Everything you need to know about working locum tenens

Thanks to locumstory.com for sponsoring this post! Locumstory.com is an educational, online resource about all things locum tenens. Their website has tons of information about the ins and outs of how locum tenens works and first-hand perspectives from actual locums physicians to help you determine if locum tenens is right for you.  

Locum tenens exposes physicians to different healthcare settings, different practice models, and can help you expand your skillset. This experience can make it easier to adapt to practicing abroad. So whether you’re new to the industry or a veteran looking for some tips on working locum tenens, here are ways to make navigating the locum tenens process easier.

Locum tenens and practicing medicine abroad

Many physicians choose to work international locum tenens assignments to work — and travel — abroad, either alone or with family. With international assignments typically averaging three to six months, sometimes up to two years depending on location, its a great opportunity to explore the world, experience new cultures, and have new adventures. You may also choose to stay beyond your assignment length to take advantage of your assignment location, like touring Asia after working an assignment or traveling through Europe after your assignment in Ireland.

Other physicians use locums to be able to live abroad part of the year – perhaps to learn the local language of the country they want to move to, and then they’ll do locums work in the US, the other part of the year to keep up their clinical skills.

Being Your Own Boss

A locum tenens physician typically works as an independent contractor. In many ways, being an independent contractor means you are your own boss. You choose where you work and for how long.

Tax Considerations

Being an independent contractor also means taking charge of your taxes.  Dr Nicholas Kusnezov, a veteran locum physician, offers these three tax tips:

1. Hire a personal accountant to manage your taxes. Tax laws change constantly, and it’s easy to overlook nuances when filing tax returns.

2. Establish a professional LLC. This will save you a tremendous amount of time and money and offers the ability to write off the business-related expenses you’ll accrue.

3. Keep a meticulous record of your business-related expenses (travel, office expenses, licenses, etc.)

The total amount you pay in taxes should be similar to what you would pay as a permanent employee; but you’ll need to create a budget and set aside quarterly tax payments which the personal accountant can help with.

Health Insurance & Retirement Considerations

If you choose to work locum tenens full-time, there are several things you’ll need to plan for in advance:

Medical and dental insurance: COBRA is a good option for short-term coverage; if you have a partner with good medical coverage, you may want to consider having them add you to their insurance plan. You may also want to check into HealthCare.gov for health insurance.

Plan for retirement: Physicians who are truly self-employed also have another outlet to put money in, called a Defined Benefits Plan. You may also want to consider an SEP-IRA which is a Traditional IRA that allows a physician to contribute more to a Traditional IRA than you can contribute outside the plan.

Working with a locums agency

Experienced locum tenens physicians may choose to work with a locum tenens agency for several reasons, according to Dr. Kusnezov:

1. Agencies are experienced negotiators. They’ll go to bat for your compensation, so you get paid what you’re worth.

2. Locum agencies coordinate housing and travel. They’ll also offer 24/7 support in case of emergency.

3. They have an expansive job board, offering many locations, facilities, and assignment options.

You can do it yourself, but working through an agency will simplify the process and give you the support you need. Most experienced locum tenens physicians recommend going with an agency at the start. Reputable agencies don’t charge you a penny to work with them. Hospitals and healthcare facilities pay for locum services, never the physician. Agencies also secure assignments for you and will help you make a successful transition. It’s also important to fully understand the locum tenens contracts you will be asked to sign when you work with an agency. And here are some tips for negotiating your locum tenens contract.

How does locum tenens pay work? 

Locum tenens physicians are paid by the hour, though in some cases it might be by the day. The hourly wage is good — on average $32.45 more per hour than permanent doctors earn, according to a physician pay study conducted by CHG Healthcare. Take a closer look at 2022’s locum tenens pay trends, from family medicine ($90 – $125 per hour), internal medicine (between $140 – $190 per hour), emergency medicine (from $100 – $300 per hour), and anesthesiology ($238 – $275 an hour).

Choosing your first locums assignment

To appropriately evaluate an opportunity, one veteran locum recommends asking about job composition. For example, is the assignment simply call coverage? Or is it working for a full-time practice with clinic and OR?

