|
|
Bumps in the Road: Problem-solving strategies for locum tenens providers | |||||
| |||||
As with any scenario, how you handle these bumps in the road—and learn from them—makes all the difference. Fortunately, you can rely on your staffing company representative to offer support and advocate on your behalf, whether you need guidance about lodging, an explanation of your contract's limitations, or simply the ear of a good listener. Read on as two industry executives and two locum tenens physicians share proactive solutions to a variety of challenges. As you will discover, if you focus on finding solutions and avoid becoming emotionally distressed, even these potential challenges can be managed well and your locum tenens experience can remain fulfilling and rewarding. CLIMBING A PAPERWORK MOUNTAIN Arranging a locum tenens opportunity entails fulfilling licensing and credentialing criteria—including applying for hospital privileges—prior to ever stepping foot inside a new practice environment. This is where your staffing agency usually assumes the lead. "We have a dedicated licensing department staffed with experts in this arena," says Marci Rigby, a physician representative specializing in cardiology and pulmonary critical care for Salt Lake City, Utah-based CompHealth. "For example, they know if doctors will need to wait for a board meeting before being granted licensure. Also, we have a separate credentialing department to deal with that element. They do most of the footwork for physicians."
Late paperwork. "On the rare occasion that doctors' licenses or credentials are not in place," comments Ms. Rigby, "we work with the client facility to push back the contract start date a couple days until all of that is secured." Brooke Garner, the director of customer care for LocumTenens. com, headquartered in Alpharetta, Georgia, agrees. "Most contracts hinge on the doctor completing the credentialing processes in a timely fashion," she explains. "If the start date cannot be moved and a contract has to be cancelled, we try to find another physician for the client and another opportunity for the doctor." OVERCOMING TRAVEL TRIALS Meanwhile, the other elements of pulling together a contract are also underway. If it is not a local opportunity, then transportation must be arranged. Once again, these are details your staffing company most likely tackles. "While the majority of physicians appreciate this service," notes Ms. Garner, "providers may prefer to make their own reservations."
"As a policy, I do not travel the day I am supposed to start a contract," remarks Wanda Jeanne Michaels, MD, a practitioner with 20 years of experience in internal medicine and psychiatry. After taking a 2-week opportunity in 1999, she returned to locum tenens practice this year, signing up with three agencies and accepting contracts through Irving, Texas-based Delta Locum Tenens. "I may arrive the night before, but I try to allow plenty of time for traveling." "Planes are increasingly crowded now since there are fewer flights, which has made travel more challenging," states William Walkett, MD, DABR, FACR, a radiologist with 20 years of locum tenens experience. Also registered with three staffing agencies, he is currently on location through Salt Lake City, Utah-based VISTA Staffing Solutions. "I fly almost exclusively with one carrier, which takes good care of me. It helps to become a familiar face to airline personnel and collecting frequent flyer miles has its perks. I am looking forward to reaching my 2 million-mile mark in the next couple of years." Fortunately, both clients and staffing companies understand that travel delays or cancelled flights happen, and they are generally willing to adjust schedules as needed. If you find yourself in a similar situation, call your agency representatives to help iron out a Plan B. Says Ms. Rigby, "We have an after-hours travel service available 24/7 to assist locum tenens physicians with any problems." Adds Ms. Garner, "Our company has a dedicated customer care department with a representative for each specialty who helps arrange all the opportunity-related travel so the doctors can have as pleasant an experience as possible. Client coordinators can assist the physicians with changing flights, locating the best hotels or accommodations, and tracking timesheets for payroll." FINDING A HOME AWAY FROM HOME "As with flight arrangements, some providers also like to find their own housing because it gives them a chance to research the area," continues Ms. Garner. "A clinician may sometimes wish to arrive a day or two early to become familiar with the community before he or she starts providing services." If you are like most physicians, however, staffing representatives will reserve lodging for you. Should your contract last a few weeks, you may be booked in a hotel room or suite. For longer-term contracts, your agency representative might select an apartment or small house, depending on availability in the region. Unsuitable housing. Unless you are returning to a repeat contract and a hotel or apartment where you have stayed before, you most likely will not have a complete picture of the place until you arrive. Fortunately, a number of staffing companies have a separate housing department with staff members who manage all the details and can assist you with arrangements. "When physicians are away from home, we want their living quarters to be suitable," asserts Ms. Rigby. "To ensure satisfaction, some of our teams are putting their providers into hotels for a week and then letting the individuals look at potential locations so they can pick out apartments that are best for them." Another way to reduce the potential for concern is to give coordinators any specific lodging requests up front. Should you have problems with the location, condition of the facilities, or simply are missing something you need in order to continue with your everyday routine, experts suggest contacting staffing firm representatives directly. Of course, you also can take the initiative to seek out resolution yourself, discussing the situation with property management. DEALING WITH UNEXPECTED DEMANDS In addition, as with any permanent or temporary situation, there may be circumstances where you are not satisfied with the practice conditions or expectations turn out to be different from those you believe were initially presented. In these