practical tips

Locum tenens after residency: crush your medical school debt

July 17, 2021 by LocumTenensGuy

Vlad Dzhashi, MD

Locum tenens after residency has a ton of pros: you become a better clinician, make hundreds of thousands of dollars more and travel America in search of the next big adventure.

That said, I want to focus on one of the BIGGEST pros of working locum tenens after residency.

What is it?

I am talking about working locum tenens to pay off your medical school debt.

Most docs would agree that medical school debt is a huge pain in the butt.

It causes stress and anxiety, eating into your budget and limiting your financial freedom.

It’s especially painful for freshly-minted residency graduates.

A lot of them put it on the back burner and keep paying the minimum monthly payments forever.

But today I want to offer you a radical solution to crush your student debt FAST!

In fact, it’s so radical that you can pay off your loans in less than a year!

Don’t believe me?

Come closer as I’m going to share my “recipe” with you.

Recipe with two ingredients:

(LOCUM TENENS + “SECRET INGREDIENT”) x (1 – 2 years) = ZERO student debt!

Why locum tenens?

The obvious reason is that it pays better than a permanent job, especially for somebody fresh from residency.

How much you’ll make depends on your specialty and how hard you work. For example, a locum tenens hospitalist would make at least 30% more compared to the average salary.

However, if you play it smart using all the strategies I describe in this post, you can add an extra 50% or more.

“Secret ingredient” for faster check out:

While the first ingredient will make you more money, the second will SAVE you a TON!

Let me ask you this:

What are the average person’s largest living expenses?

Housing, transportation (i.e.car, gas) and utilities!

Now, what if tell you that 100% of these expenses will be covered?

Sounds great!…but how?

Your locum agency covers those FOR you!

Listen: after you graduate from the residency, you’re joining the ranks of the highly sought-after professionals.

Think about it this way: It’s almost like you are a US expat working in a foreign country where your expertise is unique. And employers go out of their way to entice you: they pay you really well and cover all kinds of expenses.

The same happens with doctors, the demand is so high that agencies are willing to negotiate to make your life easier.

Plus, they pay for travel expenses anyways, you just make them channel it differently.

Now, when you’ve got the big picture, let’s look at logistics.

How to do it?

You work full-time locum tenens:

The key is to work enough to make it worthwhile for an agency/hospital to cover as much of your expenses as possible (i.e. 10-14 shifts a month for hospitalists).
This way you can make maximum money while saving like crazy.

You stick with long-term locum gigs:

Again, it makes more sense to cover your expenses if you are there for a long time.

You live where you work:

You live in the hospital vicinity in the rented place that is paid for by the company.
Another option is to keep a “free” home base by the main hospital while traveling to another one for extra shifts (with travel paid for you of course!).

You live in a small town:

Your living expenses will be lower.
You will get a better pay.

You keep your other expenses low:

While most of your living expenses are covered, you still need to live frugally to pay off your medical school debt fast.
One exception where you don’t want to be cheap is eating healthy and exercising. Also, it’s ok to spend money doing things you enjoy (nothing too extravagant though, so sorry, no yacht racing for now).
This will help you to keep your sanity and prevent burn out.

You live a “nomadic” lifestyle:

You don’t buy or own any “stuff” that can slow you down.
You should be able to take off and go to your next assignment without needing to hire a ginormous moving truck.

How much will you save?

Great question! I thought you’d never ask!

Let’s take a look:

Housing:

You see, hotels are a good deal when you are staying for a short period of time, but when you work 2+ weeks a month, it can cost thousands. It’s much cheaper to find an Airbnb or corporate apartment for you and pay lower monthly instead of daily rates.

How much do you save that way? Based on my calculations, about $15K-20K of your after-tax dollars per year.

Utilities:

When you live in a hotel or apartment, you pay ZERO for electricity, gas, internet, garbage etc.

That’s another $200-$500 monthly savings ($2500-$6000 a year).

Car:

Here’s a hack that’s even better:

You buy a car using a 3-5 year loan and ask the agency to cover your monthly payments instead of paying for a rental car. You also have them pay the gas and auto insurance.

You’re not only saving money, but you are also paying off your own car’s principal!

If you’ve already got a car you plan to own for another few years, make sure you get your gas, insurance, and maintenance expenses paid. You can also ask for a flat monthly car “stipend” instead.

That’s another $5K-10K/year saved.

How many Benjamins will you save in total?

