Lisa Grabl

The locum tenens industry first started in 1979. Since then it has become an integral part of healthcare by helping keep facilities appropriately staffed to deliver the best patient care. We’re currently facing a healthcare crisis unseen in modern times and the need for locums has never been stronger. 

The COVID-19 crisis is impacting the healthcare community from two sides: demand for care and a high risk of healthcare worker illness. Under normal conditions, the U.S. is experiencing a shortage of physicians, a predicted shortfall of 46,900 to 121,900 

. The shortage will become more pronounced as the influx of COVID-19 patients increases. For example, California is already projecting the need for a minimum of 

. Locums will be crucial to meet this increased demand. 

HIPAA, telehealth, and managing billing staff working remotely

Nurse practitioner Kelly Lueck has been working a Locums assignment in New York since mid-March, helping with the treatment of COVID-19 patients. The need for locums in New York has been extremely high.

“The rooms in the entire ER are doubled up, tripled up, and they are all COVID. I am in a level one trauma center, and even the COVIDs are coming in as traumas. Everyone that comes in, regardless of reason is testing positive for COVID. Someone with an appendicitis came in and it was a positive COVID. It is the craziest thing I have ever seen,” said Lueck.

With healthcare providers on the front lines fighting against a disease for which there is no natural immunity, cases of infection amongst providers are rising and preventing them from delivering care due to quarantine or recovery. A doctor at a major New York hospital shared that as of March 30 more than 

 have fallen sick. Hospitals will need locums to help maintain coverage as those sick take time to heal.

While facilities are adapting to this crisis so is the Locum tenens industry. We are being as agile as we can as we strive to meet the needs of facilities across the country. We’re speeding up all of processes, helping some physicians to find jobs outside their specialty, and even placing some at-risk physicians in telemedicine options so they can still help in the fight. 

With high infection rates and a lack of tests, almost every community needs additional support. Rural communities in particular report they are 

concerned about their ability to handle the increase in demand

 because their populations are generally older and sicker than those in urban areas and they have less access to care.  

Locum tenens physicians, nurse practitioners, and PAs are needed nationwide and in their own communities as well. Locum tenens work is often associated with extensive travel, but locum providers don’t have to travel across the country for assignments. Many locums can work locally by taking additional shifts at a nearby hospital or care facility within driving distance. 

Locums also are well adapted to quickly working. In a recent 

“But a pandemic really shed another light on yet another incredible facet of locums work: we are trained-through this model-to parachute into any environment, EMR, or situation and be highly functional to optimize patient care. Need me in New York? I’ll be packed and on that flight. You have that Electronic Medical Record? I can learn it fast. That’s how you admit? That’s how my other hospitals do it. You’ve got that ultrasound machine? No problem, I’ll watch a YouTube video on how to operate it. No scribes? That’s not an issue, most of my places lack them. I am on my own for emergent airways and traumas? No sweat, that’s a typical day for me.” 

For 40 years locums have been helping facilities deliver quality healthcare to those who need it. These hard-working physicians, PAs, and nurse practitioners are working across the country to provide support to overburdened healthcare systems. Now, more than ever, locum tenens providers are crucial to our healthcare system and are a playing a vital part in ensuring as many people receive care as possible during this crisis.

, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined CompHealth in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

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How the program is assisting during the COVID-19 pandemic.

Locum tenens are crucial during a time of crisis

Have you ever dreamed of quitting your job to go live on a beach in some foreign locale? Or have you always wanted to travel to exotic destinations, but just don’t have the time? It’s possible to combine both of these dreams while you continue to practice medicine: international Locum Tenens assignments allow physicians from the U.S. to practice in places as far reaching as Guam, Australia, New Zealand, Ireland, or Canada.

Finding the right time for international work

International Locums works a little differently than domestic Locums assignments. When working Locums in the states, you can often pick up a shift here or there in addition to your full-time job or you can work Locums exclusively and travel between a variety of shifts. For international Locums assignments, you commit to working full-time in a particular location, usually for six months or longer. 

Doing international Locums is a big commitment and is usually going to be easier to do when you have a natural change in your career. It’s easier to try international work right after residency, before starting a full-time gig, when you’re between contracts, after selling a private practice, or when you are transitioning into retirement.

RVUs: The basics of physician compensation

You are welcome to bring your family with you on international assignments; and if you have school aged children, you are encouraged to enroll them in the local schools. It’s important to check out schools before you go. For example, in New Zealand and Australia the school year starts in January and you will likely want to keep the kids in school for at least a year. 

 had the opportunity to take his family to New Zealand including his three teenage sons. 

