Feature | Tips and Tricks For Locum Cardiology
In a previously published article on ACC.org, I explored the advantages and drawbacks of locum cardiology practice. In this part-two article on locum cardiology, I will give you tips and tricks to optimize your experience.
Most hospitals have a panel of a few locum providers who are credentialed with them, so that they always have options. If you want to be busy, make sure you are the first choice by being available.
Prioritize one or two practices where you want to be the first choice. Folks who are scheduling the locums do not want to call multiple people. If they know that you will be available for them, you will naturally become their first choice.
By doing this, you get to pick the slots of your choice and leave the rest for others. You can also tell your locum companies which places you want to prioritize.
Know What You Are Getting Into
As an interventional cardiologist locum, I have provided coverage at a hospital where all I did was STEMI call with no general cardiology. At a different facility, I took STEMI and general cardiology call with daily rounding on 4 – 8 patients, and reading 4 – 6 echocardiograms.
At another practice, I provided weekend coverage with STEMI call and rounding on 50 patients daily (with a physician extender) and reading 10 –15 echocardiograms.
Some places may require peripheral interventional skills and may expect you to perform acute limb ischemia and/or acute pulmonary embolism interventions. Some places may also require you to see patients in office. The workload can be very variable, and the pay may not necessarily reflect that.
I strongly recommend talking to your locum company representative about how busy you are going to be. You can get a pretty good idea about what you are getting into by asking them about average daily hours previous locums put in and how many patients they round on. This will help you decide if you are a good fit for the practice and minimize surprises when you show up to work.
Choose Your State or Your Locum Company
There are different locum companies who have opportunities across different states. If you want to restrict your jobs to one state so you do not have to travel far, sign up for different locum companies and ask them to find opportunities in your state of choice.
However, if you really like one locum company and want to stick with them, you will inevitably have to get different state licenses.
Remember, locum jobs are by definition temporary jobs. You may be working at a place for six months and the facility may not require locum services. You must have other options ready to go as back up.
Bottom line: having multiple state licenses and signing up with multiple locum companies increases your odds of finding a locum at your desired dates.
Periodic Assessment of Your Career
Periodic assessment of your career is an important consideration for locums and is different from regular practice. When you join a practice, it takes 2 – 3 years for you to get progressively busy.
Even if you are not busy in the first year or so, you usually have guaranteed income. However, locum is different. You get paid when you work, and not paid you do not. Therefore, it is a good idea to look at your financial situation every so often (I would say every six months) to assess whether you are working enough and making enough money.
Your favorite place to work may not be as financially rewarding as you thought. Based on this situation, you can prioritize different locum opportunities.
There is an additional challenge here for procedural specialties. If you are doing locum full-time, you need to make sure you have enough procedures under your belt at the end of the year so you have no problems with credentialing at different facilities.
Each facility has its own criteria for minimum number of procedures to grant privileges. For example, doing one STEMI case in an entire week of STEMI coverage sounds like a good way to make easy money.
However, it may not translate into enough STEMIs/PCIs at the end of the year. As a procedural specialist, you not only have to look at the kind of work and financial remuneration of a locum opportunity but also the number of procedures to maintain your skills and credentials.
While financial literacy is important for every physician in general, it becomes more important as a locum. For example, most employed physicians get their taxes deducted from their paycheck and are offered retirement accounts through their employer.
Those decisions are entirely on your shoulders if you are an independent locum physician, and you would need to stay on top of taxes, saving for retirement and other financial matters. You can take care of these items yourself if you are financially savvy, or you can work with tax accountants and financial planners.
Some locum providers make LLCs to optimize their taxes. Bottom line: make sure you are on top of financial issues so that there are no surprises later.
This article was authored by Syed S. I. Bokhari, MBBS, FACC, interventional cardiologist at Saint Joseph Hospital in London, KY.