Due to the rising shortage of physicians, many healthcare organizations are using locum tenens physicians to fill the gaps. Locum tenens providers provide hospitals with the ability to fill absences while still providing patient care. Just like using permanent staff, utilizing locum tenens for a short period of time can open your organization to certain legal and regulatory risk management questions. It is important for healthcare facilities to be aware of these issues so they can be prepared for at the time of hiring a locum tenens physician or advanced practice provider (APP).
Malpractice Insurance Coverage
It is very important that you notify your malpractice insurance carrier of the locum arrangement to ensure that your medical malpractice insurance policy covers physician services provided by a locum tenens provider. In many cases, locum tenens staffing companies under their medical malpractice policy cover the provider up to the statute of limitations.
If you are working with a locum tenens staffing agency to source locum tenens for your facility, then it is expected that they will verify that the provider has malpractice coverage. If you are working directly with the provider, you should verify what type of private medical malpractice insurance coverage they carry. If the physician or APP negotiates their own malpractice insurance, then it is important that it meets any applicable state laws and applies specifically to locum tenens work.
The Importance Of Choosing A Locum Tenens Employee With The Same Specialty
Hiring a locum tenens with the same specialty as the provider they are replacing can help reduce liability for the healthcare organization. While finding locum providers with a specific specialty can take more time, in the long run it will ensure each of your center's patients are provided with the care they need.
For example, you would not use a locum tenens internist to work in a practice that generally treats mostly pediatric patients. Inevitably, situations will arise that will put the internist in charge of treating a pediatric patient, and it’s highly possible they won't have the skills or knowledge required.
The better fit would be hiring a family practice physician who specializes in seeing both adults and children. Having a locum tenens provider who is qualified in the required specialty allows other providers in the practice to remain focused on their tasks rather than having to step in to assist them .
Specify Skills and Case Loads before Hiring
When searching for a locum tenens you should be upfront about the required skills and time commitment required for the temporary position and that this information is conveyed to the potential hire. For example, if your practice sees a high number of patients with autoimmune disease, it is important to disclose this to the potential locum tenens candidate to ensure they have the necessary experience and expertise to treat these patients.
You should also be upfront about the time commitment needed to fill the required position. Some physicians are comfortable working a 24-hour call shift, while others may balk at the time commitment. By having these conversations during the screening process, healthcare organizations can understand any limitations the locum may have before seeing patients, making liability related issues less likely to occur.
Verify Physician Documentation and Licensing
During the hiring process, it is critical that you ensure the locum tenens physician has all documentation and licensing requirements up to date. Each state medical board will vary in its processes. In many states the licensure process can take six months or more. Lean on and understand what your staffing agency does to verify criminal background, education, training, board certifications and past privileges.
Locum Tenens Orientation
Once the locum tenens physician is accepted for a position, you should schedule time for them to become acquainted with your facility, staff and equipment. The orientation should cover:
- A tour of the facility (including the location of medications, supplies and equipment)
- Who the point of contact will be for the duration of the locum tenens contract
- Code of conduct and specific rules important to the organization
- The medical records system
- The process of ordering tests and follow ups
- The referrals process
- Where the healthcare organization stands on prescription drugs
By having a thorough discussion about the practice environment and your expectations, you will reduce your chances of unexpected situations that could affect the quality of care provided.
Understanding Compliance with the DEA
Because it is common for locum tenens physicians and APPs to practice in a variety of states, it is important that you verify that the locum physician or APP has a separate Drug Enforcement Administration (DEA) registration for the state you are located. In addition to national DEA registrations, many states have their own regulations and CSR (or controlled substance registration).
Additionally, you or the locum tenens agency should have an upfront conversation with the provider about complying with DEA and state registration in order to avoid potential liability risks. To verify a practitioner's registration for credentialing purposes, you can request a copy of their registration certificates which should include the issues and expiration dates.
Maintaining documentation is a regular occurrence for all healthcare organizations. Because the nature of locum tenens position is temporary, any patient that a locum tenens physician sees should be thoroughly documented. Expectation is that it should be documented–any patient, not reliant on LT or not. It should be done timely. If follow up appointments are required, then the handoff of the patient should be carefully coordinated with your core staff to avoid any gaps in coverage once the locum leaves. Failure to document and coordinate followup care can open your practice to significant liability.
How Staffing Agencies Share Risk
Healthcare staffing agencies are one way that facilities can lower their risk of liability and save time and resources hiring locum tenens. Locum tenens staffing agencies provide you with pre-approved candidates for your open positions. The staffing agency does all the legwork to ensure that the locum tenens physician has all the necessary documentation to work at your facility.
Health Carousel works to deliver highly qualified healthcare professionals across a range of healthcare professions. We deliver innovative and customizable solutions for both workforce management and healthcare staffing. Contact us today to learn more about how we can help your healthcare organization with locum tenens staffing.