Drumroll…

Between $25K to $35K annually!

Now, you’ll be blown away even more if you calculate your before-tax savings.

Why locum tenens straight out of the residency?

This approach will work the best after your residency.

Why?

You still have spending habits of a resident.
You have fewer obligations (family, mortgage, etc.).
It’s easier to adopt a “nomadic” lifestyle.

How long does it take to pay off your medical school debt?

One to two years depending on your student debt amount, your specialty and how hard you work.

Plug in different numbers below to calculate how long before you crush your debt.

Student Debt Pay Off Time Calculator

Total Student Debt:

Shift/day pay:

Number of shifts per month:

Shifts

Average Tax rate:

Monthly Expenses (exluding debt):

Your Monthly student loan payment:

Monthly income:

Income after tax:

Money left / month:

Time required (in months):

Number of shifts/work days required:

Ok, now when you are all excited about the idea, let’s see how you’re going to do this step by step!

11 Steps to paying off your student debt working locum tenens:

Step #1 - Figure out where you’re going to work (6 months before you start locums):

I know what you’re probably imagining now: sandy, pristine beaches of Maui or San Diego…

Stop it!

If you are a guy or gal who can relax on the beach while your student debt is piling up, then Hawaii or California may be good places.

But If want to pay off your medical school debt fast, you have to play it smart and pick the states that:

A – pay well;
B – won’t suffocate you with exuberant taxes;
C – have more work than you need;

Where will they pay you the most?

For hospitalists, the winners are states in the South, Southwest, and Midwest. (download the report)

As to the taxes, no income tax states are AK, FL, NV, TN, TX, WY, and SD.

Low income tax states are IN, ND, PA and WA.

Source: https://taxfoundation.org/how-high-are-income-tax-rates-your-state/

If you want to get a decent estimate of how much state income tax you are going to pay, check out this great online resource I found.

That said, always talk to a CPA to understand other important tax stuff (e.g. working in multiple states, nonresident vs resident taxation, etc.).

So if Wyoming has zero state income tax and a good pay, should I get a license there?

No way!

Your should pick the states with at least a few million people. This will let you tap into a good number of locum gigs.

Now, keep in mind:

If you find yourself stuck in “analysis paralysis,” unable to make up your mind on where you want to go, just focus on the states that you have a good feeling for.

Step #2 - Contact the locum agencies and negotiate (5-6 months before you start locums):

Before you do, take a look at my post where I explain how to find the best locum tenens companies. Make sure you check out the agencies reviews as well.

The caveat here is to work with multiple firms, both local and national.

When talking to the recruiters you need to:

A – Tell them to look for long-term gigs (6+ months) in the states of your choice.
B – Request that they cover your living expenses instead of the typical hotel/rental car.
C – Negotiate your pay rate for each locum gig.
D – Ask them to cover your state licensing cost (do not agree to a low pay rate just because they cover your license).

Step #3 - Apply for licenses (5-6 months before you start locums):

Get 2-3 state licenses to start.

The best advice here is to invest time and money into creating an FCVS profile.

I’ve used it many times and cut my licensing time by months!

FCVS fast-tracks your licensing for any state. It verifies your credentials (identity, medical school, residency training, etc.) and sends them to one or multiple state medical boards.

All boards accept FCVS verification and some boards require it.

Step #4 - Credentialing (3-4 months before you start locums):

Next step is to get credentialed at three to four hospitals.

Make sure you submit your paperwork as soon as you can, and have your agency help you to speed it up.

Onward.

Step #5 - Schedule your shifts (3-4 months before you start locums):

Now, you may be tempted to schedule 20+ shifts in one hospital until your debt is paid off.

Wrong!

As I’ve learned over the years, it’s impossible to know in advance what hospital is going to be a decent place to work.

To avoid being stuck in a bad spot, make sure you schedule only 5-10 shifts a month at each place for the first couple of months.

Another hack is to space out your shifts at the same hospital by 30 days (typical cancellation period). This way you can drop them before it’s too late.

After checking out a few places, you’ll get a good feel for what gig would be the best fit for you long term.

The only situation when you can commit to only one hospital upfront would be if you’ve worked there before (e.g. your residency hospital) and know all the ins and outs.

Step #6 - Get four types of insurance (3 months before you start locums):

Get your disability, life, locum tenens health insurance and some savings.

This will be your “safety net,” so don’t skip this step!

Onward.

Step #7 - