Ethics: What locum tenens physicians should know

Within the locum tenens industry, there are ethical guidelines that, when followed, make life easier for all involved—from the physicians and the facilities where they practice, to the locum tenens agencies that put the two parties together. Here are a few things every physician should know about ethics and locum tenens practice.


Let us start with what you should expect on the part of locum tenens agencies. A reputable recruiter will never present your name or CV for potential placement without your consent. This means that an agency representative should tell you enough about an opportunity before submitting your credentials so that you can say "yay" or "nay." Although you may not be aware of every little detail at this point, you should know enough to be able to say with relative certainty that you would agree to the location if the terms are reasonable. This saves time for everyone and keeps you in the driver's seat.

A recruiter must be honest with you about all aspects of a potential engagement. When you arrive at a new opportunity, you should not be surprised by the hours, patient volume, procedures you are expected to perform, or level of staff support. In addition, you should be told if the location is experiencing any sort of internal turmoil. When you are aware that touchy political issues are stirring, you can determine beforehand how to steer clear of the local drama.

If a recruiter encourages you to wiggle out of a commitment once you are within the standard 30-day "opt out" window in order to take an engagement with his or her agency, run in the other direction. Such behavior is a clear breech of ethics and should never occur with a NALTO member firm. (If it does, please report it to NALTO).


If you practice locum tenens regularly, it is likely that you are registered with more than one agency. Similarly, staffing agencies often have clients in common. If you are presented to practice at a hospital by Agency A on Monday and Agency B presents your CV on Tuesday, you are obligated (assuming you accept the engagement once the details of the contract are known) to provide services through Agency A. It is helpful to keep a log of where your CV is being sent. This can be as simple as listing the information on a piece of paper with columns: Agency, Date Sent, and Location.

When it comes to compensation, do not play one agency against another for better pay or perks. You may secure the engagement on your terms if the client is desperate, but you probably will not be offered future placements from either agency. Also, it is considered a breech of ethics to contract independently at a facility where you have practiced with a staffing company in the past 2 years (or whatever term your contract states).

If you practice at Location X through one staffing firm, and a second company contacts you to go to that same location a few weeks or months later, let the second agency know about the prior engagement. Most contracts include a non-compete clause so that if Location X wants you back, administrators are bound to stay with the company that initially presented you.

When providing locum tenens services at a facility where other physicians are doing the same, avoid discussing pay rates. If you happen to find out that another doctor is earning more than you are, tuck that knowledge away for future reference, but remember that you signed a contract agreeing to a specific rate.


A locum tenens career involves a series of temporary opportunities. That said, most physicians build long-term relationships with their favorite agencies. Expecting strong ethics and adhering to high standards will ensure that your professional relationships are not only longstanding, but satisfying as well.

An advantage of partnering with a NALTO member agency is that these 40+ firms and their recruiters adhere to strict ethical guidelines. In addition, should a question or conflict arise, NALTO's Ethics Committee intervenes, making it unlikely that a physician would ever be caught up in a dispute. Visit the NALTO website ( to download "NALTO Code of Ethics" and "NALTO Standards of Practice."

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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