“All three children go to school in New Zealand, they have wonderful public schools, the schools are very welcoming to international students. In fact, New Zealand is well known for taking students from many cultures and so they go to school not only with New Zealand students but also students from India, Pakistan, China, Japan, South Africa, England, so they have a very international experience,” said Dr. Gallehr. “It’s a lot of fun to go on a Locums experience with the family. A part of going on a Locums experience is being in another country and it sure helps to have the family around. It’s nice to come home to the family and be with everyone and experience the country through their eyes as well.”  

Pets are another question. If you want to bring an animal friend with you, they may have to spend time in quarantine upon arrival for a few weeks before you can bring them home. 

It’s important when finding an international assignment to plan to live like a local: you will have housing and transportation provided in the town where you work and will act just like a local physician working in the same setting. You are often going to be in places that need your help. Living like a local also means being paid local rates for your services, which are often less pay than you would make working a Locums assignment in the states.  

In addition, the housing, transportation, and medical facilities may be less sophisticated than what you are used to. While everything will be nice, clean, and comfortable, it may be more modest than what you are used to at home. 

“The term hospitalist doesn’t translate; nobody really knows what that is. But one thing to keep in mind is that no matter how much research you do, you have to prepare to be adaptable and flexible.” says 

, who moved his family to New Zealand for more than a year. “This is an entirely different type of system than the U.S. in that there’s no financial or profit-based motive behind healthcare. There are limited resources, and the driving factor seems to be the allocation of resources, so most people have access to healthcare. This is a very positive experience for me.”

A benefit of living like a local is that since you are working full-time you usually get vacation time that you can use to explore your location or neighboring cities or countries. From day trips to see an incredible waterfall to scuba diving throughout the Pacific there are countless opportunities for you to explore while on your assignment. Many physicians will also use the time before or after the assignment for bigger chances to explore the world. 

Simultaneously reduce burnout and boost your bottom line

Once you’ve decided an international job is for you, it’s time to find an opening. You can search job boards of foreign facilities you would be interested in but know that local hospitals may not be open to foreign physicians or be willing to help you with the licensing and visa process. They also may not be willing to pay for housing or transportation.  

The other option is to go through an international Locums staffing agency. Currently, the only U.S. based international Locums agency is 

. They will help you identify a location, help with licensing and visa issues, and usually pay for housing and transportation. 

, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. CompHealth is part of the 

 family of companies which also includes 

, the country’s only international locum tenens staffing agency.

Practice medicine while you travel the world with international Locums Tenens

Take your practice of medicine overseas

We live in a review-based society. You ask a friend for restaurant recommendations, you check star ratings before you make that Amazon purchase, and you go deep on user reviews before you book a hotel or vacation rental. Healthcare often goes a step further with more and more health systems and insurers switching to value-based care to determine reimbursements.

For physicians in private practice utilizing reviews and making positive changes based on feedback is a great way to keep insurance reimbursements high, your business moving in a positive direction, and make your patients happy. 

 about how listening to your staff can help keep your employees engaged and happy. The same goes for your patients. When a patient feels you are really listening, both in clinical settings and in online reviews, feedback forms, and surveys, you will start to build trust. They are coming to you with the most important thing in their lives, either their own health or the health of their loved ones. Trust is integral to building a solid physician/patient relationship and listening and acting on feedback is a great way to build that trust. 

Meeting with a patient in person is the best opportunity you have to build trust. This can be done in a few simple ways. First, start with a welcoming atmosphere in your practice. From the set-up of your waiting room to your front desk staff, ensure patients feel welcome. 

Once you are meeting with a patient one-on-one, it is important to take the time to let them explain their concerns. Often, when we feel we have the answer to a problem we want to just jump in and do it. Even if you have a good idea of the issue and how to treat it, it is important the patient feels listened to. 

You also don’t want to appear rushed. While you may be under time crunches, don’t let the patient see that side of the business. You need to be 100 percent focused on them while you are meeting. If you are late to their appointment it helps to acknowledge the time they have been waiting, apologize, and then focus entirely on them. 

A little personality also goes a long way. Utilizing appropriate humor or personal anecdotes help to build rapport and alleviate stress and anxiety. 

The effects of nurse practitioners replacing physicians

You have an online presence whether you are aware of it or not. Countless sites like 

 provide reviews of physicians, insurance information, addresses and phone numbers, and more. 

 is doing the same thing. Personalizing these listings and keeping them up to date can help you find new patients and offers a brief glimpse into who you are and what you can offer your patients. 

