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Logos Combination Usage

Consistency in the look and feel of the Medicus and OPTIMUM brands in all media builds and reinforces brand awareness.

When used in combination, the two brands should appear in this setup and proportions.

When color or printing prohibits this, it may be used in all black or reversed out to white.

locum tenens

101a guide for CRNAs, advanced practitioners, nurse practitioners, physician assistants

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Who can benefit from locum tenens assignments? CRNAs, nurse practitioners, advanced practitioners, and physician assistants exploring employment options at the beginning or middle of their careers, as well as those looking for a change as they work toward retirement or who want to work in retirement.

If you fall into any of these categories, you may be one of many providers examining your career options and determining your next step. Regardless of your current career stage, locum tenens may be the perfect way to help you reach your specific career goal.

why locum tenens might be the right choice for you

Benefits of Locum TenensEngaging in a locum tenens assignment can have multiple benefits:

• Supplement your income to help pay off college loans, improve cash flow to meet the needs of a growing family, or add to a retirement nest egg.

• Enjoy scheduling flexibility with assignments of varying lengths.

• Live, travel, and practice in geographic areas that you want to experience.

• Expand your professional network into new areas.

• Enjoy independence and autonomy in when and where you practice medicine.

• Ease into retirement by working for selected lengths of time.

This e-book explains the concept of locum tenens, how it works, and its advantages, as well as how to get started and the benefits of working with a reputable locum tenens agency. Most importantly, it outlines how you can quickly shift gears and take advantage of this lucrative and often rewarding career path.

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What Is Locum Tenens? .................................................................... 3Top Reasons Physicians Like Working Locum Tenens ....................... 4The Advantages of Locum Tenens ..................................................... 5Financial Benefits ............................................................................. 5Flexibility ......................................................................................... 5Simplified Work Environment .......................................................... 5Opportunity for Travel ...................................................................... 5Expand Career Options .................................................................... 5Autonomy ........................................................................................ 6Transition into Retirement ............................................................... 6The Basics of Locum Tenens ............................................................. 7Locum Tenens Agreements ............................................................... 7Top 10 Specialties in Highest Demand ............................................. 7Licensing .......................................................................................... 9Ethical Guidelines ............................................................................ 9Self-Employment ............................................................................10The Benefits of Working with the Right Agency Partner .................11Single Relationship .........................................................................11Extensive Experience ......................................................................11Support Structure ...........................................................................12Breadth of Opportunities ...............................................................13The Next Step .................................................................................14How Medicus Can Help .................................................................14

table ofcontents

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Locum tenens is Latin for “place holder” and is the term used to describe the practice of providers such as nurse practitioners, advanced practitioners, CRNAs, and physician assistants temporarily fulfilling the duties of full-time medical staff. The locum tenens industry began in the early 1970s when the University of Utah secured a federal grant to staff rural health clinics in medically underserved areas of the western United States. The staffing program proved so successful, many hospitals began calling for more locum tenens assistance.

Recent data dramatically illustrates the growing popularity of locum tenens. According to a recent report in Medical Economics, more than half of hospitals used temporary practitioners in 2013. There has been a 16% increase in the number of institutions employing the practice in the last year alone.

what islocum tenens?

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The impending physician shortage promises to spur the growth of locum tenens even further, not only for physicians but also for other providers, such as nurse practitioners, advanced practitioners, CRNAs, and physician assistants. With increased access to healthcare following federal health insurance reforms and aging baby boomers living longer and requiring healthcare services, healthcare providers will be seeing a growing demand for services well into the future. Considering that nurse practitioners, advanced practitioners, CRNAs, and physician assistants are able to provide many of the same services as physicians, they will be playing an even larger role in the delivery of healthcare services.

According to the U.S. Department of Labor’s Bureau of Labor Statistics, employment opportunities for these providers are expected to grow significantly from 2012 to 2022:

• Nurse practitioners can expect to see job growth of 34%.

• APRNs could see demand for their services increase by 31%.

