Navigating Locum Tenens in a COVID-19 Climate

Locum Tenens positions have given flexibility to both physicians and health systems for decades, but how has this changed during the COVID-19 pandemic? Whether you are an experienced Locum Tenens clinician, or you are new to the industry, there are benefits and challenges to working as an independent contractor in this climate.

A Locum Tenens (Locums) clinician is a person who works in the place of a regular clinician when they are absent or when a health facility is short-staffed. Often, these positions are on a contract basis through an agency, differing from a Per Diem position where a clinician is employed directly through the health system. While there are benefits to both, now is an ideal time to become familiar with the terms of Locum Tenens roles, as positions within healthcare are currently in flux.

Provider Solutions & Development (PS&D) has a unique Locums program where we work with candidates and agencies to streamline the process for clinicians who are searching for a Locum Tenens position. We have in-house experts whose primary focus is working with agencies, health systems and clinicians to find the best possible fit for all involved. Nick Ball, Program Manager of Locum Tenens Administration at PS&D, is one such expert and is here to give insight and advice to those who may be considering Locum Tenens work.

PS&D: Can you explain your role to those who may not be familiar with the PS&D Locum Tenens program?

Nick Ball: The hospitals and clinics we are partnered with drive their requests through our team both for Locum Tenens coverage and for agency permanent-placement support. Our goal is to find the best clinician for the role and to make the process seamless for everyone. I work with the team to make sure that we are neutral between agencies and the health system to make sure needs get filled, that we are contractually compliant and that patient populations are being seen effectively.

What is appealing about Locums or Per Diem roles to clinicians?

A huge benefit is the work-life balance and flexibility, as clinicians can usually pick which days they want to work. As a Per Diem clinician, you are able to work directly with the health system, giving more control over work assignments. Working in a Locums position can also be a great transitional opportunity between part-time to full-time work or a way to ease into retirement while keeping up your clinical skills.

What did the market look like for Locums positions last year?

Last year, we saw an increase in Locums utilization, especially for family practices. Specifically, Southern California had an increased need for Family Medicine clinicians to help with newly established Urgent and Primary Care clinics. Across the nation there has also been an increase in Psychiatry positions, with Behavioral Health becoming more of a focus. With specialty Locums placement, demand has also increased, however it really varies between each specialty.

How has COVID-19 changed the process for Locums roles?

COVID-19 has challenged all of us to think and act differently. Locums utilization this year has dipped because not as many people were going to Primary Care clinics, many elective procedures were cancelled and employed physicians were picking up other positions to meet financial benchmarks. However, this may begin to change as elective procedures start to reopen. It is also likely that more clinicians will request time off and need coverage. I think there is an opportunity for clinicians to take on Locum Tenens roles during a time where health care is constantly shifting, and there is an increase need to ensure provider wellbeing for employed providers.

What challenges can clinicians expect in taking a Locums role in this climate?

First, it’s important to know up front what the cancellation terms of the contract are. Typically, a health system needs to give 30 days’ notice to cancel a clinician, but with COVID-19, those terms can be waived because of the circumstances meaning positions could be cancelled last minute.

Second, a health system may be looking to backfill for a clinician who has left or temporarily moved, but if cases don’t pick up, the employer will need to provide work for employed clinicians before Locums clinicians. This is a difficult reality to navigate, so being even more adaptable in this climate is key.

Lastly, Locums often requires travel, and with COVID-19, there are a lot of variants in place. For example, if a flight is cancelled and a clinician can’t make it on time, it could have an impact on the whole assignment. Clinicians need to proactively think ahead about travel plans to ensure on-time arrival, as well as the associated risk of exposure to COVID-19 during travel.

What advice would you give to clinicians who are interested in Locums work?

What I recommend is to be cautious of taking an assignment in “your own backyard”, especially if you are new to Locums. If you take a Locums assignment with a health system, often the agency has ownership of your ability to work at the health system for up to two years. This system-wide ownership may limit your ability to take a future position within the health system, or in that location, unless the health system buys out the contract. If a clinician works Per Diem directly with the health system, there aren’t as many additional contractual obligations. Here at PS&D, we have site-specific ownership of contracts to protect both the clinician and the health system.

I also advise clinicians to read contracts thoroughly, whether through an agency or a health system, as terms can vary significantly. It’s crucial to know the terms, clauses and responsibilities. As mentioned before, at any point the position could be cancelled, so it’s important to be prepared because these circumstances can impact clinicians financially. We recommend that a clinician interviews with several agencies before signing up with any one specifically. Having a good relationship with the recruiter, the company and the process is essential to having an effective and rewarding Locums assignment.

What makes PS&D different when it comes to our Locums team?

PS&D recruits our own Locums positions before opening them up to agencies. This gives us the ability to source clinicians ourselves and work on terms and processes that provide more transparency for both parties. This leads to highly successful Locums engagements that put the clinicians and patients first. Our recruitment team has experience in all specialties, so we are able to hone in on specific clinician’s needs. Clinicians and health systems often agree that direct communication and coordination by a health system streamlines the application process, drives down healthcare costs and leads to a better experience for everyone involved.

Is there anything else you would like potential Locums clinicians to know?

Our team is always eager to talk to those who are interested in pursuing Locums work. We are happy to chat about your needs, what the market looks like and to keep you posted on changes and positions. As career navigators, we’re here to provide advice, insight and support to those who have general questions about the industry.

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