Top Frequently Asked Questions About Locum Tenens


Author: John Paulk, Co-Founder and COO of Pacific Companies



1. What is locum tenens?

Locum tenens. Well, it translates the Latin phrase for placeholder. I didn’t study Latin at any stage of my education, so I don’t know if that’s the actual translation. But what it is practically is a temporary physician or other clinical provider stepping in to fill an interval of time where the primary physician is either on vacation, left the practice, is on maternity leave, they’ve taken a sabbatical or something along those lines.

Increasingly, though, a locum that is an assignment is filling in until a permanent candidate can be hired. So that’s what we see quite frequently, maybe they don’t need a full-time person or somebody on a part-time basis. They supplement that schedule with a locum tenens physician.


2. What are the benefits of working as a locum tenens physician?

There are several benefits to working as a locum tenens physician. Even physicians working with a permanent full-time job can often fit in a locum tenens assignment. A locum tenens assignment tends not to be always an 8 to 5, Monday through Friday kind of assignment. In many instances, it involves coverage over the weekend. There are occasional locum tenens assignments that become available for telemedicine, for instance.

So having some flexibility in considering what your schedule will accommodate opens up many opportunities for physicians interested in supplementing their income. Maybe there’s a short-term income goal so they can fly their entire family to Europe, for instance. And I want to make some additional income or maybe I want to retire some of my student loan.

The other thing that I think a lot of physicians can gain from a locum tenens assignment, and I mean, when I say physicians, I mean advanced practice providers as well, is additional experience over and above what they’re ordinarily getting on their 9 to 5. So, the benefit there is you can increase your income, and you can increase your experience in a setting that maybe you wouldn’t otherwise have the opportunity to do.

Additionally, from a locum tennens perspective, particularly a physician or advanced provider who is coming out of their training program, maybe they’re not sure what kind of practice setting they’re interested in, and or maybe they’re very specific about where they would like to practice. This gives them the opportunity to continue gaining experience and income while devoting a portion of their time to identifying the right opportunity.

It allows you to get that experience rather than sitting around and, you know, hoping that somebody is going to call you and say, hey, let’s sit up an interview. I think the other principal advantage for most of the contractors we engage with is that they like the flexibility. You feel like there’s a certain level of control over your ability to accept or decline an assignment.

There really are a number of advantages. I would say as well for a lot of contractors, a lot of providers that we work with, is that because of the structure for locum tenens, it’s a 1099. In other words, as opposed to a W-2. You’re not an employed physician; you’re not an employed advanced practice provider; you’re on an independent contractor status, which the tax code 1099 indicates that there are no taxes withheld.

There are a few states that would withhold state income tax. California is one of them if you are not an in-state resident. Having said all of that, you’re getting all the income that provide some people, depending on their tax situation, greater flexibility on how they account for their personal income tax.


3. How long are typical locum tenens assignments?

Yeah, that’s a good question. Assignments can vary. I don’t know that there is a typical assignment, at least with Pacific Companies. We have a wide variety of assignments, the duration of which can span long term, in some instances for years. In some instances, the assignment might be no more than, say, three months. I would say if you wanted to look for an average or a median, it might be six months.

But remember that that’s not probably six months away from home. There will be instances where you have an assignment that you might be traveling into and out of a community where you’re providing locum services. So, it’s hard to say. Is there a typical duration? There really isn’t. But in most instances, the physicians we communicate with prefer longer assignments. Most of the opportunities, if not all of them, that we represent tend to be longer in length.


4. What is the compensation structure for locum tenens work?

It’s 1099, which is a tax code. The compensation works generally based on an hourly basis. Then in many cases, it will be a flat daily rate. And the structure will vary depending on the assignment. If there is a 24-hour call responsibility, if there’s a 12-hour shift, if it’s an evening call, if there’s I’m coming back in, I’m staying in a hospital, and I’ve been called back in to consult or see a patient. All of those have some variation.

The way we look at it is the basic building block or foundation for compensation is structured around an hourly rate. That hourly rate might be imputed to build into a call schedule or a flat daily rate. That’s generally how it’s structured. And again, it’s going to depend largely on what the particular assignment requires.


5. How does malpractice insurance work for locum tenens physicians?

Pacific Companies maintains its own medical malpractice insurance policy. We have a policy with what is regarded as the best medical malpractice insurance company in the nation. They’re A-plus best-rated. They are the top of the top creme de la creme, if you will, in French. That policy is claim-made.

The advantage of a claims-made policy is it’s a lot more affordable for locum tenens agencies. And that is, by the way, the industry standard. People I talked to were experts on this or unaware of anybody who uses the other variety, which is occurrence-based medical malpractice. Our claims-made policy covers you for all the work that you do.

That would be because you’re seeing patients in a clinical setting. Once you’ve completed your assignment with Pacific Companies, we maintain that policy. It’s an ongoing coverage that will last at least until the statute of limitation for somebody who might have an incident filing a claim. You’re covered after you’ve completed your assignment, and you’re covered during that assignment as well.


6. Do I need to obtain a new state license for each locum tenens assignment?

Depending on where you’re going to be practicing, most physicians have a couple of state licenses. There is variation if you’re working on behalf of the federal government in our defensive unit, health services or the Veteran’s Administration. They don’t require a license in that particular state. But if you were going to say, gosh, I’d really like to go work in South Carolina along the, you know, the coast there, if you don’t have a license, you’ll need to obtain a license.

Is that something Pacific Companies can assist with? Yes, we do often assist with obtaining a license. Our assistance typically includes helping facilitate gathering the appropriate information and communicating with the license courts and licensing boards. As you can imagine, they are often inundated with inquiries about the status of my license application and other people inquiring about that. And they’re busy. We often are prohibited from contacting them directly. So, we work very closely with a contractor to obtain the license.


7. What is the benefit of working locum tenens for my professional career?

It provides you with an opportunity to gain additional experience. In terms of volume, there are several specialties where you cannot become board certified without demonstrating a certain case volume. For a locum tenens physician who is truly board eligible, having recently completed training, they could enhance their case volume and their experience by doing locum tenens so that they obtain that in maybe a faster fashion.

You can expect to be busy in locum tenens assignments and earn the corresponding income. So that impact is probably substantial, but it kind of depends on the individual. I think many of the physicians and advanced practice providers we work with aren’t ready to retire, or they’re not ready to give up medicine altogether.

And so, they can continue to be involved and provide patient care for patients in a variety of settings and still keep their hand and skill set current. So, I think probably the biggest impact is for that group of physicians where they will continue to keep their skills sharp.


8. What is a compact license?

Compact license, or as it is referred to an IMLC Interstate Medical License Compact, Licensure Compact. The IMC is a formal arrangement between, I believe, 36 states here in the United States that if you have any license within that one of those states and wish to obtain a license in another one of those states, there’s an expedited process that allows you to gain the license in a sort of an abbreviated manner.

It still requires certain qualifications and credentialing to take place from the licensing process. But what you have usually takes about 2 to 3 weeks, maybe a month at most, for the initial process. Then you’re in; you’re introduced to the opportunity to apply for a particular state.


9. How do I find locum tenens job opportunities?

We post all our open locum tenens assignments on the Pacific Companies website. We are also sending out text messages, emails, and direct calls. So, if I were a physician practicing locums or had a permanent position and whether or not you have an active interest in pursuing a locum tennis assignment, I would certainly be monitoring that. You might not be ready right now. We end up placing many locum physicians when the right term assignments come along and one of our recruiters reaches out.

Respond back to a professional recruiter and Pacific Companies and say I’m considering this. Here’s what I would be interested in. Can you call me when you have something that meets those criteria? And I can assure you that we’re going to be very generous speaking with you and work closely with you and your schedule to accommodate that set of criteria.


10. Why should I work with Pacific Companies Locum Tenens recruiter?

This is a real source of pride for me. I will argue that our locum tenens recruiters are among the best, if not the best, in the business. They’re dedicated, well-trained, educated professionals that are committed to delivering a very high caliber of service. The client pays us, but we regard every contract or every advanced practice provider, every physician in an equal manner as a customer.

And so, one of the things that I think distinguishes us substantially is the level of talent and professionalism among our recruiters. Our recruiters are also quite adept at obtaining good information about each assignment that is supplemented by our permanent physician recruiting division, that in many instances, is working there in conjunction with the locum tenens division and affords us a tremendous amount of additional information about the network, the systems, referral patterns, the activity, the volumes, etc.

The other thing that’s really sort of apparently, it’s not very common, our recruiters will give you their locum physician either their mobile telephone number or cell phone, and we have people who are prepared to answer your questions after hours if there’s a travel snag. And unfortunately, that happens outside of our control. There are three series of people in line to be able to pick up the call and talk to.

If I were a physician and I was out on an assignment, I would feel very, very comfortable knowing that I’ve got a dedicated professional just a phone call away, and if he or she is unavailable, I’ve got two other people I can reach out to and talk to who we’re going to help me with an issue. And that’s not just after hours.

If you have a question or concern about a current assignment, pick up the phone, give us a call, send us a text, send us an email. We’re going to get back with you right away. We have received a great deal of compliments and accolades for being responsive. And again, we pride ourselves on being that way because at the end of the day, look, I’m tending to sort of a commoditized business when it comes to the agency.

So, our differentiators are professionalism, that level of education and knowledge and that customer service response for that practitioner.


11. What support is provided by locum tenens agencies like Pacific Companies during an assignment?

Well, that’s a great question. Thanks for asking that. In addition to a professional, well-trained, educated physician recruiter, we have a dedicated travel schedule and staff. We have a dedicated risk management call, a credentialing staff that will work very closely with you. You can pick up the phone and discuss your travel arrangements. We will work within the budget that the client defined to find quality accommodations, a rental car, and all other necessities.

We want to take care of you in that sense and offer a sort of concierge level of involvement on your behalf. The risk management team is devoted to facilitating this process. I don’t know anybody who likes paperwork, including physicians and advanced practice providers. Nobody likes paperwork, and there’s a lot of paperwork with respect to entering and getting a new assignment.

We’re there as an advocate and assistants, helping to accumulate the necessary documentation to facilitate a more expedited process. As a result of that, we’re able to get people credentialed through this process with our hospital clients, I suspect, in a much timelier manner than many of our competitors.

So in summary, you always have access to travel and scheduling personnel. The risk management team, as well as the recruiter. That’s why you should work with us.


12. To any physician who has been considering giving locum tenens work a try, what would your advice be?

I reference back to Dr. Seuss, who wasn’t a medical doctor but an author of children’s books. And one of my favorites is Green Eggs and Ham. Try it, Sam. I am happy because you don’t know if you’ll like green eggs and ham until you’ve tried it.

And we encounter hundreds if not thousands of physicians that once they’ve tried it, they’re like, this is great, what a wonderful experience. Thank you for taking care of me; I want to do it again. What’s the next assignment?