The use of locum tenens surgeons is no longer a matter of if you’ll have a need for general surgery, vascular surgery, cardiothoracic or neurosurgery coverage, but rather when you will and how you will make it work best for your hospital when that time comes.
Here are seven tips to ensure the locum tenens coverage goes well:
- Whether it is the in-house recruiter, medical staff secretary or the vendor management company, provide whomever is charged with securing coverage full details regarding the scope and volume of the work to be performed, the hospital services and capabilities related to the specialty needed, the procedural skills required, and so. For example, if you need a CT surgeon, the locum would want to know how many CABGs are performed at your hospital annually and whether or not he or she would have a PA working with him or her at a minimum.
- Be sure to have one of your surgeons speak with the prospective locum tenens surgeon by phone prior to beginning the credentialing process. Some locum tenens surgeons actually require this before accepting an assignment. It shouldn’t take more than 15 or 20 minutes, and it’s extremely valuable in determining whether or not the locum arrangement is a fit for all parties. Once you have settled on a particular surgeon, you may also want to have your Director of Perioperative Services call him or her in advance of the locum starting at your hospital.
- Be sure you have information from the prospective locum tenens surgeon regarding his or her liability claims history as well as a recap of clinical activity (cases performed) in the last six months. This will tell you whether or not you should proceed with credentialing the candidate. The last thing you want is to find out two days before the surgeon is supposed to start that he or she won’t be able to get privileges at your hospital. Be mindful that locum tenens general surgeons working in small rural hospitals have probably been relegated to providing low volume urgent and emergent surgical care, so they may not come with a case log as robust as a surgeon in an established practice. In addition, cardiothoracic surgeons engaged in full-time locum work are primarily used to provide cath-lab backup, so they may not come with substantial case logs, either. This does not necessarily mean that they should not be considered, so long as they have done any surgery in the recent past.
- Be sure that your surgeon(s) and the locum tenens surgeon have a clear understanding of how the call will work for the ED, any in-house patients, ICU patients and after-hours calls to any local surgeon’s offices. If the coverage is for cardiothoracic surgery and you are expecting the locum to also cover your vascular service, this should be made known upfront. The same holds true for a general surgery locum also needed to perform endoscopy. If you happen to have a trauma center designation, then a general, orthopedic or neurosurgeon would want to know which designation you hold and what role he or she will have in providing trauma care while on assignment.
- The incoming locum tenens surgeon should be scheduled for an orientation (usually part or most of the morning of the first day of coverage). This time should be utilized to familiarize the locum tenens surgeon with your EMR and other computer systems as well as other departments and services that a surgeon would need to access to provide patient care at your hospital.
- It may be understood, but make sure you have an understanding in place as to who will follow the locum tenens surgeon’s patients post-operatively.
- Lastly, there is the cost of the coverage and how the locum tenens surgeon is compensated. It is both the agency’s and the locum tenens surgeon’s responsibility to make sure there is a mutual understanding of the terms between them. Clearly establish how your agreement works and how you will be billed for the locum tenens surgeon’s time. It is usually an on-call or base daily rate with additional hourly billings based on the number of hours actually worked. You just want to be sure that you understand the hospital’s commitment and that you don’t caught in the middle of some misunderstanding when it comes time to process payments. You should expect that when a locum tenens surgeon comes to your hospital from another location that he or she will want to take as much call as possible and be able to work a schedule of successive coverage days. For example, scheduling a trauma surgeon to take first call for 24 hours on a Saturday, then not covering any clinic or taking call again until Tuesday, is not a workable plan.
Locum tenens surgeons fill a much needed role in the support of surgical practice in rural and semi-rural urban hospitals and trauma centers. Once you have completed the steps listed above and have indeed determined that a locum tenens surgeon is suitable, you should not be afraid to move forward to provide the necessary relief for your current panel of surgeons.