• CRNAs can expect a 25% increase in employment opportunities.2

• Physician assistants could see employment growth of 38%.3

In addition to the emerging physician shortage, fewer doctors are practicing in rural and inner city areas. HSRA currently designates over 6,200 Health Professional Shortage Areas (HPSAs) for primary care nationwide, areas in which over 65 million people live. Two thirds of HPSAs are in non-urban areas where the ratio of primary care providers to patients is less than one per 2,000. This situation creates increased opportunities for nurse practitioners, advanced practitioners, CRNAs, and physician assistants to provide healthcare services to patients.

Healthcare providers will increasingly look to locum practitioners to help cover these shortages and to better balance the availability of healthcare services offered. Locum tenens solves ongoing staffing issues by providing healthcare organizations with the ability to maintain high standards of patient care by hiring qualified temporary staff during vacations and peak periods, or bridging hiring gaps while seeking to fill permanent positions. These factors ensure there will be a robust market for locum tenens providers for many years to come.

Top Reasons Physicians Like Working

Locum Tenens1. Focus on patients, not politics

2. Earn typically higher pay

3. Enjoy flexibility: choose the timing, length, and location of your assignment

4. Contribute to a situation in need of your expertise

5. Broaden your skill set and enhance your résumé

6. Test out a potential full-time position

7. Experience how other healthcare facilities operate

8. Expand your professional network

9. Gain in-depth experience in your particular specialty

10. BE YOUR OWN BOSS

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Practitioners are drawn to locum work because of the many advantages it offers. Several of these factors may make locum tenens an attractive option for you.

financial benefitsYou can enjoy the financial benefits of locum work at every stage of your career. If you are just starting out, you can take locum assignments on weekends or on days off to help pay your education loans. As a full-time practitioner, you might be looking for extra income through a locum assignment. If you are approaching retirement, locum assignments are an effective way to build up retirement savings.

The amount you earn will depend on your skills, the locations in which you are willing to practice, and the amount of time you can devote to taking assignments.

the advantage oflocum tenens

flexibilityFlexibility is cited most often as one of the top reasons practitioners choose to work as a locum tenens. Working locum means you choose the timing, length, and location of your engagement. You may select assignments for a week, six months, or even longer depending on your personal situation. You also can determine the settings of your engagement—hospital, office-based practice, rural health clinic, or government facility.

simplified work environmentChoosing to work as a locum can eliminate many of the challenges faced by permanent providers. Being a locum gives you the opportunity to care for patients without having to work through some of the typical politics that are sometimes involved with permanent positions.

opportunity for travelYou can select a locum assignment in a particular state or region of the United States that you have wanted to visit. You can coordinate with your recruiters to line up assignments that best match your lifestyle and interests or that will allow you to pursue your hobbies. Many locum practitioners travel with their spouses and with some advance preparation can arrange assignments to coincide with family events like weddings, graduations, or the birth of a grandchild.

expanded career optionsLocum engagements provide opportunities for you to expand your professional network. If you are in the early stages of your career, you can explore different types of settings and assignments to find the right fit—without having to make a permanent commitment. If you are in mid-career and are considering a change, a locum assignment is a perfect way to

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experience a new working environment or to practice in an institution with more up-to-date technology. A locum assignment also may help you secure a permanent placement if you decide the position is a good fit.

autonomyDownsizing is a threat in all areas of the economy, including healthcare. Locum work is one way to take control of your career and ensure your own job security. As a locum, you practice as an independent contractor with a high degree of autonomy. You decide where and when you work and can negotiate the pay and terms you desire. Being an independent contractor puts you in control and allows you to decide what is best for you.

transition into retirementFor some practitioners, the prospect of retirement creates feelings of uncertainty and raises questions about the next stage of life. Have I saved enough to enjoy retirement? Will I be able to offer financial support for parents or children? Will I miss caring for patients? How will I stay mentally sharp if I’m not working?

Taking on locum tenens assignments can help provide some of the answers. Locum work allows you to take shorter engagements at places and times of your choosing, helping you ease into retirement.

