The National Association of Locum Tenens Organizations (NALTO) was established in 2001 to create and enforce industry standards for the locum tenens profession. These standards also pertain to all physician locum tenens specialists.

NALTO's website, http://www.nalto.org/, lists 39 member agencies that specialize in locum tenens recruitment and placement. These firms do business with thousands of commercial and government clients across the nation that utilize contract providers as part of their overall staffing plan.

Locum tenens physicians benefit in a number of ways from working with NALTO member agencies:

In working with NALTO agencies, locum tenens providers can be assured that the firms' recruitment operations and business practices promote integrity, professionalism, and commitment to customer satisfaction.

Should disputes arise among locum tenens agencies—especially involving contract providers—NALTO has in place a well-formulated arbitration process to reach amicable solutions for all concerned. Thus, at all times, the professional interests of physicians are respected and upheld.

NALTO sets high standards that enhance the profession. NALTO emphasizes honesty, integrity, objectivity, and competency in all of the dealings of its members. Each member firm is obligated to conduct business matters in such a manner that its actions reflect positively on the profession and the Association.

Specifically, the organization's "Standards of Practice and Procedures" establish clear, effective parameters of behavior for all persons associated with the industry, including both clients and physician candidates.

Physicians can enhance their candidacy by following these standards in regard to providing complete references and credentials, acknowledging where they have been presented and by whom, and by responding in a timely manner to locum tenens recruiters' e-mails and phone calls.

NALTO members respect industry protocols. NALTO members fully respect various industry protocols related to acceptable practices for temporary physician staffing.

For starters, physician candidates must agree to allow locum tenens recruiters to formally present their curricula vitae and other supporting documents to clients for practice opportunities. Agency recruiters are strictly prohibited from presenting candidates for opportunities with-out their explicit permission and cooperation.

The "law of first introduction" states that the recruitment firm that first presents a physician candidate (with the physician's permission as outlined above) to a client for a specific practice opportunity is considered the official "Procuring Agent" for the placement if the candidate is accepted. Responsible locum tenens recruiters respect this protocol and do not attempt to place the given candidate with a client that is already considering the candidate through another referral source.

The "non-compete" agreement means that once a locum tenens agency has placed a provider in a specific practice setting, no other locum tenens firm can present the same provider to that client for a period of time specified in their agreement (no longer than 2 years). The exception to this rule concerns federal government entities that reserve the right to retain the services of specific locum tenens providers in order to maintain continuity of patient care.

Extending 30 days' notice of contract cancellation is another industry protocol that NALTO members fully support. Typically, provider agreements specify that except for an emergency situation, a locum tenens practitioner must give at least 1 month's notice that he or she is unable to continue a contract—for good cause, of course.

Locum tenens providers who opt to be represented by NALTO firms can avoid the difficulties that often arise if industry protocols are not respected by recruiters who represent them in their pursuit of practice options.