Locum tenens physicians are self-employed contractors under the law. Thus, every new assignment comes with the opportunity to draw up a new contract between practitioner and healthcare facility. How contracts are structured can mean the difference between a successful locum career and one that is less than desirable.

Experience is a great teaching tool for generating contracts. In the absence of such experience, new locum practitioners should tap into the wealth of knowledge possessed by their more experienced peers. They should be asking questions, doing research online, and even seeking out legal advice.

So, what goes into locum tenens employment contracts? Potentially a lot. Below are the top five contract concerns that every locum practitioner should start with.

1. Total Compensation

Locum tenens practitioners are compensated differently than their permanently employed counterparts. That’s because total compensation is comprised of multiple moving parts, as it were. Locums must structure their contracts in such a way as to cover each of those moving parts adequately. Total compensation for the locum includes the following:

  • Salary and productivity bonuses
  • Paid travel or travel stipends
  • Paid housing or housing stipends
  • Other pay (e.g., signing bonuses, etc.).

Practitioners should also remember that staffing agencies need to be paid. How they are paid depends on their contracts with clients. If their pay is a portion of the doctor’s total compensation, that needs to be accounted for in the contract.

2. Regular Duties and Other Requirements

The locum contract should spell out exactly what the doctor’s duties will be. If there are any other requirements above and beyond day-to-day duties, they need to be spelled out as well. Failing to adequately detail duties and responsibilities leaves the door open for abuse on either side, and that is never good for locum-employer relationships.

3. Work Hours and Scheduling

One of the things locum practitioners often cite as an advantage to the way they work is the ability to control their own schedules. But if that is going to happen, work hours and scheduling need to be laid out in the contract. If such language is not included, practitioners have little to no recourse should hours and scheduling turn out to be not in their best interests.

4. Malpractice Insurance

It is fairly routine these days for staffing agencies to cover malpractice insurance for their locums. Regardless of who provides insurance though, the locum contract should spell it all out to limit liability. Furthermore, doctors should insist on tail coverage if it is not provided by the staffing agency. Malpractice tail coverage is non-negotiable for the modern locum tenens practitioner.

5. Productivity Expectations

Locum tenens practitioners may have a difficult time meeting productivity expectations if said expectations are not spelled out in their contracts. And because productivity is important to employers, productivity expectations are a top priority when writing contracts. Locum practitioners need to know exactly what is expected of them if they ever hope to deliver.

The main challenge with productivity expectations in a contractual sense is their ambiguity. Indeed, there is little room for ambiguity in contract negotiations. Practitioners should strive for as much detail as possible, thereby reducing the risk of not meeting expectations down the road.

Writing contracts is a normal part of the locum tenens model. Time and experience are great teachers, so practitioners need to be patient as they learn the ropes. In the meantime, working with an attorney or a more experienced physician can help equip the new locum with the necessary knowledge to protect his or her own best interests during contract negotiations.

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Adrian Grant

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