As a locum tenens worker, you'll find you have new responsibilities when it comes to taxation. Your status as an independent contractor, coupled with the fact that you may work in several different states over the course of a year, adds to the complexities you will face come tax time. You may be required to file in several states, and you will almost certainly face expenses that other medical employees never have to deal with.

Of course, these annual headaches are greatly outweighed by the many benefits to locum tenens work. You are likely to earn more money and gain more control over your schedule.  Additionally, you can also enjoy a variety of write-offs designed to reduce your tax burden since you're virtually acting as your own employer, to an extent.

NALTO Multiview Briefing #1 — Interstate Licensure Compact
Key Facts About the Interstate Medical Licensure Compact

In early October, a bipartisan group of U.S. senators endorsed the Interstate Medical Licensure Compact. In a letter to the Federation of State Medical Boards (FSMB), the lawmakers stated, “As strong supporters of the state-based system of physician licensure, we believe the Compact represents a significant step forward in the licensure of physicians and we applaud the work of the FSMB and its member boards in this area.”

National Association of Locum Tenens Organizations, February Multiview Briefing: National Relations Labor Board & 1099s

NRLB & Locum Tenens
How a National Labor Relations Board ruling could impact locum tenens staffing companies. What “Independent Contractor” Means to the IRS A closer look at what defines an independent contractor for tax reporting purposes, and locum tenens companies.

Locum Tenens (Latin for “in the place of”) staffing is a growing industry, supporting healthcare facilities nationwide to meet needs for qualified practitioners. As many as 6% of all active practitioners have worked locum tenens at some point in their careers, most with great satisfaction.

When it comes to understanding the “nuts and bolts” of hiring locum tenens, some common questions emerge. We’ve got your FAQ’s here. Contact us if you have any others.

The VA has proposed a new rule that would allow NPs to see patients without the oversight of a physician. If the rule is put into effect, it could increase veterans’ access to healthcare.

There is little doubt that the Department of Veterans Affairs is struggling to keep up with the healthcare demands of former military members. In fact, some veterans wait over 100 days to see a physician at a VA facility. Despite some failed attempts at ameliorating the system, the VA has now proposed a new rule that could increase veterans’ access to healthcare across the country.

Medical providers who wish to practice in multiple states have traditionally faced a timely and cumbersome licensure process to do so. Therefore, many locum tenens companies have entire departments dedicated to helping physicians and advanced practitioners complete the necessary verification and credentialing requirements needed to begin any assignment. This includes assisting providers who need to attain (or renew) their license to practice medicine, a process that’s historically taken as long as six months in a single state.

Therein lies the recent good news from the Federation of State Medical Boards regarding the onset of the Interstate Medical Licensure Compact (or “IMLC”), designed to expedite the process for physicians to obtain multiple licenses through a single application.

Medications can be a critical component to treatment plans. They alleviate pain, minimize symptoms, and combat infection. However, the government has deemed it necessary to regulate these controlled substances in order to prevent illegal distribution or abusive practices. Because medications vary from mostly benign over-the-counter products to powerful narcotics, they have been divided into five Schedule categories. Schedule V drugs contain limited amounts of narcotics or stimulants—cough syrup is an example of a Schedule V controlled substance. The most powerful medications administered in medical settings, such as oxycodone and fentanyl, fall within a Schedule II classification. Schedule I substances typically have no medical applications under federal law.

The U.S. Drug Enforcement Administration (DEA), a division of the U.S. Department of Justice, determines who is qualified to dispense regulated medications. And according to the DEA, as it
applies to practitioners, the term “dispense” means to “deliver a controlled substance to an ultimate user or research subject by, or pursuant to the lawful order of, a practitioner, including the prescribing and administering of a controlled substance.” Physicians, and where legally applicable, mid-level providers must apply for and receive registration from the DEA to legally dispense/prescribe scheduled medications to their patients.

This past Spring, at the Annual NALTO® Conference in San Antonio, TX, we held a New Member Orientation Session and Reception. This was successfully attended by over 35 attendees. One of the key topics of interest was the NALTO® Credentialing Guidelines within our Standards of Best Practices. Frank Phillips, President of MDA, Inc., and current Past President of NALTO® gave the presentation.

As NALTO® Member Firms, we have agreed to uphold good industry standards of Best Practices which include the intake, credentialing, and verification of our Physician Candidates.

Reviewing and signing a long-term employment agreement can be a daunting experience. Page after page of legal language plus difficult to decipher compensation formulas are enough to give you a headache and heartburn, and that is before your attorney starts poking holes in every other clause. When it comes to reviewing a locum tenens agreement, however, you can leave your analgesics and antacids in the medicine cabinet.

These agreements run, at most, a few pages and you will most likely understand every paragraph even if you don't happen to have a law degree. This does not mean, however, that you should sign an agreement or engagement letter without reviewing it carefully. The short-term nature of a locum tenens engagement and the fact that you are an independent contractor make the agreements fairly straightforward. But you are entering into a contractual business agreement, so it is important to understand what you are signing. Read your entire agreement and pay special attention to the following:

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

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.

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.

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.