If you haven’t done it recently, just Google your name and see what comes up. You may be surprised with how many places you live online. 

It is equally important your practice has its own website and social media sites. Your patients need to be able to find and interact with your practice online. If you are not there, you are missing out on potential business. 

Online reviews are great for patients looking for a new physician. If you have built trust with your patients, they will hopefully give you positive reviews. If you need more reviews, there is nothing wrong with encouraging patients to leave them. If you have specific sites you want them to leave reviews on, tell them. 

Replying to reviews could potentially be a full-time job. You don’t need to feel obligated to reply to everyone; however, it is important to reply if questions are being asked or if the review is negative. When replying, make sure to never be defensive or even worse, offensive. The goal in replying to a review is less for that reviewer and more for others who may read them. Remembering that HIPAA doesn’t allow you to share any personal information, your best bet is acknowledging their experience and if possible, positively encouraging them to reach out to your office directly to discuss. 

Supplying patients with a feedback form or sending them an online survey is a great way to receive direct feedback. You can utilize multiple choice questionnaires, ask about their experience with the front desk and the physician, or just let it be an open-ended question about their visit. Regardless of how you ask for the feedback, the most important thing you can do is use it in your future plans. Showing that you have made positive changes based on patient feedback is another way to build trust. Hearing what patients really feel also reaffirms the positive things you are doing and helps you to see ways you can make the patient experience better. 

It’s important to remember that feedback and reviews are positive things, even when they say things that are hard to hear, utilize them to improve your patient interactions and make your practice better.

Get insight into positive changes you and your practice can make.

Utilizing patient feedback and reviews

In my nearly 20 years working in healthcare staffing at 

 I have never once felt that my gender played a role in my success, how much I was paid, or if it determined whether I would face any sort of harassment at work.

It is for this reason that it was so troubling to me that a 

 our company issued on women in medicine discovered that women receive less respect, less pay, have lower opportunities for advancement, and are harassed more than men. In addition, the survey also found that both men and women feel that the medical industry has an issue with harassment. Women were also more likely to leave the field because of harassment.

Different perceptions between men and women

The survey revealed a difference in perceptions between female and male physicians. Here are some of the top findings:

·       Only 12% of women reported having never dealt with some form of sexual harassment versus 38% of men.

·       Women are also more likely to experience discrimination, insubordination, retaliation, physical violence, and sexual harassment than men.

·       69% of men felt that women and men were respected equally in their organizations compared to just 34% of women who agreed.

·       63% of women felt that men were more respected than women.

·       87% of women feel patients treat them differently than men while only 58% of men feel they are treated differently. Similar numbers were found when looking at treatment by nurses, administration, other physicians and other staff.

·       70% of men feel opportunities for their gender are the same as for women, while just 49% of women feel the same.

Gender shouldn’t play role in how one is treated

I find it extremely disheartening that in 2019 women are still dealing with these types of issues in any workplace, much less in an industry that is focused on the care and healing of our fellow beings. The fact that harassment and receiving a lack of respect is a regular part of many female physician’s lives is extremely sad. Simply being a woman should not make either of those things okay.

So, what do we do about it? Making changes on this level starts with those responsible for leadership, hiring, and the culture of an organization. The example of people in those positions sets the stage for the rest of the company. If they ignore the problem or feel the problems don’t exist, then nothing will ever change.

However, it is not just up to the C-suite to solve these problems. Every single employee within an organization can create changes that make the workplace more welcoming to women. Look at your own behavior and actions to ensure you aren’t doing anything to place female coworkers in a subservient role. Also, if you see someone being disrespected or harassed, say something. There should be no place in a work environment for that type of behavior. If getting directly involved is outside of your comfort zone, you can still report the behavior to your human resources department. Certainly, don’t go along with something or write it off as being “the way things are.”

More women are involved in medicine today                                                                                                    

On the positive side, there are now more women being accepted to med school than men. If that trend holds, we will see natural changes to the healthcare landscape as female physicians become more prevalent. While the survey results are disappointing, things do appear to be getting better. Those of us working in healthcare today can keep the improvements coming by encouraging the women we work with, striving for equity, and treating everyone with more respect. I hope someday all women will have the same experience I have had in my career. One where your gender doesn’t determine what you do, how your paid, or how you are treated. 

In 2019, women in healthcare are still dealing with many negative issues

Author | Lisa Grabl

Articles

Locum tenens are crucial during a time of crisis

Take your practice of medicine overseas

Utilizing patient feedback and reviews

Survey reveals disappointing state for women in medicine