Locum tenens: when you need one, how to get one

Key Points

No doubt about it-hiring a locum tenens physician is costly. However, it's costlier if you don't.

If you belong to a group practice, a substitute doctor with the fancy Latin name can save you from burnout-and all its costs-when a colleague suddenly quits and somebody else must pick up the slack until a permanent replacement comes aboard. Maternity leave and illness also create vacancies to plug.

The benefits of a locum, combined with a physician shortage, explain why demand for them is burgeoning, says Dustin Koger, executive vice president of a locum placement agency in Irving, TX, called Staff Care. His company recorded a 30-percent increase in the hours of temporary help requested by hospitals and clinics in 2006. Given this heated market, locums command high prices. When you add up base pay and other costs, a primary care doctor secured through an agency for a two-week stint can easily ding you for $10,000.

Anyone who spends that kind of money should shop wisely. We've interviewed consultants, executives at locum agencies, and doctors who've used locums to advise you on hiring that substitute stethoscope.

What a locum agency will do for you-and for how much

Perhaps the simplest way to land a temporary doctor is calling a locum agency. Locate one by Googling "locum tenens jobs," visiting the website of the National Association of Locum Tenens Organizations ( http://www.nalto.org), or asking peers for recommendations.

A locum firm will connect you with candidates who are vetted as qualified and competent in your specialty. Once you select someone, the company can book the locum's lodging and transportation and help get him credentialed with hospitals. Dissatisfied with his performance? The agency will replace the replacement.

The vast majority of assignments, though, are successful, notes Clarke Shaw, a senior vice president with VISTA Staffing Solutions in Salt Lake City. Several decades ago, locum work was viewed as a refuge for doctors who couldn't survive in private practice, but the bar has been raised since then, he says.

"Locums are in a fishbowl," says Shaw. "Every time they receive an assignment in a new state, they must be licensed there and credentialed at new hospitals. They're reviewed constantly. If they have skeletons in their closet, they won't work."

Agencies charge clients a daily rate that can be roughly $700 a day for a primary care physician and almost triple that for a radiologist. Between 70 and 80 percent of the agency rate goes into the locum's pocket, says Pam McKemie, a senior vice president with LocumTenens.com in Alpharetta, GA. The rest covers the locum's malpractice coverage, agency overhead, and profit.

The daily rate is based on eight hours, with overtime typically calculated on a time-and-a-half basis that's prorated per hour. Weeknight call is worth an hour of pay; carrying a beeper an entire weekend equals a day's compensation.