Locum Tips for Communities and Physicians Seeking Doctors

Preliminary

The movie "La Grande Séduction," also known in English as "Seducing Dr. Lewis," is the fictional story of an isolated Quebec community seeking a family doctor. It has some tips you can use, though with MDWork.com you will not have to go to the extremes that community did in their efforts to attract a physician!

Finding a Locum

To start, provide as much detail as possible in your job posting. On call duties and practice expectations should be clearly stated. Also provide as much information as possible regarding the financial aspects, including information on practice patterns, usual number of patients seen each day and during on call, overhead split, on-call stipends, and daily guarantees. Ideally, provide an estimate of expected daily/weekly billings.

For non-urban locations, accommodations or expenses are generally provided by the community/physician. Travel costs are generally covered as well.

The Resident Benefit

Consider recruiting residents. Residents are medical doctors who have completed their medical school training and have obtained their medical degree, but still require an additional 2-5 or more years of residency training in their respective specialty to obtain their final license to practice medicine independently. In any given year there are over 2000 family medicine residents and over 5000 Royal College specialty residents training in Canada.

Many provinces will grant a restrictive or provisional license to senior residents to allow them to perform short term locums or moonlighting. The services they can perform range from family medicine or emergency room coverage following 2 years of residency up to performing anesthetic or surgical coverage during 4th and 5th years of residency, subject to meeting specific training criteria.

This is a win-win situation for all involved. Residents carry a large debt load from medical school and are often seeking ways to supplement their income, which opens up a large locum pool if you are willing to consider them. Secondly, communities get a well trained doctor to give their physician workforce a well deserved break, and the resident may end up coming back to practice upon graduation.

Also, consider sponsoring medical students, residents, and international medical graduates to come and shadow you or one of your physicians during a period of time during the summer. While this will not help you with manpower in the short term, the chance of one of these individuals choosing to set up practice in your community following their training is higher if they have previous exposure to your community.

Making the Locum a Good Experience

Consider every locum that comes to your community as a potential full time physician. If they happen to like the experience and the area they may elect to return for other locums or even to stay full time. At the least, they may recommend your community to their colleagues.

Consider creating a welcome package for locums. Include details such as information on Bed and Breakfasts, hotels, car rentals, restaurants, take-out menus, outdoor recreation, cultural activities, etc.

Provide a short list of important phone numbers and contact information. Include referral physicians in each major specialty (General Surgery, Obstetrics and Gynecology, Cardiology, Neurology, etc.) as well as relevant community resources (closest hospital, home care, physiotherapists, 24 hour pharmacies, outpatient radiology, ultrasound, etc.)

Provide a brief list of special patients such as inpatients, term or complicated pregnancies, chronic narcotic users, and those with particularly challenging personalities who you think may need special attention.

Post a letter in your office in the weeks prior to the locum stating that you will be away during that period and introduce the fact that you will have a locum replacing you. While your locum is working, be sure your receptionist notifies patients that they will be seeing a locum so there are no surprises in the exam room.

Ideally, have your established support staff present during the locum. Having a replacement physician working with replacement or new support staff is a recipe for disaster.

Provide a written contract clearly describing duties, expectations, and reimbursement. This protects both you and your locum from misunderstandings. A sample contract can be found at www.medi-mouse.com/business/contract.html.

Having Locums Return / Planning for the Future

At the end of the locum, be sure to have a “debriefing” meeting. Find out what went well and what the problems were. Use the feedback to improve the experience for future locums.