October is here — along with a chill in the air, fall leaves rattling in the streets, and spooky yard decorations. It’s also the perfect time to share locum tenens horror stories. Before you click away from this article screaming, keep in mind that everyone has skeletons in their closet. But they also have the hard-learned experience and advice to help you avoid these situations in your own hospital or health system. Here are a few of our favorite locum tenens horror stories along with ways you can prevent them from haunting your doorstep!
Locum dentist brings escort to work
When a dentist who signed a three-month contract in a rural northwest Kansas community sent a message that he was delayed 24 hours getting to his assignment, the staff was understanding. Then he showed up to work unshowered, smelling like alcohol and sweat. Even so, the staff decided to give him the benefit of the doubt, thinking maybe something had happened on his drive.
“He had not checked into the housing they had set up for him,” recalls Sasha Randolph, recruitment and retention manager at the Kansas Recruitment and Retention Center. “That night, the CEO called him, and he said, ‘I do not want to sleep at the hotel. I’m sleeping in my car.’ She tried to make other arrangements, and this was a rural location so it was difficult. The next day, he’s supposed to be at a breakfast meeting with other providers, and he brings in an escort — a call lady he had met on the side of the road.”
Because the CEO had a stop clause allowing her to end the contract if there was any dissatisfaction, she quickly dismissed the dentist and found another provider, Randolph says. And this experience had a big impact on the way she screens locum providers today.
“That was the first big horror story that made me stop and say, ‘What does the background check look like? Had they practiced somewhere else? Were there testimonials of their work life?’ I had not been asking for it or recommending my clients ask for it,” Randolph says. “I never went back to look at this provider's references, but we put some new policies and procedures in place to make sure it didn’t happen again.”
Sexual harassment within hours on the job
Mark Douyard, a senior physician recruiter at Bayhealth, recalls what he describes as the most “outrageous” incident in his career.
“We had an emergency medicine doctor who, on his first night shift, actually pulled a radiation tech onto his lap and said, ‘You’re kind of cute’ while he was sitting at the nurses’ station,” Douyard says.
While Douyard admits this was an isolated incident and he doesn’t think the hospital could have avoided it, it’s important to note that staff members quickly reported the situation.
“He lost his license over the issue, and his assignment was cancelled as soon as people found out about it. Maybe he was fooling around, but obviously the other people involved didn’t think he was joking,” Douyard says. “Could it have been prevented with more screening? Maybe.”
You’ve probably felt inadequate at work at times or woefully unprepared — but you probably haven’t impersonated a physician. Steve Jacobs, physician recruitment manager for Einstein Healthcare Network and president of the Mid-Atlantic Physician Recruiter Alliance (MAPRA), says his locums horror story “takes the cake.”
“The worst incident we ever had was a person who presented themselves as a physician, but they weren’t a physician,” he says. “They had the CV written out with medical school and all kinds of stuff, but it was really obvious they didn’t know what they were talking about. The locum company bought into it and moved the CV on to us. We did some digging, and it turned out they weren’t even a medical doctor — they were a botanist.”
Although Jacobs is proud they caught the mistake before sending the “doctor” on for credentialing and privileging, he recognizes that this was a training issue where a staff member didn’t review the CV properly. He says it’s also important to vet locum tenens providers the same way you would a permanent provider.
“The pandemic changed the playing field. Now I can actually do a Microsoft Teams meeting with locums and see who they are and get a feel for them. Before it was a call on the phone,” Jacobs says. “We now have our chairperson talk to them as the group leader and do a little more due diligence. It’s a balance of the agency sending someone and me doing my fact-checking.”
Fighting over who “owns” the locum
Locum tenens horror stories aren’t just limited to the locum providers. Sometimes working with a locum tenens agency can be a nightmare.
Jacobs says the worst experience he’s had with an agency was when a recruiter at a locum tenens agency starting fighting with him over control of a locum tenens candidate.
“The candidate was sent over by the company, and I said, ‘No, we already had that one presented by another company.’ They said, ‘Prove it. We need to see who that is. Otherwise, we’re going to charge you,’” Jacobs recalls. “It was an overzealous locum agency employee not knowing I keep track of every locum presented to me. I said, ‘If you ever want to do business with me again, you’ll back off right now.’”
Douyard says he has also faced this issue, receiving calls from an agency saying the candidate had an exclusive agreement with them. “They were going to bill me for his hours, and we ended up using the doctor through another company. No doctor signs an exclusive agreement with a locums company,” he says. “They pestered me constantly for two or three weeks.”
Fortunately, the solution to this situation is keeping clear paperwork about the agencies you worked with to bring specific doctors on board, Douyard says.
Jacobs reminds recruiters that they dictate what happens, not the agency they are working with.
“You’re in a lot more control than you think you are in terms of the contract and the relationship. They work for you, not the other way around,” he says. “I learned early on that if I said no, they were either going to disappear or listen. If they listened, then we would meet halfway and maintain the relationship and move forward.”
Best practices for preventing locum tenens horror stories
One of the best ways to get quality locum tenens providers is to create a “locum toolbox” to refer to, Randolph says.
“I reached out to other organizations who had been using locums and asked ‘What are you looking for on the provider side? What are you looking for on an agency side? What communication or stopgaps can you do on the client side?’” she says. “I needed to know what kind of resources people were using and what I could implement internally to make sure no horror stories were happening. If you don’t have a system or process set up, you cannot be successful.”
It’s also important to keep clear records on who you’ve been working with, Douyard says, and keep in touch with the agency and the physician.
“I have met and communicated personally with every locum doctor who has worked here in the five-and-a-half years I’ve been with the company,” he says.
Finally, Jacobs points out that having an organized process is key.
“When I started here, everybody was doing their own thing when locums came into their department. There were 57 different processes going on at one time. We stripped it down and centralized it through me,” he says. “We have four people: one for payor credentialing, one for medical staff privileging, one for malpractice, and one for HR. You have to simplify. If you’re waiting for ‘John’ to come back from vacation to make a decision, you’re going to have a hard time getting your process to work.”
Most locum tenens providers are talented clinicians of the highest quality, but when you first start hiring locum tenens, it can feel like stumbling about in the dark. However, with the right planning and preparation, you can have a great experience hiring locum tenens…and avoid the horror stories.
What are the pros and cons of hiring locum tenens providers? Find out in the CHG State of Locum Tenens Report