Life as an independent contractor can be challenging at times. One of the biggest challenges we face is when starting a new gig. Every time I step foot at a new site, I get butterflies in my stomach. You’re in a new system, surrounded by new staff, new city, new EMR, and different way of doing things. All eyes are on you. You don’t want to appear flustered, but you probably will at some point during your first couple of shifts. Your mind knows what it wants to do, but the EMR won’t comply. This feeling usually subsides after a few shifts and you go on being the life-saving badass doctor you are with full confidence.
But how do you maximize your chances of getting paid top dollar, land the best gigs, and get the most out of the locum tenens experience? I will break this up into two categories: before starting, and secondly, how to keep a good gig once you start.
I go over How To Find A Locums Gig in another post. Here I will discuss some additional ways to maximize your opportunities and pay.
- Shop around. See what pay rates various locum companies are offering. But do not let them present your CV to a site until you are confident you would like to work there. Pay rates vary drastically and there are several factors that affect it. I will discuss this in a separate post.
- Ask friends working locums what rates they are getting. This is the best way to ensure your locum company isn’t low balling you. I was offered a below market rate by my first locum company and because I was naive and had not done my homework. I later learned I should have been making 1.5x what they were paying me.
- Don’t price yourself out. Some doctors have unrealistic expectations of pay rates. People unfamiliar with locums will most commonly make this mistake. When asked what rate they want, they will sometimes answer 2-3x the going market rate. Good luck finding a gig.
- Always have at least 2 gigs at any given time. This is to ensure you are never out of a job. If one gig dries up, you have another one going. Then start looking for another gig.
- Acquire multiple state licenses. For obvious reasons, this increases the number of jobs you are eligible for and can start right away. Obtaining a state license can take anywhere from a few weeks to 6+ months (average around 3-4 months). Remember, most locum companies will pay for your state license, so ask them to get your licenses in states you want to work.
- Store credentialing files on the cloud. Options include Dropbox, Box, Google, etc. It is a pain to sift through old emails to locate all the documents you sent your recruiter in the past. Save them securely on the cloud and update your folder regularly. This way, you have access to your documents at all times and can send a quick email to your recruiter if needed when you are away from your computer. Be vigilant of when your state licenses and DEAs expire. Also keep track of when your various certifications expire (ACLS, ATLS, PALS, etc).
Ideally, you want to have the option of keeping a gig for as long as you want. Some gigs are temporary, while others are ‘ongoing’. The latter means, they will likely need locums for the foreseeable future. Changing jobs frequently is not fun. Credentialing is a pain, and reducing the number of times one goes through it has been directly linked to lower blood pressure. Jokes aside, although no studies have been done on this, I’m sure if there were any, my assertion would probably be accurate.
There are a few things to keep in mind to ensure you make a great first impression. If you make a good first impression, you will get priority for shifts hours, number of shifts, and generally get preferential treatment. This is where you want to be.
- Work hard every shift. Do not take it easy just because you are the locum doctor. Everyone likes to work with a team player, so when someone is slacking, this will be noticed and it burdens your teammates. The hospital is tracking your metrics, so if you are not pulling your weight, you will be taken off the schedule.
- Be courteous to everyone. This may be hard for some, but at least try not to be a jerk. I’ve worked with doctors that treated everyone with disrespect and were condescending. Needless to say, I didn’t see them after a few shifts.
- Know your stuff. Nothing beats morale more than the staff knowing you aren’t competent and they can’t trust your clinical judgment. Keep up with your CMEs and if there are areas you are weak in, address them! You also represent a malpractice liability if you aren’t keeping up with your clinical and procedural knowledge base, so if the hospital senses this, you will be let go.
- Complete your charts. Kinda important. Hospitals cannot bill for your services if you do not complete and sign your charts. Sometimes you can sign charts remotely, so work with the IT department to set that up if needed. The hospital can withhold your pay if you do not complete charts in a timely fashion. This is usually stipulated in your contract.
- Come in early, stay late. Remember, you are part of a team. If others on the team are drowning, and the time for your shift is up, stay and help your colleagues out. I’ve stayed up to three hours past my shift end time to help because the ED volume was crazy. The nurses, docs, and administration will appreciate your efforts and want you to continue working there. Make sure to add the extra time onto your timesheet as you will be paid for it.
- Don’t burn any bridges. Even if a site doesn’t work for you, no matter the reason, don’t leave on a bad note. Address any issues with the director and with the locum company, and if things go unaddressed, leave in a respectful way. I know doctors who knew there were going to leave a site soon and failed to complete charts, or just checked out mentally. The medical world is small and word gets around. Don’t be that doc.
- Demonstrate your value. There are several ways to do this. The more shifts you pick up, the more value you demonstrate to the hospital. They would rather work with one locum doctor picking up several shifts, than several picking up a few shifts each. Help out, even if it is inconvenient at times. Work holidays when you can, as it alleviates the burden and plus, you get paid 1.5x.
Remember, a solid doctor will never be out of a job. Know your market value, work hard, don’t be a jerk, and you will be treated like a rockstar. OK, maybe not exactly, but I’ve gotten a lot of love from my locum jobs, and am always thanked for my services. Not a lot of employed doctors can say that.