According to the Association of American Medical Colleges, the average debt for a 2008 medical school graduate is $139,517, and more than 75% of graduates have debt in excess of $100,000. These figures are comparable to a home mortgage in some parts of the country. This enormous debt can be daunting, especially considering that a physician does not begin earning (residency salary aside) until his or her late 20s or even early-to-mid 30s.

Doctors often want to pay off student loans as quickly as possible, but investment executive Joe Potosky of MV Financial Group in Bethesda, Maryland, ( http://www.mvfgroup.com/) says they should approach debt management strategically. "People get psychologically attached to accomplishing an objective that may not be the most sound," says Potosky. "Don't let your emotions get in the way of a good business decision."

There is no shortage of information available today about how to "go green" and reduce your carbon footprint. At home, many people take steps toward this effort by adjusting the thermostat, recycling, combining errands to save gas, or buying locally grown food. But what can you do while traveling to and from locum tenens engagements, and practicing in unfamiliar surroundings? Plenty.

Before you leave home. If your house will be empty while you are away, unplug electronics, put your water heater on the lowest possible setting, adjust thermostats to a "protect the home" level, and suspend newspaper delivery. Do you prefer to prepare your own meals while on location? Then, use the Internet or call ahead to find out where to buy local produce and other goods.

Every physician knows that the process of applying for medical staff membership and privileges can be tedious and time consuming. The forms and photocopies, that long list of yes/no questions, and pouring over the clinical privilege request sheet can take hours. The good news for locum tenens physicians is that, with a little organization on the front end, this process can be streamlined considerably. The best locum tenens agencies do everything they can to reduce paperwork for doctors who are busy traveling the country (and sometimes the world) to practice medicine.

While locum tenens agencies are not in a position to perform formal "credentialing," any reputable firm will do a thorough credentials review based on the same standards as hospitals before presenting a physician to a practice location. Because they not only understand their clients' quality standards, but are also responsible for procuring or facilitating malpractice coverage for the physicians with whom they contract, staffing companies engage only well-trained and highly-qualified individuals.

Much like obtaining staff privileges at hospitals, the process of getting state medical licenses is becoming more arduous for physicians as medical boards tighten standards. As you consider your locum tenens career, think strategically about which licenses you will need. The more places you are licensed, the more choices you will have, but that does not mean you need a license in dozens of states. Depending on the size of the primary states in which you practice—the larger the state, the more opportunities typically available—five to eight is probably about right.

STATE PREFERENCES

When the economy is unstable, as it is now and most likely will be for some time to come, even high-income professionals feel the impact. An economic downturn probably will not mean, as it does for many people, that doctors will have to cut back on essential purchases such as food, clothing, and fuel. But if you are watching your retirement account balance fluctuate wildly and have seen the value of your home decline over the last couple of years, you may be feeling the pinch—if only in terms of your ability to plan for the future and afford a few luxuries.

Depending on how long you have been out of training, your curriculum vitae (Latin, meaning "course of life," CV for short) may fit onto one page or have the heft of a small book. Either way, it is important to keep this record of your education, training, experience, and professional accomplishments up to date.

Physicians often have questions about what to include and what to leave off their CVs. Here are tips to help ensure that your CV makes a positive impression when you are seeking locum tenens engagements.

You never get a second chance to make a first impression. That rule especially applies to phone interviews for locum tenens positions. Unlike approaching a permanent-practice opportunity where you might engage in several phone interviews followed by an on-site visit, the locum tenens evaluation process usually occurs during the course of a single phone conversation. During this brief encounter, it is important to make a good first impression, and equally important to use the time to make sure you will be comfortable stepping into the temporary practice opportunity under consideration.

Before the phone interview, your recruiter will have made a provisional "match" between you and the hospital or clinic you are considering. You will already know a reasonable amount about the scope and requirements of the assignment, and the person interviewing you will have reviewed your CV and references.

Physician staffing can be a fickle business. In today’s fiercely competitive market where loyalty runs thin, staffing agencies will bend over backwards to attract and keep a physician in their locum tenens pool or a hospital as a client. So when a physician or client insists that you sweeten the pot by providing workers’ compensation, what’s a locum tenens agency to do?

The answer is simple: To quote a former first lady, “Just say NO!” And if the physician or client challenges your frugality, explain you are simply trying to protect the independent relationship for all three parties to the transaction.

For decades, physicians have engaged in locum tenens practice for a variety of reasons at different times throughout their careers. Newly minted residents unsure about where they want to settle or what type of practice setting they might enjoy use locum tenens as a way to explore options. Mid-career physicians take locum tenens engagements to see how other practices operate or when they are between permanent jobs. Semi-retired doctors enjoy that locum tenens allows them to keep a hand in medicine without the hassle of staying fully immersed in practice.

Today, given the unstable economy and that healthcare reform is under serious discussion in Washington, physicians are looking at locum tenens for new reasons. Here are a few scenarios that locum tenens agency recruiters are seeing unfold.

One of the many benefits of practicing as a locum tenens physician is that the hassle and expense associated withliability insurance is largely a non-issue since it is an industry standard that locum tenens agencies provide practitioners with insurance. Still, if you are considering practicing as a temporary physician, you must consider certain issues and ask questions to make sure you are well taken care of in this regard.