Understanding locum tenens agreements

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:


Some agencies use a blanket contract to cover all placements that a physician accepts over the course of a year or perhaps even 2 years. In this case, the details of each engagement will be outlined in a separate acceptance letter. Other agencies draw up a unique agreement for each engagement. Either way may be fine, just know what you are signing and make note of the length of the agreement.

Malpractice insurance

If the agency you are working with is a member of the National Association of Locum Tenens Organizations, you can rest assured that you will be covered with a good quality professional liability policy. Be sure it is clearly noted in your agreement that insurance is being provided for you at the agency's expense.


When you take an engagement with a hospital or group, you will most likely be asked to agree not to accept a permanent position with that organization for some period of time following your tenure there unless the entity pays your locum tenens agency a recruitment fee. This is standard in the industry. A non-compete clause may also state that if you provide services in location "x" under an agreement with one locum tenens agency, that you cannot, within a certain period of time, do so again at that location under an agreement with another agency. Again, industry standard. Do not sign a non-compete clause that is unduly broad (i.e., covering a large geographic area or spanning more than 2 years).

Getting paid.

How and when you are paid should be spelled out in your agreement. The locum tenens agency will ask you to submit your timesheet on a regular schedule. Attention to this detail will ensure that you are paid in a timely manner. Remember that you are an independent contractor responsible for paying your own income taxes, including self-employment tax. Speak to your accountant about how to handle your independent status before tax time comes around.


Either in the agreement or in a policy document, you will find details about which expenses are covered by you, by the locum tenens agency, and by the hospital or group where you are practicing. If in doubt, ask for clarification.


Each agency handles cancellations a little differently so be sure you understand what your responsibilities are in the event that you have to back out of an agreement at the eleventh hour and what your rights are if the hospital or group where you have been assigned cancels at the last minute.

A good agreement should be fair and equitable for all parties. If a contract seems too one-sided, proceed with caution. Even in short, simple, non-heartburn-inducing agreements, questions and points for negotiation may arise. Stay in close contact with your locum tenens agency representative so that you can have your issues or concerns addressed quickly and thoroughly. This is where trust, communication, and integrity come into play.

Views and opinions expressed herein are those of NALTO and not necessarily those of Advanstar Communications Inc. or LocumLife.

About the Author

Karen Childress is a Colorado-based freelance healthcare writer currently crafting a series of articles on behalf of NALTO.

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