*This post was initially published on the Barton Blog.
I have been working locum tenens assignments for over five years, and I’m enjoying it even more now than I did in the beginning. This is probably because experience has taught me how to handle the variety of challenges and unknowns that are a part of the job. Excelling in these environments leads to more assignment opportunities, meaningful professional relationships, and repeat business. If you’re interested in honing your locums skills, here’s how to do it:
1. Be prepared
Before traveling to your assignment, prepare a clipboard that will contain all the key information you will need while on assignment. This should include:
- Your state license number, DEA number, and NPI number
- Your login and passwords (you may receive them in advance or on day one of your assignment).
- Common CPT and ICD-10 codes
- A blank org chart that you can fill in with names of your supervisor and other key personnel. (E.g. Chief of Staff, Nursing supervisor, Medical Records, Admissions Coordinator, Risk Management, etc.)
- Frequently called phone numbers (e.g. pharmacy, lab, hospitalist service, etc.)
You can do this with a tablet or smartphone if you prefer, but I find that most hospitals still prepare paper handouts for me during orientation – so an “old school” clipboard works well.
2. Dress professionally
They say you never get a second chance to make a good first impression. I find that scrubs and a white coat are clean, professional, and easy to travel with. It’s hard to know what the dress style will be at your assignment, but no one complains about a doctor in scrubs and a white coat. Scrubs are comfortable, and coats have plenty of pocket space for equipment. If you feel more comfortable in dress shirts and slacks, that’s fine too. Just remember that you may have long days and be on your feet for many hours, so plan accordingly. Footwear can make or break you!
3. Be tech savvy
It’s difficult to acclimate to new hospital documentation processes, but do your best to do so quickly and without complaining. You may not like the EMR at your assignment, but it’s not going to change, so you may as well dig in and figure out how to make it work for you. Do your EMR training in advance if possible. Plan to be able to compose your documentation on day one. Standing out as a locums often hinges on your ability to adapt to technology quickly.
4. Work hard
Although many locum assignments are short term, it’s still important to work just as hard as if it were a permanent position. Plan to carry the same census as your peers and work about the same hours. You will certainly stand out if you show that you are pulling your weight and are a valuable member of the team. Schedule assignments with facilities in advance and don’t cancel them within a 30-day window.
5. Document thoroughly
If you want to be invited back repeatedly to a facility, make sure you document thoroughly and accurately so that they can bill for your services. Provide them with CPT codes on a daily basis, and make sure you have signed all your charting. If you are off site and medical records call you to complete some documentation, do so quickly and without complaint. They will be grateful!
6. Develop staff report
It’s important to treat everyone with respect. Attend team meetings. Listen well. Avoid the attitude of “I don’t need to learn about this because I’m only here for a short time.” People will remember your attentiveness. Offer your cell phone number to the staff so they can get in touch with you at all times.
7. Be humble
When providers first arrive at an assignment, the natural tendency is to want to change everything to suit their own way of doing things. Resist that urge, and try to adapt to the way things are run. Every facility has its own personality and has developed a working routine. Observe it carefully before making suggestions for changing it. If you see someone doing a good job, be sure to praise them for it.
8. Be clean
Keep a tidy office space. Don’t clutter up common areas, leave old food in the staff fridge, or leave private patient information lying around. You don’t want a facility’s last memory of you to be the rotten egg salad with your name on it!
9. Have a sense of humor
When you’re the new guy/gal you’re bound to make mistakes, forget names, get lost, miss meetings, etc. Instead of being frustrated, just take it in stride and laugh at yourself and the situation. Apologize often, learn from your mistakes, and thank staff for helping you to stay on track.
10. Provide excellent patient care
In the end, the most important thing is that patients get good care. Be thorough, evidence-based, and compassionate. Engage in patient and staff education, citing medical literature as appropriate. Listen to your patients, and engage their families in their care.
If you keep these 10 tips in mind as you prepare for your next locums assignment, I have no doubt that you’ll stand out as the kind of provider everyone wants around!
*This post was initially published on the Barton Blog.
As a locum tenens physician in rehabilitation hospitals, I see patients with some of the most unique injuries. From rare brain infections contracted in exotic lands, to the consequences of ill-advised horseplay with guns or ATVs – I’d begun to wonder if maybe I’d seen it all.
