The following article was authored by Sheila Gibson, WMS Account Executive. Sheila has over 15 years of experience working with healthcare facilities in Alaska.
Managing a healthcare facility is challenging in the best of times and keeping qualified providers on staff is one of the most difficult tasks in today’s healthcare environment. Sooner or later most healthcare organizations rely on locum providers to fill in when there are gaps in coverage, especially gaps that can be planned for. Whatever the reason is that you need additional coverage, here are our recommendations for how to build a successful locum tenens provider rotation.
Reasons Why You Might Need Locum Tenens Healthcare Providers
Many facilities augment full-time staff with locum coverage to fill vacation slots, cover FMLA leave, military deployments, position vacancies and keep up with increased seasonal demand. Additionally, when you know a provider has an upcoming surgery or military deployment, or someone is retiring or leaving the clinic practice, you can prepare in advance. All these scenarios create the perfect opportunity to begin building a locum tenens provider rotation model that can serve your facility’s needs indefinitely.
Begin by Assessing Your Current Staffing Model
To build a successful locum tenens provider rotation, you need to start by assessing your staffing model and the number of providers you’d like to have working.
Factor in Time Off
Think through what your current staffing model looks like and how many people it takes to cover a week (or a month) of clinic, ER, and after-hours call. Be sure to factor in annual paid time off, continuing education leave, sick leave, military leave, etc.
The reality is that each full-time provider you have on staff will likely have six weeks or more time off each year when you combine scheduled leave employees receive.
Multiply the number of providers by the number of weeks they’re due for leave, and you can estimate the FTE you will potentially need to cover. When you do the math, you quickly realize that you can be fully staffed according to your clinic model, and still have significant time to cover for clinic and call.
Consider How Your Facility is Structured
Every facility in every community is different, so you need to think through how your facility, in specific, is structured.
Consider the following:
- Does your provider staff manage after-hours call?
- Do you use some providers for clinic only and others for ER and call only?
- Does your clinic offer full-range primary care?
- Does the position that is coming open leave your clinic in need of a provider with a specific focus/specialty?
- Do you provide pediatric care?
Use this information to begin identifying the types of locum tenens providers who could be useful to fill in staffing gaps that may occur. This will help you to figure out what type of coverage you need. Some facilities will use different locum tenens providers for different needs in coverage, so having options is helpful.
Add Time for the Unexpected
Plan for flexibility. While some providers may not use their full allotment of PTO, others will have unexpected health issues, family issues, or some other situation that will take them out of the schedule without a lot of warning. Thinking through the “unknown” scenarios ahead of time and planning for options to overcome them in advance can save your facility money, and you unneeded stress when the unexpected occurs.
Think Through the “What Else”
You’ll also want to think through the less obvious things. For instance, do you specifically need a male or female provider to round out your staffing mix? Are you set up to provide housing and vehicle for one or more locum providers? If so, how many can you accommodate at once?
If you’ve successfully used a locum in the past, take into consideration the things that worked or didn’t work when you’ve used them and use that information as part of your process.
Keep these things in mind as you begin to calculate how much coverage (people, house, specialties, etc.) you’ll need to help your facility run with a full staff.
Nail Down the Logistics
When you have a good sense of the type of coverage you need and the amount of time you’re looking to fill, consider a best-case scenario and a bare minimum scenario. If you want to augment your staffing with more than one locum provider, but budget or lodging or some other factor is a barrier, look at your staffing calendar to determine how you can best deploy the number of providers you have to work with.
Dealing with Long Gaps in Coverage
If you have a long gap of time to cover unless you find someone who’ll commit to the whole assignment, you may have to use two or three providers in sequence, one at a time, to keep the locum position filled or to prevent overwhelming your housing or vehicle resources. You’ll create a provider pool of recurring providers.
When you talk with a prospective locum provider in a pre-assignment interview, let them know you’re looking for a recurring presence. Set an expectation up front that if the provider is a good fit, the first assignment could be the beginning of an ongoing relationship. (Better yet, let your Wilderness Medical Staffing account executive know you’d like to establish a locum pool and we can help you connect with providers looking for just that sort of rotating presence.)
Benefits of Recurring Providers and Provider Pools
We’ve found that adding recurring providers to your locum tenens pools is not only helpful to your facility, but it provides consistency of care for your community and creates steady, but flexible work for your locum tenens providers. Here are some additional reasons why using recurring providers is always a win for your facility.
- After a provider is in your facility for the first time, they don’t have to re-discover how you operate your clinic, and that takes a training and education burden off your staff.
- The provider learns your EMR and is already familiar with return trips.
- The provider gets to know the permanent staff and patients.
- The provider gets acquainted with the community in general and gets familiar with the climate, recreation in the area, etc.
- The staff knows what to expect from the provider’s practice style and experience.
