Five mistakes to avoid when starting a locum tenens position

Beware inefficient placement systems


For the last 8 years I have worked as a locum tenens hospitalist. I began on this path when it was the least popular option upon graduation from residency.

Dr. Geeta Arora, a member of The Hospitalist's editorial advisory board

Dr. Geeta Arora

I did countless hours of research trying to find accurate information about locum tenens companies, but never found anything written by physicians, only by the companies themselves. So, I stepped into this field blindfolded and learned the hard way. Since than, I have worked with over 16 locum tenens companies, 14 hospitals, and eight electronic medical record systems.

Through these experiences I’ve realized that, unfortunately, some locum tenens companies do not act with the professionalism and efficiency that both physicians and hospital systems would expect. This can lead to more stress than an actual employed position for physicians, and poor coverage with enormous costs for hospitals.

I decided to take matters into my own hands because I wanted to make the locum tenens system easier to navigate. I believe that the system can play a role in decreasing physician burnout, and I deeply understand the need that hospitals have to serve their patients with a shortage of doctors. As locum tenens physicians, we serve a need and shouldn’t have to deal with inefficient placement systems.

Here are five mistakes to avoid for physicians that are first entering into the locum tenens world:

1. Beware choosing a “factory mill” locum tenens company. Bigger companies have higher overhead, which usually means that they take more of a margin from physicians. Generally speaking, larger locum tenens companies pay their recruiters a lower percentage commission, so each recruiter has more physicians. This can lead to mistakes which can cause stress for both physicians and hospitals.

2. Beware long travel. Hourly rates that are $5-$10 dollars more per hour in remote locations are attractive. However, the amount of travel needed to get to these locations may not be worth it. When negotiating a rate, make sure not to lose sight of the amount of time it will take to travel to the hospital or outpatient location.

3. Beware short-term placements. There are a lot of hospitals that just need one or two weeks covered. Even if it’s at a much higher rate, the amount of paper work and credentialing hassle may not be worth the amount of time you work there. The greater number of cumulative hospitals worked, the longer credentialing will take in future locum tenens placements.

4. Beware using multiple travel services. Stick to one airline, one rental car company, and one hotel chain. This way when you are not working, you may be able to use the points earned during your work days for future vacations.

5. Beware companies that are not organized. If you find that a locum tenens company is asking you to do all of the paperwork to get credentialed, move on. This can be a red flag and may mean they lack credentialing staff. You should never have to fill out your own paperwork; rather you should be the one that simply reviews and corrects it.

Dr. Arora works as a liaison between hospitals, physicians, and locum tenens companies and is a member of The Hospitalist’s editorial advisory board. She negotiates rates and expectations with multiple locum tenens companies on behalf of physicians in all fields of practice and does not own or endorse a locum tenens company. You can contact her at

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