*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 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.
This post originally appeared on The Barton Blog.
It’s both expensive and time-consuming to obtain temporary coverage for a hospital or medical practice. Locum tenens clients have every right to expect high-quality care from the locum tenens providers they hire; but even the very best locums may not perform to their full potential if their onboarding isn’t carefully planned.
As a locum tenens physician with licenses in 14 states, I have much experience with the onboarding process. Here are 12 tips for facilities eager to encourage smooth transitions, foster good provider relationships, and provide excellent patient care.
1. Arrange for provider sign-outs.
Since lapses in provider communication is a leading cause of medical errors, you can protect your patients by organizing a face-to-face (or phone call) report between the current provider and the locum who is going to be assigned to their census. Studies have shown a 30% decrease in error rate when physicians hand off their patient panel in person.
2. Allow for at least one day of training overlap, if possible.
The incoming provider will adapt best to your unique environment and care process if he or she has the chance to “shadow” the current provider for a day. Various questions will naturally arise and be answered during real-time patient care. In emergency fill situations, this will obviously not be possible; but it will help ease transitions in cases where it can be done.
3. Get your IT ducks in a row before the locum tenens provider arrives.
Electronic medical records (EMR) systems are difficult to master, and attempting to learn how to navigate in a new one (or newer version of one) in the middle of a full patient caseload is a recipe for disaster. Logins and passwords should be set up long before the locum tenens provider arrives. EMR training needs should be discussed and planned for in advance. If an IT professional is available to sit with the locum during his or her first round of documentation attempts, so much the better.
4. Plan for a day or half-day of orientation.
A facility tour, combined with an in-person meeting of key hospital players, is extremely important. The following people should be included:
- Unit medical director
- Nursing and therapy supervisors
- Risk management staff
- Human resources
- Medical records staff
- Coding and billing staff
- Pharmacy staff
- Laboratory staff
5. Prepare a welcome packet in advance.
This packet should include important information about the organization, the assignment, and the facility, including:
- Site maps
- Parking instructions
- Orientation day schedule
- Door key codes (if applicable)
- ID badge instructions
- EMR login and password
- Dictation codes
- Cafeteria location and hours
- A hospital directory with key phone numbers highlighted
Make sure the locum knows who signs their time sheets and where their office is located. A coding “cheat sheet” may also be appreciated.
6. Invite the locum tenens provider to lunch or dinner at some point during their assignment.
This is a friendly way to show that you appreciate them, and you want to get to know them. Being on the road can be lonely, and most locums appreciate opportunities to socialize.
- See more at: http://www.bartonassociates.com/2015/08/18/12-ways-to-help-your-locum-tenens-provider-succeed/#sthash.6KV0S3vE.dpuf
It’s no secret that physicians are experiencing burnout at an exponentially increasing rate in our progressively bureaucratic healthcare system. Many are looking for “alternative careers” as their salvation. I receive emails from physicians all the time, asking for advice about getting out of clinical medicine, since I have spent a few years outside it myself. As my own career pendulum has swung from full time clinical work to full time editorial and/or consulting work, I’ve found that the best mix is somewhere in between.
If you’re like me, you’re happiest using both halves of your brain. You have a creative side (I’m a cartoonist and blogger) and an analytic side (hospital-based physician). It’s not easy to make a living as a cartoonist or writer, and it’s soul-sucking to work 80 hour weeks in the hospital without rest. So how do you make a living, but participate in all the things you love? You work as a traveling physician (aka locum tenens) one third of your time, and spend the other two-thirds doing the creative things you also enjoy.
“But I couldn’t survive on 1/3 of my salary,” you say. Actually, I make the equivalent of a full-time academic physiatrist salary while working ~14 weeks a year as a traveling physician. Really? Yes, really. Because when I’m filling in at a hospital with an acute need, the work hours are long, and I’m paid by the hour. It can be grueling, but it is short, and the pay is fair so morale remains high. Drawing a flat employee salary (and then often discovering that the work load requires double the time estimated by the employer) can cause a lot of unconscious resentment. But when you are paid for your time, long hours aren’t as dread-worthy. This is what attorneys have been doing from day one, so why not physicians?
“But if all physicians suddenly dropped to half or 1/3 time, wouldn’t that do irreparable damage to patient access?” you cry. Yes, it could be catastrophic. However, if physicians stay the course and do nothing about our burnout, then the powers that be will continue tightening the vice – targeting physician reimbursement, increasing the burden of bureaucratic monitoring, pay for performance measures, and meeting “meaningless abuse” requirements for our electronic medical records systems. If there are no consequences to their actions, why would they ever stop?
I don’t think that most physicians will read this blog post and quit their jobs. I’m not worried about a sudden reduction in the physician work force. What I am offering is a suggestion for those of you who have a secret passion outside of clinical practice – a pathway that allows you to continue practicing medicine, and also enjoy cultivating your other talents. I’m hoping my advice will actually reduce the full drop out rate (if you believe the polls, up to 60% of PCPs would retire today if they had the means) to partial drop out rate (keeping those wanting to quit completely working part time).
So if there’s something you’ve always wanted to do (A non-profit endeavor? A low-paying, but rewarding job? Running a small business that can’t pay all the bills but is fun to do?) I say do it! Life is too short to get caught on the clinical treadmill, driving your spirits into the ground. You love your patients but can’t tolerate the work pace? Don’t quit altogether… you can still be a fantastic, caring, clinician in fewer hours/week and make the salary you need to maintain a reasonable lifestyle.
Please see my previous blog post to gain more insight into whether or not locum tenens might work for you.
And here’s a video of my recent thoughts about locum tenens work:
The Benefits Of Locum Tenens Work