Even Small Groups May Need a Fill-In Doctor

By Cejka, Sue | Medical Economics, July 12, 1999 | Go to article overview

Even Small Groups May Need a Fill-In Doctor


Cejka, Sue, Medical Economics


When your practice needs an extra physician, a locum tenens may be just the ticket.

In large physician groups we work with, an annual 10 percent turnover rate is common. So these groups are accustomed to hiring locum tenens while they seek permanent replacements. But to small groups with no regular physician turnover, hiring a locum may seem like a radical step.

Yet even a five-doctor group sometimes needs a temporary physician's help. It may be that a partner abruptly dies or is stricken with a disabling illness. A doctor may suddenly quit or require a lengthy leave of absence. You may join a new health plan or IPA that swells your patient load overnight, or a flu epidemic may leave your waiting room swamped.

When you find yourself in a situation like this, you can't count on doctors and staff to fill in if they're already grappling with a full patient load. You risk losing patients, doing poor quality work, and seeing staff morale plummet. So when your group is down a physician, hiring a locum tenens makes sense.

You won't lack for choices. National and regional locum tenens firms are proliferating. The easiest way to find them is on the Internet. Just type "locum tenens" into the query field of a meta-search engine, which can search over a dozen search engines and other sources at once. (Two good ones: www.dogpile.com and www.isleuth.com.)

You may have heard horror stories about locums. Some of them, alas, are true. There have been locums who were sacked for reeking of alcohol-or body odor. The temporary apartment of a locum psychiatrist smelled so raunchy that neighbors complained. Also, an inspection revealed that the woman had not only trashed the place, she kept a large packing crate filled with cuttings of her hair-30 years of it.

Don't magnify such anecdotes out of proportion, though. They apply to a tiny fraction of locums. The vast majority are competent and credentialed. Otherwise, respected groups like the Care, Guthrie, and Hitchcock clinics wouldn't hire them.

What to expect when you call a locum firm

If you anticipate needing temporary help, don't procrastinate. Contact a locum tenens company as soon as possible. It may take a month or more for an available doctor to complete his current assignment before he can appear in your office.

Contact three or four locum firms to comparison shop. The firms do compete for business. If you contact several, you'll be better able to negotiate the best rate. A primary care physician on locum assignment typically earns $65 or so an hour-more if you give him night call or want him to work weekends. What you'll pay a locum firm, however, will be in the neighborhood of $115 an hour-nearly twice what you probably pay a primary on staff. But that amount also includes the locum's malpractice insurance, licensing, credentialing, relocation, and housing. …

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