cases, experts urge you to address the issues and try to seek some sort of compromise. Changing expectations. Dr. Walkett suggests giving an opportunity a few days before drawing any conclusions. "In radiology, it can be difficult to judge your workload at first, especially if the contract begins on a Monday. Traditionally, that is the busiest day because of films left over from the weekend. But if the volume continues to be heavier than expected, I may ask about overtime pay. Of course, I do not have to extend beyond the initial commitment if I am less than satisfied with the experience." He adds, "In any situation, you have to know your limitations. You cannot be afraid to ask questions or to ask for help." Dr. Michaels agrees, commenting, "At one of my contracts, I was one of two locum tenens physicians. During my stay, the other temporary doctor had to leave due to a family commitment, and I was asked to cover his patients. I did not request assistance since I figured it was expected of me. Fortunately, the medical director volunteered to take some of the cases." "Sometimes, facilities expect independent contractors to assume a patient load that is more than a physician may be comfortable with," offers Ms. Rigby. "We try to mediate with all parties to reach an acceptable conclusion. Resolution may require a simple change, such as altering the on-call schedule." Says Ms. Garner, "If something comes up that is not discussed previously—like additional call duties—physicians generally try to work it out with their supervisors at the facility or practice. The decision is always at the discretion of the providers. Of course, they can contact us if they feel uncomfortable addressing the issue and would like mediation. We will be their voice." CANCELLING A CONTRACT The process of cancelling a contract, either with the client facility or with a locum tenens professional, is looked at as a last resort by staffing company representatives, who prefer to act as advocates to resolve the situations and ensure quality patient care is provided. Although cancellations happen infrequently, you should be aware of what to expect if they were ever to occur. The provider's perspective. "As long as professionals are in situations that put them, their patients, or their licenses at risk," states Ms. Rigby, "we support their wish to cancel their contracts. We also realize that unforeseen emergencies and other commitments, such as military or jury duty, can occur which may cause professionals to terminate their agreements earlier than anticipated." "If a provider simply is not happy with a situation," conveys Ms. Garner, "we ask for the industry standard, 30-day notice of termination so we can find another qualified professional to provide services to the client." A client's wish. "Contract facilities are bound by a 30-day clause, as well," she continues. "While unsuitable matches are rare, we ask for this time so we may locate another opportunity for the locum tenens provider. Of course, if it is a clinical issue with the professional, we do not require 30-day notice." "If clients cancel with less than 30 days notice," explains Ms. Rigby, "we inform them that they will be billed for the remaining days, up to a maximum of 30 days. We will bill the client and pay the physician when we receive payment. Once we receive word of cancellation, we immediately start looking for another opportunity for the practitioner. Although this scenario does not occur very often, it may appear in recruiting situations, where a department hires a permanent provider before the end of a long-term temporary contract." "I have had a couple opportunities cancelled before I headed out to the facilities," admits Dr. Walkett. "The last one occurred when the physician I was to replace decided to stay in town. I am currently working with my staffing company on rescheduling the contract for later this year." Dr. Michaels, who operates her own practice in the South, adds, "A few arrangements were cancelled when clients found other coverage for my time period, but I have not had any cancellations after I was scheduled to start. I did, however, need to cancel a contract once due to a situation at my office that required my attention. Once I realized I could not keep the commitment, I immediately contacted my agency, giving them more than a week's notice to find another provider." STAYING POSITIVE Experts and providers agree that most inconveniences you may encounter in your locum tenens experiences are outweighed by the benefits of this practice alternative. "You get to set your own pace," says Dr. Walkett, "while living in new and exciting places." Choosing opportunities on a full-time basis when he began his mobile career, Dr. Walkett still maintains 16 active licenses and takes contracts approximately 20 weeks out of the year. "When I started locum tenens practice in my 50s," he recalls, "I thought I would provide services until I was 65 or 70. At 75, I continue to enjoy it. I love travel so much, I think I could do it forever." "This career alternative has given me the opportunity to visit different regions and discover places of interest wherever I go," observes Dr. Michaels, who currently has four licenses and typically accepts locum tenens opportunities a week a month. "I enjoy caring for diverse patient populations, incorporating new lessons I learn into my practice, and networking with professionals I would not be able to meet otherwise. Locum tenens offers me an excellent opportunity to build a nationwide reputation." Reminds Ms. Garner, "While challenges likely exist in any position, whether temporary or permanent, they can be easily overcome with the right attitude, support system, and advanced preparation. The key is to keep an open mind and make the best of the situation." "To be a locum tenens physician," Dr. Michaels adds, "you have to be comfortable with change and be tolerant of the unexpected. If you are adaptable and flexible, the mobile lifestyle could be for you." Concludes Ms. Rigby, "When considering this type of practice, remember, every region and practice environment has many positives. Review your options carefully and compare available opportunities with your goals and expectations. Each contract can be an adventure—with new places to explore, new people to meet, and the chance to make lifelong friends while furthering your professional development." |