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Participating in a locum tenens arrangement makes you an independent contractor providing services to those healthcare organizations that have a need to fill. Your first step should be to connect with an experienced locum tenens agency that can help guide you through the details of establishing locum arrangements. The agency will work to understand your particular requirements and help find the opportunities that best fit your needs.

the basics oflocum tenens locum tenens agreements

Once you have chosen an agency, you will be asked to enter into a locum tenens agreement. As with all legal agreements, you should have your lawyer review the agreement before you sign. The basic components of the locum tenens contract—and items to look for—include:

termSome agencies use a blanket contract to cover all placements that a practitioner accepts over a given period of time, typically a year or two. In this case, the details of each engagement will be outlined in a separate acceptance letter. Other agencies draw up a unique agreement for each engagement. In either case, make sure you are aware of and accept the length of the agreement.

liabilityIf you are working with a National Association of Locum Tenens Organization (NALTO) member agency, you will be covered for malpractice with a quality professional liability policy. Be sure your agreement clearly notes that insurance is being provided for you at the agency’s expense.

non-competeA non-compete clause is an industry standard. It will outline any stipulations or restrictions such as working with another locum agency or permanent placement opportunities.

paymentYour payment will come directly from the locum agency. Agencies earn their fee in exchange for matching you with opportunities; handling

Top 10 Specialties in

Highest Demand1. Primary care physicians

2. Hospitalists

3. Surgeons 4. Oncologists

5. Emergency medicine physicians

6. Anesthesiologists

7. Internal medicine sub-specialty physicians

8. Radiologists 9. Nurse practitioners

10. Physician assistants

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the licensing, credentialing, and privileging process; making travel and housing arrangements (often on short notice); and providing malpractice insurance.

Locum practitioners are typically paid by the hour or day, with potential additional compensation for weeknight and weekend calls and overtime pay for exceptionally long shifts. The amount, method, and timing of your payments should be specifically spelled out in your agreement.

Pay rates for locum practitioners are market driven. Increased demand in a specific specialty or geographic area commands a higher rate of compensation. Pay rates can be negotiated to some degree, but most locum tenens companies tend to offer a similar range of competitive compensation.

Submitting timely and accurate hours or days-worked reports to your locum agency should ensure you are paid promptly.

expensesThe agreement or a separate policy document should detail which expenses will be covered by the locum agency or the hospital/group where you intend to work and which ones will be your responsibility. If in doubt, ask for clarification.

cancellationsIt is important that you understand your contractual obligations. Your agreement is a binding legal document that specifies your rights. An effective locum agreement should be fair and equitable to both parties. Stay in close contact with your locum agency representative to quickly and thoroughly address any concerns that you may have.

“ Submitting timely and accurate hours or days-worked reports to your locum agency should ensure you are paid promptly.”

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licensingObtaining state medical licenses can be an arduous task for practitioners. As you consider your locum tenens career, think strategically about which licenses to acquire. Your locum agency can help you apply for licenses, either in anticipation of an assignment or based on the locations in which you wish to practice.

Some agencies—like Medicus Healthcare Solutions—will reimburse you for licensing fees once you have completed a certain number of shifts.

When deciding where to become licensed, factor in personal preferences and demand for your skills. The time required to process medical licenses can vary from two weeks to several months. In general, the larger the state, the longer you can expect to wait. Initial application fees also vary significantly, ranging from less than $100 to well over $1,000.

Most locum agencies have staff dedicated to helping practitioners with the paperwork needed to practice, including obtaining licenses. With your permission, they also are able to communicate with some licensing boards about the status of your pending application. For more information regarding licensing, visit:

• CRNAs: National Board of Certification and Recertification of Nurse Anesthetists

• Nurse Practitioners: American Academy of Nurse Practitioners Certification Program

• Physician Assistants: American Academy of Physician Assistants

You also might want to consider using the Federation Credentials Verification Service (FCVS). This service can act as a primary source of verification for credentials. It costs a few hundred dollars but might be worth the investment, especially if you are an international graduate or a practitioner who anticipates applying for several licenses. You also should be aware that a few states require the use of FCVS, so if you are applying in a state that does require this, plan for additional lead time.

