In the Medium Sized Companies category, Staff Care was a winner. Staff Care is a division of AMN Healthcare. According to Staff Care, they have grown 20 to 40 percent annually since their establishment in 1992, with no debt or reduction in workforce. Pretty good in today’s economy. Among other things, Staff Care provides an employee assistance program to employees and their families, and has a healthwise program to help employees manage their health and fitness.

In the Large Companies category, CHG Health Care Services was a winner. CHG is the parent company of CompHealth, Weatherby Locums, Destination Healthcare Staffing, RNNetwork, Foundation Medical Staffing, and AHR Pharmacy Solutions. CompHealth is the founding company in the suite of companies, and was started in 1979. According to CHG, “putting people first isn’t just the company’s philosophy, it’s integrated into every aspect of the company.” Among other things, the organization places a great deal of emphasis on employee communication, provides flex-time, and telecommuting schedules.

What does this mean to you; the pysician, nurse, or allied health care provider? If these companies take such good care of their employees, you can be pretty sure those employees will turnaround and take pretty care of you.

Again, congratulations to Staff Care and CHG Health Care Serivces, their employees, and the medical professionals who work with them.

Of course, you may be enjoying a different practice type in your locum tenens assignment (one of he great benefits of locum tenens work). But you can generally expect to have similar circumstances regarding holidays as you do at your home base. The most important thing to remember is to talk with your locum tenens recruiter about holiday work before you accept an assignment. And if you are are expected to work a holiday, what about the pay? Maybe you are just expected to take call. What pay is involved with that?

And while you are pondering which locum tenens assignments to take, please take a moment today to thank a vet. We all owe them.

Physicians have always filled in for one another to make it feasible to take vacations, attend meetings for CME, and such. But at some point, actually in the late 1970s, the practice of filling in for other physicians became formalized as the locum tenens industry.

Alan Kronhaus was involved with a program funded by the Robert Wood Johnson Foundation that helped provide medical services to under-served areas. He then started KRON Medical, one of the first organized physician locum tenens organizations. He sold the company in the early 1990s. So, what he doing now?

From what we can tell, Dr. Kronhaus got back to the basics of medicine and formed Doctors Making Housecalls in Chapel Hill, NC.  He is also the health and wellness editor for Boom Magazine. Check out either of these websites to learn more about what Alan Kronhaus, a pioneer of the locum tenens industry, is up to.

A friend recently told me that as a locums, he explains his situation as similar to other doctors in the practice taking call for a colleague. Simple. Straightforward. And according to him, quite understandable to the patients. Trust is the biggest issue, and if they know their regular physician trusts the newbie, so do they.

What is your experience with informing patients about locum tenens and their place in the world of health care? Let me know. I would love to hear about it.

If you don’t want to be contacted by anybody selling anything, first and foremost, don’t give out your phone number. Did you know that even when you give your phone number and address information to the American Medical Association, they sell the information? You can opt to keep you contact information private. Do you? Can you remember if you told them not to publish the information? I doesn’t matter how many times you tell a search firm or locum tenens company to stop calling you or mailing you information, you will still keep getting bombarded from other companies…because they are most likely getting your information from the AMA.

What if you have given out your personal information? You have some options. If you want to stop phone calls, get registered on the National Do Not Call Registry. You can get on the list for an initial period of five years by registering at www.donotcall.gov. The Federal Trade Commission manages this service. Tell any company calling to stop calling, and that you are on the FTC Do Not Call register.

Although not managed by a federal entity, the Direct Marketing Association has developed a Mail Preference Service. The service lets you register with them with the intent of substantially reducing the amount of advertising mail you receive. This method isn’t perfect because it is not backed by any law. Companies voluntarily scrub their mailing lists against the service and remove names and addresses of those individuals who do not wish to received advertising mail. It makes sense for the advertiser because they save money on printing and postage by not sending ads to people who up front say they don’t want them.

Email addresses are the latest and greatest method of getting in touch with physicians. Great, if that is your preferred communication medium. But what if you keep getting contacted by a company and you just want it to stop? By federal law, every advertising email a company sends you must contain information on how you can “opt-out” of future emails. You can contact the FTC or go to their website to get information on the CAN-SPAM act (no, not the pseudo-meat). A company has a set amount of time to remove you from their list, or the FTC can levy fines of up to $11,000 per infraction. Ouch.

Again, many companies, including locum tenens firms, have great news for you and offers that really will make your life, or practice, better. But it should be on YOUR terms.

