“How do I start locum tenens?”
What follows is the step-by-step approach I took to go from no knowledge to entertaining my first locum opportunity. These are basic steps. This is meant to provide a framework to show that if I can do this then you can do this too.
I did this while post-call, nights, and weekends. It spread out over nearly 12 months, but it really should have taken me only a few weeks to execute assuming I wasn’t working 80 hour weeks in the ICU back-to-back…wait, a minute…
At the time, I only knew of one person who had taken the leap. We had spoken maybe two times before around the hospital. But after sharing my thoughts with other friends, I found other contacts. That was my start.
Maybe you don’t know anyone to talk to about the process.
But, actually, you do. I can help. This is why I’ve made these resources, to help you find a better path. Message me on the socials (link at the bottom of each page) and we can set up a time to discuss for 30 minutes. No catch.
Ok, so what did I do?
Background Research
I talked to the only 3 people who I knew personally who had made the complete leap to locum tenens doctoring – 1 acquaintance in Pulm/Critical Care who is a decade my senior who found a way to work one week a month upstate and yet be around her teenage children at their Brooklyn home more than she ever had when working at our mutual prior employer , 1 friend from medical school who, straight out of residency, joined an emergency medicine locum group that covered a couple dozen ER’s across New Jersey, 1 current close friend general Anesthesiologist who jumped ship from our mutual prior employer and could give me actionable info regarding our specific metro area.
I googled everything about the process I could find. I searched Reddit, Student Doctor Network, and GasWorks listings. Find the forums and job boards for your specialty. The truth is out there.
After doing copious research, you must have a sense of hourly pay for your specialty. And not only for your specialty, but also for the specific state and region. When you look through jobs later in the process, you will need to be armed with knowledge of what you are willing to accept. Similarly, you will need to give specific parameters for your agencies to find you locum gigs.
Family Decision
I discussed the options before me with my wife, my brother, etc. I made sure that my wife and my expectations’ were aligned. I wanted her to know that there would be more uncertainties going down this path. She was adamant that I find a way to claw back my time and shed my misery. I love her.
Find Agencies
I went on the NALTO (National Association of Locum Tenens Organizations) website members directory to find agencies who at least said they had good ethics and wanted to be part of such a membership/listing. I contacted every one of them either by the listed email contact or a webform with a pre written short script (and yes, I know it was not very good and it evolved rapidly since then!):
“I’m interested in locum options as an anesthesiologist and am interested in working anywhere in the country that offers a great opportunity covering any adult case types. I am Board Certified in Anesthesiology, Critical Care, and Perioperative Transesophageal Echocardiography. I have been in practice for almost 5 years at a major quaternary care medical center taking care of very sick patients as a Cardiac Anesthesiologist (50%) and Intensivist (50%).”
I did in fact contact every listed member on the NALTO directory at the time I searched. The marginal cost to contacting an additional agency is very small after you’ve contacted a dozen.
Do your homework, don’t settle, don’t leave things undone. This is your life and career.
Create a Work Email, You Will Thank Me Later
Only use a specific locum/independent work email because you will be flooded. Do not use your work email or work phone for searching or communicating with potential job opportunities. In fact, do not use any of your current employer’s resources to do so as it is likely in violation of your terms of employment. That means no wifi, no office desktop. Do this on your own time or on your own data connection.
If you have access to a separate phone number, for the same reason, use it instead. I refused to answer, and still refuse to answer random calls, instead I only talk if we have planned to talk ahead of the phone call.
Talk to Agents and Tell Them What You Do
You will find that some are learned and understand your specific skill set and what you do fairly well. Mostly, however, you will be talking to someone young and inexperienced. The worst are the hard sales types who think they have to convince me to take a job. The benefit to talking with many recruiters/agencies/agents is that you get to ask questions and gain insight into the process: I wanted to learn as much as I could about the process, what standards in the industry were, etc.
Hopefully you will find somewhere between a handful and a dozen that you will pursue discussions with for whatever reasons. I wanted people to be professional and knowledgeable. It turns out the majority are women and the majority of the good ones are women. I think this is just the demographics of the job. It might also be that all the men I am continually contacted by are too pushy, too “used car salesman” when the jobs sell themselves.
Work with the agents/recruiters you choose. Set parameters on what you are, or are not, willing to do. You might say, “I’m looking for jobs that pay at least X… I am not willing to cover pediatric patients below the age of 8… I will only travel for positions that are less than an hour from the airport… I am not willing to cover (as an anesthesiologist) 1:4, my maximum rooms to cover is 3…”
Be specific. Ask for what you want. Be clear.
DON’T RUSH
I had a mental timeline of when a reasonable time to leave my full-time job would be and I wanted to give at least 100 days of notice. This was my desire so as to limit how much negative externalities there were for my, soon to be, former colleagues. (You are not required to give a period of notice prior to leaving a job if you are employed “at-will.”) From first contact with agencies, to signing my first agreement it took about 6 or 7 weeks.
It cannot be overstated, do not rush the start. Do not be desperate.
If you have the choice, don’t jump. I understand if you are reading this and you are desperate, but the last thing you want to do is to “rush into a gunfight” as they say. Jobs are desperate for locum work and pay handily because others can’t, won’t, or shouldn’t work there. Your job is to stay calm until you have a reasonable answer for all three questions after vetting as best you can. Don’t be afraid to ask for contact information for someone placed there in a similar capacity in the past or currently. As an anesthesiologist, I have spoken to nurse anesthetists to give me the real nitty gritty on an operating room culture since my agency didn’t have any MD’s placed there recently.
Your recruiter/agent from the agency, and the agency themselves, make money when you make money. Usually, the hospital contracts them for a set rate and your total compensation (pay, travel, etc.) is taken out of that. The remainder is for the agency. They have an incentive for you to find a good fit where you can be successful and satisfied.
Getting started at locum tenens and finding a desireable locum assignment aren’t hard tasks. It just seems daunting from the outside. There will always be things you don’t know in everything you do. Don’t let them stop you from getting what you want.
There are unwritten and undiscussed rules to any game. You’ve learned much of what goes unspoken in the workplace through experience and one-on-one conversations. Working as an independent contractor in locum tenens assignments is no different. You just need the experience. I’ve expanded on some of these rules as they apply to the world of locum tenens in this post “The Unwritten Rules of Locum Tenens”.
Whenever you’re ready to consider a different path, reply to this email [email protected] or message me directly on the socials here:
Tell me how I can help your specific situation and find a way for you to take control of your time.
Help Patients. Work Less.
Do More of Everything Else.