Career locums also note that it’s important to consider the accessibility of the facility as well. How far away is the nearest airport, for example, and how often does the weather affect travel? This could be a problem if you expect to travel much during your assignment. Larger, more established locum agencies will cover airfare, travel costs, and rental car for the duration of the physician’s assignments. There may be instances where they will pay for spouse’s travel, particularly for international assignments.

You should also pay attention to how accessible urban locations are. How far away will you have to live from the hospital or clinic where you plan to work? Will you be relying on public transportation to get to work or driving?

Locum tenens licensing

The idea of obtaining medical licenses in multiple states can seem like a lot of work, but taking the time to get licensed in the states where you would like to work is well worth the investment.

First, it’s critical to keep everything up to date. Due dates and expiration dates hold a lot of weight in the licensing world. This applies to state licenses, board certifications, CME requirements, etc.

1. Keep copies of all certificates, transcripts, or records

Many boards require copies of all certificates, university transcripts, and other records, so it’s helpful to have these items already copied or scanned in electronically.

2. Keep a concise chronology of activities

Having accurate dates for employment, graduation, training, and exam attempts will make the licensing process faster and smoother.

3. Apply for expedited licensure through the IMLC

If you’re eligible, apply for expedited licensure through the Interstate Medical Licensure Compact (IMLC). This simplifies the locum tenens licensing process significantly. In order to be eligible, you must be a resident of a state of principle licensure (SPL) and meet all qualifications.

4. Apply for the Federation Credentials Verification Service

The Federation Credentials Verification Service (FCVS) is a fast and convenient service offered by the Federation of State Medical Boards (FSMB) that stores primary-sourced verified education information that can be sent to multiple state medical boards.

6. Renew existing licenses

Career locums physicians stress the importance of keeping all of your currently obtained licenses active.

7. Obtain a new DEA license

Most locum tenens providers can expect to need a new DEA license to go with a new state license. Most reputable, established agencies, like Weatherby Healthcare or CompHealth, may cover the cost of obtaining the necessary licenses.

For more information on working locum tenens and licensing, check out Locumstory’s licensing tips.

What about Malpractice insurance?

If you’re working locum tenens without an agency, you may have to provide your own malpractice coverage while on assignment. But most locum tenens agencies are going to provide malpractice insurance while you’re on assignment, and good agencies will provide tail coverage in case a suit is brought once a physician’s assignment is done.

The broader benefits of working locum tenens

While many physicians choose to work locum tenens for its flexibility and high pay, there are other, equally valuable benefits.

New ways of doing things

Locum tenens provides the unique opportunity to be exposed to, learn, and adopt the best practices from other institutions across the country. This opportune exposure to a variety of contemporary, evidence-based practices promotes the mixing of ideas and can serve as a basis for improvement in efficiency and patient care at your own primary institution.

It may lead you to adopt portions of such practices or fine-tune the practices which are already in place at your own institution.

Different operating models

All locum tenens assignments are different, and while some may have certain similarities, each institution has its own unique hierarchy and functions differently. When you’re in a new environment, these differences can affect how much you enjoy an assignment.  

These reasons generally fall under the categories of:

  • Patient volume and case variety
  • Work pace and call tempo
  • Institutional efficiency (be it in the clinical, surgical, or emergency setting)
  • Accessibility (either physical, within the hospital, or electronic, via the medical record system)

Exposure to the differences you’ll encounter while on locum assignments can give you new insights into the factors that contribute to the efficiency and accessibility at the respective institutions. Ultimately, these insights can provide you with the opportunity to bring the most attractive features back to your own facility.

Making locum tenens work for you

Pursuing a career as a locum tenens physician can lead to many exciting, rewarding experiences. Then again, it doesn’t have to be a full-time career. You can use locum tenens to stay clinically active while spending part of the year abroad. You can also use locums to build your skill set to be more adept when working abroad. Whatever your situation, it’s good to know how locum tenens works!

Jennifer Hunter has been a marketing writer for over 20 years. She enjoys telling the stories of healthcare providers and sharing new, relevant, and the most up-to-date healthcare news. Jennifer lives in Salt Lake City, Utah, with her husband and two kids.

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