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How I Choose Which Locums Agencies to Work With

Published on: Oct 17, 2022

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Orthopedic surgeon Nicholas Kusnezov, MD, shares the factors he considers when choosing which locum tenens agencies to work with.


Once you’ve completed residency training and hit the open market, you’ll find that there is an exhaustive network of locum agencies  that you can tap to find locum assignments. You will find that most companies have similar exposure — in that they will present you with the same job around the same time. However, in my experience, there are a number of important considerations when choosing a locum agency with which to work. These boil down to:

  • Compensation
  • Negotiability
  • Customer Service
  • Availability for travel coordination and troubleshooting
  • Size and/or reach of the agency
  • Exposure
  • Reputation

And lastly the intangibles — such as how good of a match you are with that agency.

The Most Decisive Variable for Me

Compensation is initially the most decisive variable for me, because the number that you are presented generally reflects how efficient the locum agency is (in regard to overhead) and how much they value you as a physician.

As I said, you will often be presented with the same opportunity through different agencies, but the amount and structure of compensation will vary. You may get a flat rate from one company and a base pay with an hourly rate from another. I figure out what I think my time, per hour, is worth, find out from the locum agency roughly how long physicians work on average at the facility, and then run the numbers. I am more inclined to go with an agency that more closely mirrors my ask price. That being said, you should always negotiate, and often times, negotiability becomes a key discriminating factor of choosing between agencies.

A Company That Goes to Bat for You

Negotiability is directly tied to compensation but also includes scheduling and accommodations. Know your worth, stick to your guns, and find a company that will go to bat for you. I approach every potential assignment with a minimum number I’m willing to accept. Like any financial negotiation, I start by finding out what the assignment is offering and then look to the locum agency to determine whether the difference in compensation is reconcilable. Often times facilities and agencies are much more flexible than they may initially seem.

A good locum agency will always fight for you. During negotiations, you will get a sense of whether they are working for you or more for themselves and the hospital. For instance, my top agencies will almost always squeeze for my ask price. Conversely, I have worked with plenty of agencies that not only present the same job for less but then make it seem like there is no room to budge. This is never the case and usually just reflects the agency wanting to maximize its own profits at your expense.


A Better Experience

Customer service and the availability of the representatives is another important aspect that may sometimes get overshadowed by financial negotiations. You absolutely want to choose a locum tenens agency that you can connect with at the drop of dime. Whether this is for last minute changes to the schedule, confirming dates, or coordinating travel, this is paramount.

Top agencies will have after hours emergency lines through which you can get travel coordinators on the phone 24/7. If this isn’t offered, I’d recommend looking elsewhere. You will invariably run into snags and need someone to quarterback issues when they arise. This is not on you as the physician. Make sure that the agency you choose is receptive to your needs and requests, be it for travel or accommodations. They should be, or you should find one that is.

Size Matters

As I said earlier, there are many different locum tenens agencies, of different sizes and with different exposure or reach. You will find that some agencies are always privy to new opportunities while others are smaller and have more limited opportunities available.

In my experience, you want to find an intermediate-sized company — one that has exposure to a good number of opportunities but a company that isn’t too big. Very large locum companies often don’t have to negotiate with you, because they will fall back on another physician who will do the same job for less. Conversely, companies that are too small may not only not have adequate exposure but may also not have the financial means to give you what you ask for.

Someone You Mesh With

The final piece is the intangibles. Find an agency and locums agent you mesh with. Do you work well with that agency, or do you frequently clash and feel uncomfortable dealing with them? You want to find an agency, or agencies, that you feel will take excellent care of you and on which you can rely.

Hear more from Dr. Kusnezov on this topic or take a look at open jobs.

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