And then I met a grandma from New Jersey, who had a life-changing encounter on a nature trail out west. In her dutiful effort to corral her teenage grandchildren, and keep them following the guide’s directions, she shouted for them to remain on the path. In so doing, her yelling attracted the attention of an ill-tempered bison. The animal rapidly approached from behind without her notice. In the blink of an eye, the bison threw her up in the air with a flick of its horned head.
“As a locum tenens physician in rehabilitation hospitals, I see patients with some of the most unique injuries.”
As she crashed to the ground, she rose up again instinctively (to dust herself off and prepare to run) as the animal came back for a second hit. One of its horns sliced a huge gash in her buttock as she fell head first on the ground, causing brain bleeding. The guide managed to scare off the beast as my patient’s granddaughter had the presence of mind to staunch her bleeding wound by having her sit on her thigh, as the guide called in an air flight to my hospital.
After stabilization in the ICU and several surgeries to correct the gashes, my patient arrived in the rehab unit with a traumatic brain injury. She was quite disoriented, her pain was poorly controlled, and even the slightest noises were very disturbing to her. She had flashbacks of the event and would call out in fear during her fitful sleep.
With careful therapy, low stimulus environment, and better pain management, I began to see glimpses of my patient’s usual brilliance and keen sense of humor. She was determined to improve, and participated eagerly in the full gamut of activities, including focused attention tasks and balance and agility tests.
One weekend I was eating at a local restaurant and noticed bison carpaccio on the menu. I couldn’t resist the opportunity to “get even” for my patient. I ordered the dish and took a photo with my smart phone. On Monday I showed her the image – and told her I had evened the score. Her face lit up from ear to ear. She told me to keep eating buffalo for the rest of my days!
*This blog post was initially published on the Barton Blog.
When doctors complete their residency training, they are under a lot of pressure to land their first “real job” quickly. Student loan deferments end shortly after training, and whopping debt faces many of them. But choosing a job that is a good long-term fit can be difficult, and gaining a broader exposure to the wide variety of options is key to success. That’s why “try before you buy” can be an excellent strategy for young physicians.
Locum tenens agencies such as Barton Associates work with healthcare organizations and practice locations across the country to offer a variety of temporary assignments for physicians.
These agencies negotiate your salary and call schedule. They also arrange the logistics, covering the costs of travel and accommodations. Once the doctor and the facility agree to terms, the physician simply arrives on the required date(s) and takes on the responsibilities requested. It’s a hassle-free, minimal-commitment arrangement that pays an hourly or daily rate for work.
Locum providers are given the convenient option to receive direct deposits to their bank accounts at regular intervals. Physicians can travel as broadly as they like for assignments, and the agency credentialing team works to efficiently complete any needed paperwork for new licenses and hospital privileging.
I enjoyed “living la vida locum” for six years before I landed my dream job. That’s a long time to be living out of a suitcase, and I doubt that most of my peers would want to do it for that long of a stretch. But an amazing thing happened during those years: With each new hospital experience, I gained insight and knowledge about my specialty. By rubbing elbows and networking with a wide swath of patients and experts across the country, I became a sought-after consultant in my own right.
I experienced different ways of delivering healthcare — from critical access hospitals to bustling academic centers. I learned about best practices and creative solutions that administrators and clinical staff had discovered to improve care quality, given the limitations of Medicare rules and private insurance restrictions.
When I was hired as the Medical Director of Admissions at St. Luke’s Rehabilitation Institute in Spokane, Washington, I came armed with creative ideas and a wealth of experience to draw from. I was a highly seasoned physician who had been exposed to the widest variety of patient populations and practice styles. I knew all about the unique struggles, successes, and solutions of various rehab centers across America. I now leverage that experience to drive change at my institution, and I am virtually unfazed by new problems and challenges.
The career value of locum tenens work is extraordinary. Take the time to look around you at each assignment. Learn what works and what doesn’t work, and file it away for future reference.
Like a bumblebee cross-pollinating hospital or medical practice “flowers,” locum tenens providers have the potential to drive change like no one else. When you’ve seen it all, your insights become invaluable, and you gain the maturity to know when a full-time job is the right cultural fit. Choosing the right job, on your terms and in your time, is the key to finding happiness in healthcare.