Locum tenens is a Latin phrase that means “to hold a place”. A locum tenens physician is a “placeholder” or one who temporarily works in place of the regular physician when they are absent. Locum tenens physicians play an important role in healthcare because they allow for continuity of patient care when a practice is short-staffed or when a physician is gone for vacation, illness, sabbatical, training, etc.
Locum tenens can be a valuable experience for physicians all throughout their career. A new grad can try out different types of practices in different locations to see what they like before committing to a full-time position. Some physicians enjoy the opportunity to fill-in for a friend from medical school/residency or help a colleague who trusts them with their patients. Physicians who experience a sudden job loss or who may be looking to bridge the gap can work as locums to make some extra money. Physicians who are later in their career can use locum tenens to begin scaling back their practice or work locums after retiring to continue practicing on a limited basis.
Before you jump into your first assignment, however, be sure to consider the medical malpractice insurance implications of being a locum tenens physician.
Working for a Locum Tenens Placement Agency
If you are working through a locum tenens placement organization, that company will likely provide your medical malpractice insurance. Be sure to ask about the coverage that is being provided for you (what company, what limits, what policy type, etc.). If they are providing you with Claims-Made coverage, ask about tail insurance so that you’re clear on who will be responsible for purchasing it after you leave. If it’s not already spelled out in your employment contract, make sure you get it in writing so there is no confusion when the time comes. It’s also wise to keep a copy of your certificate of insurance or policy declaration page for each year that you work for the locums agency, so that you have record of the insurance that was provided for you during that time. You will need this information for future malpractice applications, credentialing forms, or in the event that you need to report a claim.
Filling in for a Friend/Colleague
If you’re not working for a locums agency, you can still work as a locum tenens physician on your own. The most common situation is filling in for a friend or colleague while they’re gone. Often, a physician’s medical malpractice insurance policy affords them a set number of free locum coverage days per year. This means that a locums physician can be endorsed onto their policy at no charge, and that locums provider would be covered in the event that a claim occurred resulting from services rendered while they were working for the insured physician. Most insurance companies will require underwriting approval before they allow a locums physician to be endorsed onto the policy.
If it’s not possible for the locums physician to be covered under the insured physician’s policy (due to state requirements, availability, or other issues), they can request their own individual coverage. Often insurance carriers are willing to write short-term policies for only the period of time in which the locums physician will be filling in, as opposed to the typical annual policy.
The Hidden Risks with Tail Insurance
As mentioned above, it’s important for locums physicians to learn about their tail requirements as part of their contract negotiation with a locums agency; however, there are other (often hidden) risks for locums physicians to be aware of. Before you fill in for your friend or colleague, be sure to check the tail requirements if the insured physician carries a Claims-Made medical malpractice insurance policy. As long as the primary physician keeps continuous coverage, there will be no issue with coverage for the locums provider. But if he/she cancels coverage, fails to pay, or drops coverage for any other reason and then fails to purchase a tail policy or secure ongoing coverage, there may not be coverage for the locums physician. Be sure to discuss this risk with the physician that you will be filling in for and get a statement in writing, if necessary, to make sure you will be protected.
Another hidden tail insurance risk for locums physicians affects those providers who have retired and then want to go back to work at a later time. As discussed in a previous blog post, many carriers offer free tail insurance for providers who are fully retiring from the practice of medicine. If a provider retires, earns their free tail, and then wants to go back to work (as a locum tenens physician or otherwise), the previously offered free tail can potentially be voided. Providers with Occurrence coverage will not have this issue, but those on Claims-Made policies should ask their insurance agent or carrier before jumping back into practice after retiring.
Locum tenens work can be a fun, fulfilling way to earn some additional income, travel, and gain more experience and knowledge, but before you jump in, make sure you’re asking the right questions. Talk to a knowledgeable malpractice insurance agent to make sure you’re prepared and protected as you venture into the world of locum tenens.