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[Editor's Note: This is a guest post from Melissa Byington, the president of the locum tenens division of CompHealth the nation's largest locum tenens physician staffing company and a leader in permanent and temporary allied healthcare staffing. Melissa's career in physician recruiting spans nearly two decades. She also serves as the president of the National Association of Locum Tenens Organizations (NALTO). CompHealth is a paid advertiser on this site, although this is not a sponsored post, meaning I receive no compensation as a result of running this post which was judged on its own merits to be a worthy topic for discussion here. Many times this site focuses on how to best manage the income you have. In reality, sometimes it makes sense to simply increase your income. Locum tenens can be a good way to do that, part-time, full-time, temporarily, or even permanently. You can learn more at Locums Story.]

Like early frontier doctors who traveled from community to community, today’s locum tenens doctors travel across the country to meet the needs of rural and underserved communities. The idea of these traveling assignments dates back to the late ‘70s, when two physicians at the University of Utah saw a need for healthcare in rural settings that were unable to attract full-time physicians. One of these physicians, Dr. Therus C. Kolff, went on to found the first locum tenens staffing agency, CompHealth, in 1979.

Locum Tenens by the Numbers

Melissa Byington

Melissa Byington

Locum tenens staffing is now a $3.2 billion industry. More than 40,000 physicians work locum tenens assignments each year, throughout the US and internationally. The locum tenens industry will continue to grow as baby boomers near retirement. In addition, nearly 70 percent of physicians ages 50 or older say they plan to work part-time after retirement age.

Because there is a constant need for physicians in hospitals and clinics to cover shifts — whether it’s for vacation or maternity leave, to fill spots between permanent physicians, or just relieve burnout within the facility — 90 percent of US healthcare facilities use locum tenens physicians. The vast majority (90 percent) of locum tenens work these temporary assignments in addition to a permanent job.

How Does Locum Tenens Work

So how does locum tenens really work? Though some physicians contract directly with healthcare facilities to work temporary shifts, the majority of locum jobs are filled by staffing agencies that bring together the facilities that have jobs and the physicians that are looking for them.

Locum tenens physicians are independent contractors and usually receive an hourly wage, negotiated in advance, by the staffing agency placing them. Working hours, job expectations and the length of the assignment are also all determined in advance.

In addition to paying the physicians’ wage, a good staffing agency will cover travel expenses, housing and provide a rental car for the physician during the assignment. The agency pays the physician’s malpractice insurance, handles credentialing and can even help with state licensing. Because they are independent contractors, locum tenens physicians are responsible for their own taxes, health insurance and retirement planning.

Why Do Facilities Need Locums?

There are a variety of reasons healthcare facilities use locums. Some rural facilities still have a hard time filling permanent positions and often use locums for in-demand specialties. VA hospitals and Native American reservation hospitals and clinics also use locums when they have issues finding full-time providers.

Facilities in both rural and urban areas are now using locum physicians to help fight burnout among their full-time staff. Bringing in a locums to cover a maternity leave or even a permanent physician’s vacation is proving to be a much better option than just adding those physicians’ workloads onto their coworkers.

The final reason is financial. Physicians are the only healthcare providers that are true revenue generators. Bringing in locums to meet higher patient demand or to cover for an absent employee ensures the facility still makes money, even while a full-time staff member is on vacation or they’re waiting for a new hire to start.

Why Do Physicians Work Locum Tenens?

The reasons for doing locums as a physician are even more varied. Here are some of the top reasons physicians work locum tenens, either in addition to a full-time job or instead of one:

  • Money on the side — Locums is a great way for physicians looking to make money on the side. Some doctors pick up extra shifts on nights and weekends, others use their vacation time to work locum assignments.
  • Try before you buy — Not every job is a good fit. Before deciding to relocate to a new area or work at new facility, some physicians choose to work temporary assignments as a way to test drive the job.
  • Keeping skills fresh — In most large facilities and practices, physicians become very specialized. By taking assignments in rural locations, doctors are often able to see a wider range of cases and refresh their skills. Locums also allows doctors to see how other practices do things, which can be taken back to their permanent job.
  • A cure for burnout — Burnout is increasing in every specialty. Some doctors find the solution to burnout is not a new career, just a change in environment. A locum tenens assignment can be reinvigorating for the traveling physician and a lifesaver for the full-time staff they’re helping.
  • Scheduling flexibility — Full-time locums work when they choose. If they want to take time off for an extended vacation, they can do so without having to ask permission. They can arrange their schedules around family events, hobbies, or passions outside of medicine. Some doctors use this flexibility to make time to participate in medical missions or volunteer work.

Depending on your specialty, assignments can be as short as a weekend or last six months or more. They are available in your hometown or anywhere around the country or even the world.

How Do Locum Tenens Get Paid

Locum tenens physicians are considered independent contractors and as such are responsible for paying their own taxes and arranging for their own benefits. Because of this, they usually receive a higher wage than an equivalent physician in a permanent role. Locums are paid hourly for the time they work in addition to traditionally having their housing and travel expenses covered as well.

Locum Tenens at Different Career Stages

Dr. Brian Harmych knew he wanted to open his own facial plastic surgery practice after finishing his fellowship. But launching a practice doesn’t happen overnight. While he was working through the logistics of getting his own business up and running, Dr. Harmych worked locum tenens assignments. In addition to the financial benefits, Harmych found mentors at his locum assignments that impacted the way he runs his own practice.

“From a financial standpoint, it’s an excellent opportunity, primarily because of the flexibility,” Harmych says of locum tenens. “I can pay the bills and arrange my locum assignments around important meetings [for my own practice].”

Fully established in her career, Dr. Tina Passalaris loved working as a full-time oncologist at a large hospital, but it was taking a toll on her family.

“I was absent from my kids’ lives. I didn’t go to school plays, and it was uncanny how often I would be on call during the most important nights,” she says. Now she works locum tenens assignments about four months a year and spends the rest of the time at home. “Although I’m absent 100 percent when I’m on an assignment, when I am home, I’m 100 percent home.”

Though he’s practiced internal medicine for more than 40 years, Dr. Norman Baron has no plans to hang up his stethoscope. In fact, he says, “Retirement will never be in my sights. In my blood is this burning desire to practice medicine — it’s just as much as a hobby as it is a vocation for me.” He has found that locum tenens allows him to keep practicing medicine, but on his own terms. He determines both the length and location of his assignments, allowing him to work near family — or sometimes in new areas he just wants to explore. “When I’m on assignment, I see myself as a good doctor who’s giving the best opinions that he can with his many years of experience and seeing that patient do well.”

Regardless of your stage in life, what your goals are for your career, locums could be a good option.

What do you think? Have you done locums before? What was it like for you? Have you considered doing it in the future? Why or why not? Comment below!