are retirees who are not ready to stop practicing entirely, approximately 15% were early career physicians who have just finished residency. Some choose LT to try out various geographic locations or types of worksites before making long-term decisions. Others find LT to be an appealing option for their career.

Pros:  

• Flexible schedule 
• Gain clinical experience in a variety of practice and organizational settings 
• Explore different geographic locations and communities 
• Gather information to determine the best fit for a long-term position 

Cons: 

• Contract work offers little income stability 
• Possible unpaid gaps between assignments 
• No benefits such as health insurance, retirement plans, or disability insurance 

Some Important Contract Considerations

The key to a successful LT experience is a good contract. Recognize that the staffing company that recruited you is paid by their client (such as a medical group, clinic or hospital). As a result, contracts can be written in their favor, not yours. It’s always a good idea to advocate for yourself or seek legal advice. 

Payment terms are usually based on an hourly wage. It can be paid by the recruiter to you or directly by the worksite. Figure out which is best for you. Some LT physicians recommend being paid on a weekly basis to allow a quick departure if the position is not a good fit. However, this will need to be spelled out in the contract’s “out clause.” 

Malpractice insurance is essential. If it is not an occurrence policy, you must be sure that the staffing agency also covers “tail insurance” for claims brought after the policy has been terminated. Otherwise, you’ll have to buy your own tail insurance which is about 3 times more expensive than regular medical liability insurance. Without tail insurance, you’ll have no insurance coverage, should you be sued after you’ve left that LT position and the “claims paid” medical liability insurance has been terminated. 

Housing is usually provided. It’s important to stipulate your requirements for satisfactory housing.

Travel expenses should cover to and from your original location to the LT site. It should also cover to and from your housing to the work site. Typically, daily travel is covered by a car rental. Make sure the staffing agency pays for this directly. It’s not good practice to agree to put the car rental on your credit card and get reimbursed later. 

This is not an exhaustive description of LT. There are other contract issues to be considered. Therefore, legal advice is an essential expense.