Keep your licenses active to prevent having to start the process from the beginning. Also, a lapsed license can raise a red flag during future credential checks, as well as when you apply for additional state licenses.

ethical guidelinesPractitioners considering a locum arrangement should be aware of several ethical issues relative to the industry.

what you should expect from an agencyA reputable recruiter will never present your name or CV for potential placement without first outlining the opportunity and obtaining your consent. A recruiter must be forthcoming regarding all aspects of a potential engagement. Before agreeing to the engagement, you should be aware of the hours, patient volume, procedures you are expected to perform, and level of staff support. You also should be made aware of any potential adverse local conditions that could affect you during the assignment. A respectable recruiter will not ask you to cancel a commitment with another agency to take an engagement with the recruiter’s agency.

what is expected from practitionersIf you practice locum tenens regularly, you may be registered with more than one company. Once you commit to an engagement with one organization, you are obligated to provide services through that agency.

“ Some agencies — like Medicus Healthcare Solutions — will reimburse you for licensing fees once you have completed a certain number of shifts.”

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Also, it is considered a breach of ethics to contract “on the side” with a healthcare provider that you have worked with through an agency within the past two years (or whatever term your contract states). You should disclose any prior engagement with a firm at a location if you are offered another assignment at this location by a different company. Your original contract’s non-compete clause will likely require the institution to engage you through the original agency.

A locum tenens career involves a series of temporary engagements, but many practitioners build long-term agency relationships. Expecting strong ethics and adhering to high standards will help ensure longstanding, satisfying professional relationships.

self-employmentAs a locum tenens, you are acting as an independent contractor and therefore have the responsibility to run your own business. You should contact your lawyer, accountant, and financial planner to discuss your personal situation in detail.

accountingYour locum compensation will likely be higher than your traditional employee pay for various reasons. Most importantly, because taxes will not be deducted as they would in a traditional paycheck, you are responsible for paying the associated tax on that income on a quarterly or annual basis. On the expense side, some of your costs will be deductible, which will partially offset your income and reduce your tax liability. Your accountant can help you set up the bookkeeping required to manage your business and to provide appropriate tax planning advice.

financial planningYou also will be responsible for your own health plan and other insurances typically handled by an employer. You should consider retaining a financial planner to help with this and with investment and retirement planning.

legal adviceEvery business needs occasional legal advice. The most important role of a lawyer will be reviewing your engagement agreements, but there will be other instances when having an experienced lawyer on your team will be beneficial.

For more information on the locum tenens process, check out the National Association of Locum Tenens Organizations (NALTO) website.

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the benefits of working with

the rightagency

partner

Once you decide to engage in locum tenens, you will discover that your services are in high demand. Multiple locum companies looking to fill the growing number of available assignments will likely approach you. Keeping track of which agencies have presented your CV to which healthcare organizations can be confusing and time consuming. Trying to handle this complexity while working a full-time job and managing your personal life can be an overwhelming task.

Your best choice is to partner with one reputable locum tenens agency that specializes in building long-term relationships with healthcare institutions, enabling the agency to facilitate equitable matches for both parties. There are many advantages to working with the right organization. Here are some things to look for when choosing your locum tenens agency.

single relationshipWith the right agency partner, you are part of a team that represents you and your particular career goals. Ideally, you should have one dedicated contact that continually communicates with you to ensure your changing needs are always considered. Knowing your situation intimately will enable this individual to present you effectively to hospitals and other healthcare institutions.

Your dedicated recruiter will handle contract negotiations and assist with credentialing and licensing details. Once you are on assignment, your recruiter becomes your advocate in areas such as keeping the institution accountable for your workload and ensuring acceptable working conditions.

extensive experienceLook for an agency partner with significant experience in the industry. An agency that contracts with a broad range of facilities, from hospitals to outpatient clinics

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in a number of geographical areas, can provide a variety of options when you are choosing assignments. It is also beneficial to deal with a partner that has a Federal Supply Schedule (FSS) contract, which enables the agency to place you in short- and long-term assignments in federal government facilities.

