Locum Logistics (How Providers can Get There from Here)

After wading through that tome-of-a 5th chapter on the legal and financial considerations of working locum tenens, you’ll find this chapter short and simple. Now we prepare you to actually “hit the road,” get to the hospital or clinic where you’ll fill in, and settle into your temporary living quarters (unless your assignment is close enough to “home” for you to drive back and forth).

In Part 6 of Locumpedia’s No-BS Guide to Locum Tenens, we’ll cover:

Section 1: How Much Travel Does Locum Tenens Involve? Will I Ever Be Home if I Do This?

Once again, let’s be honest: Traveling for work can be both a blessing and a curse.

Yes, there are frequent-flyer miles to accumulate (albeit, less generous than they once were), hotel-stay points to add up, and places to see beyond where you’ve lived or visited previously.

However, let’s be real,traveling can be stressful.

You’ve probably traveled by air before, so you know the drill. But just as a reminder (and because it makes for great spoiled-American sarcasm)…

First, there’s the packing — lightly and efficiently, if you want to avoid the risk of your belongings boarding a different plane than the one you’re on because you had to check them.

While you’re culling unnecessary or impractical items from your potential “cargo,” you might as well remove anything that could be used as a “weapon” from what you carry day-to-day. Otherwise, TSA screeners will remove and keep those items for their ‘things-people-try-to-bring-onto-planes’ stockpile.

Also, there’s the volume limit on toiletries, and the requirement they be segregated in see-through ‘packaging’ so TSA agents can view them as your bag(s) pass through the scanner. Nothing of volume more than 3.4 ounces (100 milliliters) or less per item, got it?

You’ll need to remove all things metallic from your pockets and the watch from your wrist, along with the shoes from your feet and the belt around your waist (should you wear one). Those must be scanned via X-ray, as well. Oh, and remove that laptop from your bag and place it in its own bin for scanning.

You must arrive at the airport at least two hours before your scheduled domestic flight (add an hour for international travel) to ensure you make it through the security checkpoint before your flight boards — unless you’re not checking luggage.

TSA precheck is a must for a hassle-free airport experience for locums. The benefits of precheck more than make up for any cost and the weeks it generally takes to get approved once it reduces your pre-flight arrival time by as much as an hour.

It’s also helpful for physicians to unpack as little as possible between trips, so adding clean clothes is the extent of packing for the next trip. The only thing you ever need to take out of your luggage should be your laundry.

How Long is an Average Locum Tenens Assignment?

Locum tenens placements were originally only for two weeks at a time or less and were primarily to assist doctors that were on leave or absent for vacation. But in recent years, assignments have become much longer from five weeks to as long as six months. Almost 40% of clinicians prefer assignments that last between one and four months, and 16% prefer assignments between nine and 12 months.

Some locum physicians experience unsatisfactory housing conditions and struggle with unfamiliar documentation and billing systems. But, the length of the job won’t ever be a mystery. The duration of locum tenens jobs is always a known entity.

Why do assignments vary so much? The reason for coverage, of course. A provider may need to cover a sudden hole until a hospital can find a permanent replacement. Other common, seasonal needs include vacation coverage or extra coverage for a hospital expansion.

While noting that assignment length varies based on client situations and needs, most locum assignments last between two weeks and two months.

Pegging the typical locum tenens assignment at 3 to 6 months for hospital medicine there are opportunities to manage locum tenens work while allowing for your travel time in this post.

Are Travel Expenses Covered for Locum Tenens Doctors?

In short, YES, generally.

If your assignment requires flying, an agency rep will work on securing a flight that accommodates your schedule. In most cases, you have no out-of-pocket costs unless you decide to upgrade or make in-flight purchases.

Most agencies will reimburse you personally for the cost of a flight if you choose to book it on your own unless you choose to fly first class. Agencies typically only reimburse for reasonable and customary costs.

Even though you’ll be responsible for other add-ons — like seat upgrades, in-flight services or food, and alcoholic beverages — some of these things may be tax-deductible since you’re a 1099 contractor. You’ll need to consult with your tax advisor to learn more — don’t just take our word for it!

In the event you decide it’s easier or more convenient to drive your own car to the assignment, you’ll generally get reimbursed for the miles you travel at the IRS standard mileage rate.

Will I Have to Pay for Transportation If I Want To See My Family While On a Multi-week or -month Assignment?

Again, yes, most likely.

While this is agency-dependent, and not addressed publicly online, most family-related expenses for a locum tenens assignment are the contracting physician’s (or other clinician’s) responsibility.

This makes common sense, right? If it weren’t the case, the benefits of working locum tenens really wouldn’t be equal for providers with and without families in the picture, would they?

Looking at the question from the hiring facility’s perspective, it’s easy to appreciate that the hiring entity needs a physician to fill an open slot. It expects to pay for expenses related to getting the provider there, housing them during said assignment, and returning the provider home once the contracted assignment is over. Accommodating a provider’s family-related needs would add to the already-elevated cost of filling the clinic or hospital’s staffing gap.