- The initial questions about where to find, how to do, who to call, etc., have been addressed.
- Returning to a previous location is much easier for the provider when they know the clinic housing, amenities to expect, and travel route.
With a rotating provider pool model, occasionally someone will take a permanent job, retire, or for one reason or another, drop out of the mix. But while you look to replace that provider, if you have two or three people who are still in your rotating pool, you should be able to introduce a new person to the group without too much disruption.
Many people work locum jobs as their main source of income like having recurring assignments, for all the reasons discussed above. If you make providers aware of your goal of creating a rotating pool, they may even have suggestions to offer for someone who would be a good fit for your facility and staff. Be vocal about your goals. Providers share opportunities with their friends, as you’d expect.
Structuring Recurring Locum Tenen Provider Rotation Schedules
You can create a regular locum tenens provider rotation cycle, such as a month-on, month-off routine; or you can opt for episodic coverage, perhaps a few times a year as you have needs. Either way, using the same providers regularly can benefit everyone, and gives patients familiar names and faces to encounter, even if the provider is only in your community occasionally throughout the year.
When you identify a provider or two who you’d like to have return, it would be helpful to discuss your scheduling needs with them (if possible, even while they’re on site) and determine if they’re available to return when you need coverage.
One issue with temporary duty staff is that just about the time the person gets comfortable and knows their way around the clinic, it’s time for them to leave. When you create a rotating pool of providers, you overcome that issue with repeated visits.
Considerations for Solo Provider Sites
If you’re staffing a solo site, it can be even more critical to have providers who become established and familiar with the location and patients. If you create a pool of people who have worked at your site and are familiar enough to slide in easily and pick up where they left off from their last trip, the stress of having locum providers decreases significantly.
How to Address Housing for Locum Tenens
A difference between your full-time staff and your locum tenens is that they will need to have a temporary place to stay when they are working at your facility. While figuring this out upfront is important, don’t let it be a deterring factor in working with locum tenens.
Even in some of the most austere and remote villages in Alaska, our clients and our team can secure housing for locum tenens.
Whether your organization owns housing or rents lodging, please be sure that the space is clean, outfitted with basic supplies for the kitchen, bedroom, and bath; and that you’ve identified a point of contact for any housing issues or questions that may arise when a provider is in residence. Housing can be basic and still clean and comfortable; that’s the minimum standard you should use.
To be most welcoming and increase the chances of provider interest in returning, consider providing WiFi, TV, and any additional amenities/comforts that are reasonable options. Remember, people who travel to your community to work are usually a long way from home and family, and especially in bad weather, need access to the internet and enough “comforts of home” to make their space welcoming.
Get Creative with Housing
Depending on where your facility is and the type of facility you work at, you may have simple housing options. Perhaps an apartment or small house nearby can be used as provider accommodations.
However, if lodging for locum providers is a problem, get creative in thinking about options. Is there a hotel or Airbnb in the community you could rent for temporary lodging? Does your clinic have a space that could be used for a private room for a locum provider? If so, be sure there’s an option for kitchen facilities, showers, etc. Another option is using an RV for provider housing. Is there an RV in the community that can be used?
If you need to get creative with housing, be sure that your healthcare providers will be able to get the rest and privacy they need, so they can perform their job at your facilities to the best of their abilities.
Using Google Calendar to Schedule Your Locum Tenens Provider Rotation
One simple tool that can make scheduling your locum tenens easy for everyone is Google Calendar. Here is a simple setup of how to use the calendar. For a more in-depth guide on how to use Google Calendar, reference this guide.
- Create a shared calendar using color blocking for each person.
- Add work dates and any pertinent notes for permanent staff as well as locum staff.
- Invite everyone who is scheduled on the calendar, as well as essential support staff, to have access to view using each person’s Gmail address.
- Edit the permissions so only select people can add to or edit the calendar, but everyone can view and keep up to date on who is working when.
Google calendars can be viewed by anyone who has the link to access, regardless of whether they’re on-site or not. The calendar app can be added to phones and makes checking the schedule to see who’s working, who’s off, and other relevant information, very simple, from any location.
Once you have your locum tenens provider rotation scheduled and listed on your Google Calendar, you can work through the details of who you’ll use for scheduled patient visits, who will be on call, who will cover same-day/walk-in patients, etc. This makes managing the clinic, especially in a multi-provider setting, easier for everyone, particularly for staff who are scheduling appointments and managing patient flow.
By doing some work in advance to plan with the provider, you can begin to build a staff calendar several months in advance and be more responsive to last-minute changes or gaps when you know who you have to work with.
Strive to be a facility with a reputation that attracts good people. The surest way to create a successful rotating locum model is to create an environment that is attractive in every way: welcoming, organized, responsive, offers competitive pay and encourages temporary staff to return.