Even the term locum tenens is odd. It is used as a noun, “She is a locum tenens.” And it can be used as an adjective, “She is a locum tenens psychiatrist.” But the Latin grammar aside, why is locum tenens the oddest industry on the planet?

Most companies have a product or service that they offer for sale. They have that product or service ready and available so that when a person is interested and wants to make a purchase, a transaction follows, money changes hands, customer and proprietor are happy. As long as the proprietor or company keeps providing a great service and as long as customers keep coming and paying for that product or service, business is great.

Locum tenens works in a very different way. Locum tenens companies have two sets of customers to whom they must sell. Set one is a group of medical facilities that need temporary help for any number of reasons. Maybe they are recruiting and haven’t yet found that perfect emergency medicine physician. Maybe their census rises for three months every year and they don’t want to hire full time nursing staff year-round, when they really just need the extra help for those three months. Possibly, a dentist is going out on maternity leave and they need someone to fill in for three months until she comes back to work.

The second set of customers a locum tenens company has is medical providers, whatever their niche is. We will use physicians for our example here. Locum tenens companies provide great work experiences for physicians who want something temporary, whether temporary to them means two weeks or two years.

Now here is the odd part and what makes the locum tenens industry the oddest one on the planet. Locum tenens companies’ customers are also the product or service that they sell. They need to bring on medical facilities as a customer and then they turn around and sell them as a product. And they bring a physician on board as a customer, and then turn around and sell him or her as a product to the medical facility that they just brought on as a customer. It is a “Catch 22.”

In the industry, the term “fill rate” means the percentage of requests from a medical facility (customer) that the locum tenens agency is able to take care of by providing a locum tenens physician (product). So if three hospitals each need one physician and the locum tenens company provides each hospital one physician, the fill-rate is 100%. That rarely happens over the entire spectrum of medical facilities that any locum tenens company works with.

Numbers on locum tenens fill rates are difficult to find. But Staff Care publishes documents from time-to-time that have such information, and we will use their numbers here1. Although the data is a few years old, one could assume they are similar today and similar for all locum tenens companies, not just Staff Care.

• 2003 fill rate was 63%
• 2004 fill rate was 58%
• 2005 fill rate was 63%

So you can see that at best, a medical facility only gets the product/service they want about 2/3 of the time. The other 1/3 of the time they are just out of luck.

On the physician side, there isn’t a “fill rate,” but a rather telling statistic about how physicians make sure they get temporary jobs they want. Physicians who want to work locum tenens sign up, on average, with two or three locum tenens companies.

In reality, the medical facilities also sign up with two or three or seven or twelve locum tenens companies too. On each side, the theory is that the more locum tenens companies they sign up with, the better their chances of get the product/service they want.

Can you begin to see why locum tenens is the oddest industry on the planet?

• Customer one is the product/service for customer two.
• Customer two is the product/service for customer one.
• A locum tenens company works with the same customer number one as all of the other locum tenens companies.
• A locum tenens company works with the same customer number two as all of the other locum tenens companies.
• Both customers one and two feel the need to sign up with multiple locum tenens companies to get their needs met.

So is it worth it? Of course. Most locum tenens companies have year over year growth rates. Physicians, or other medical providers, are in the driver’s seat, as they can work 100% of the time if they are willing to take assignments that may not meet 100% of their requirements for the perfect assignment. Medical facilities, although they don’t get their needs met more than 2/3 of the time, at least get that 2/3, which is better than getting no help at all. And the biggest winner in the entire spectrum of the locum tenens industry is the ultimate customer; the patient.

When locum tenens are in place at a facility, patients continue to get great care, facilities can continue to provide that patient with a continuity of care that they would otherwise not be able to provide, and the patients get the best, most qualified medical providers that the profession makes available.

Reference: Staff Care Inc. 2005 Review of Temporary Physician Staffing Trends.

On Assignment at NASDAQ

The opportunity was in celebration of On Assignment’s 16 years of trading on NASDAQ. On Assignment, parent company of locum tenens firm VISTA Staffing Solutions, is a diversified professional staffing firm providing flexible and permanent staffing solutions in specialty skills including Laboratory/Scientific, Healthcare/Nursing/Physicians, Medical Financial, Information Technology and Engineering. The Company provides contract, contract-to-hire, and direct hire placements. On Assignment, Inc. was founded in 1985 and went public in 1992, and has projected revenues of over $600,000,000 in 2008. On Assignment is one of the largest Healthcare/Professional Staffing firms in the U.S.