However, this is not to say that, in difficult-to-fill situations, a willing physician couldn’t negotiate some family-related accommodation into the locum tenens contract. As seasoned locum tenens providers have noted, ALMOST everything is up for negotiation BEFORE the contract is signed by all parties involved.

What If I Want to Bring My Family Along?

Doctors may like to bring their families along and make the locums assignment a working family vacation.

Staffing agencies often help with the travel arrangements for family members, too. But you’ll likely have to cover the cost of airfare. Here are additional things to consider when you take your family on an assignment with you:

Be sure to let the agency planning your housing know early that you will be bringing the family. If the cost of housing the entire family is more than the allotted budget, then you may have to pay the difference. Whether you have a spouse, significant other, children, pet, or any combination of those, agencies will often work with you to make sure everyone can tag along.

Agencies staff full travel teams that arrange all travel for your assignment. This is all dependent on the length of the assignment, but agencies find comfortable housing in apartments, extended-stay hotels, or vacation homes in the community when they can. For onsite interviews for permanent positions, clients also cover travel, hotel, and related expenses.

Section 2: What About Housing? Will I Stay in Hotels All the Time?

Many of us would welcome staying alone in a quiet hotel room for a few days or weeks, especially if that hotel is in a city or town offering new things to see and do, plenty of (affordable) places to eat out, and meaningful work at above-average rates of pay.

Sounds almost like a dream, right?

Nevertheless (as we’ve alluded to in previous sections) not all travel accommodations are quiet and comfortable; not all locales are accessible and entertaining; and neither the work’s importance nor the paycheck premium is worth tolerating the personalities, politics or processes involved in completing, or extending, the assignment.

This is not to completely rain out your ‘locum tenens parade,’ but to suggest you remain realistic about where you’ll stay when traveling for work. (Hey, at least you won’t be required to share a hotel room with a coworker, as we’ve heard some MAJOR retailers expect their managers to do.)

The average locum tenens assignment will place you in an extended hotel stay, which is perfectly fine for one person, but maybe not an entire family. If needed, agencies will find accommodations to account for an entire family. The full expense might not be possible, but agencies will do their best to work with you.

Accommodations will likely be more similar to an extended stay vs. a cozy house rental.  This probably won’t be your home away from home, but if you have any questions or happen to hit a snag in your travels, the agency will be available at your every beck and call to provide help. Most companies have entire departments specially dedicated to handling travel details.

Physicians can specify lodging expectations in their locum tenens contract— minimum standards, at least. Asking for a small apartment, which affords both privacy and kitchen access, also helps physicians avoid expensive or unhealthy meals. Typically, locum companies will not cover your food expenses, but if they do supply lodging that allows you to control food expenses. So, put this in the agreement!

Section 3: What About Food and Incidental Expenses (e.g., Laundry) Who Pays for These?

For those traveling to locum assignments, travel, tolls, and housing are all covered by agencies. Which means you are responsible for any personal expenses from laundry service to meals.

But even if all your costs aren’t covered, you’re operating as an independent contractor and some of your expenses can be deducted from your tax deductible. A tax professional can help you better understand what’s needed to report.

If a provider takes a local job that’s within driving distance, agencies can cover the cost of gas or reimburse mileage, but those are things a provider needs to negotiate on the front end.  Always get these things in writing before accepting any locum work. There are not many significant incentives for travel for locums. For the job, it’s a necessary evil.

Keep in mind though, that high-demand jobs needing to be filled immediately give you the most leverage. If a hospital is desperate enough for a provider, they could agree to pay you more to come out on a moment’s notice, in which case they’ll meet more of your requests. However, don’t assume that you’ll receive the very best housing or travel benefits when you’re negotiating a contract.

The onus is on the provider to clarify to a locum agency what their role is in travel assistance and to get any changes to the travel terms in writing.

Travel costs on these medical-staffing assignments are typically reimbursed and you may also receive a per diem for meals and incidentals.

Testing a Theory

To test out this theory of per diem meals and incidentals, we used our Locumpedia Search engine, which allows physicians, CRNAs, and advanced practitioners to search job listings posted on staffing agency websites from a central location. The search engine is free to use and does not require registration by employers or by job seekers.

Guess what: When we searched “per diem for meals and incidentals” among industry job listings, Locumpedia Search came back with more than 1,000 responses containing at least “some search terms.” So this theory of per diem and incidentals being covered is a valid one.

Unlike traditional job boards, which require registration; verification; expensive fees; and manual posting, staffing agency jobs are included in Locumpedia Search automatically with no action needed by agencies. Right now, physicians can access more than 30,000 locum tenens opportunities, and this index is continuously growing. (Don’t mind our shameless plug.)

Anyway, back to per diem and incidentals. This is not to say ALL locum jobs offer per-diem reimbursement for meals and incidentals, but just about everything in the locum tenens business is up for negotiation, including the details of your travel.

So, to summarize: NEGOTIATE, NEGOTIATE, NEGOTIATE! (And stay safe and healthy out there.)

Next Up: Making Locum Tenens Your Practice Style.