Your agency partner should be able to place you in assignments that offer financial incentives such as referral and shift completion bonuses. Some agencies often reward their practitioners with travel, vacation, educational, and financial incentives as they reach particular milestones in the relationship.

support structureA key reason for working with an agency is to eliminate the hassles that are involved in working locum assignments. To that end, you should look for an agency partner with a strong internal support structure to handle many of the details involved.

medical malpractice insuranceThe agency you choose should provide malpractice insurance. The policy should cover multi-million dollar claims and tail coverage with A+ rated insurance companies.

“ Your agency partner

should be able to place

you in assignments that offer

financial incentives like referral

and shift completion bonuses.

Some agencies often reward

their practitioners with travel,

vacation, educational, and

financial incentives as they

reach particular milestones in

the relationship.”

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credentialingObtaining the appropriate credentials for your assignment can be complex, so your agency partner should relieve you of much of that burden. The agency should have a team of specialists on staff that coordinates and expedites the credentialing paperwork and process for you. Some will even offer administrative assistance for licensing to keep track of expirations and requirements.

In a case where an assignment requires a license you don’t have, some agencies will not only help you obtain it, but will also cover the licensing fee.

travel logisticsThe right agency partner will handle all your travel arrangements and expenses and make sure you are as comfortable as possible while you are on assignment. The agency should coordinate and pay for all rental car, housing, and flight arrangements. The agency also should take into account your travel preferences and rewards programs when making these arrangements.

availabilityYour locum agency should be available at all times to answer questions or concerns while you are on assignment.

breadth of opportunitiesConsider working with an agency that offers more than traditional locum assignments. A broad-based organization can provide you with opportunities beyond practicing, such as consulting arrangements, interim leadership roles, and program launches. This enables you to leverage the skills and experiences that you have obtained throughout your career to positively impact other organizations.

“ In a case where an assignment requires a license you don’t have, some agencies will

not only help you obtain it, but will also cover the licensing fee.”

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the nextstephow Medicus can helpLocum tenens assignments can be financially, professionally, and personally rewarding experiences. Taking that first step can be overwhelming, but it doesn’t have to be. The team at Medicus Healthcare Solutions is here to help you get started.

Medicus Healthcare Solutions provides hospitals, physician groups, and other healthcare organizations nationwide with resources, services, and strategies to help cover staff shortages, optimize service lines, and build-out departments. Clients turn to Medicus for supplemental and permanent staffing, comprehensive consulting services, program launch support, department restructurings, and help with creating efficiencies throughout their hospital or health system.

Medicus is a full-service resource for practitioners, hospitals, and healthcare providers. We have exclusive arrangements with hundreds of hospitals and health systems to fulfill their practitioner recruitment needs, providing opportunities not available elsewhere.

Medicus offers specialty-specific recruiters and dedicated teams of credentialing and travel professionals who provide customized career management services to practitioners. Our goal is to match your clinical and geographical interests with the most suitable opportunities.

Unlike other staffing firms, Medicus offers services and benefits that lead to exclusive preferred provider and long-term partnerships with hundreds of healthcare facilities. By focusing on quality, commitment, and accountability, we have built long-term relationships with both practitioners and hospitals. The result is a proven history of success.

Elevate your path by calling 1-844-217-1221 or emailing Maureen Cragon, Director of Physician Recruitment, at mcragon@medicushcs.com to begin your locum tenens journey.

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Logos Combination Usage

Consistency in the look and feel of the Medicus and OPTIMUM brands in all media builds and reinforces brand awareness.

When used in combination, the two brands should appear in this setup and proportions.

When color or printing prohibits this, it may be used in all black or reversed out to white.

Corporate Headquarters22 Roulston RoadWindham, NH 03087

West Coast Office550 S. Wadsworth Blvd, Suite 200Lakewood, CO 80266

1-844-217-1221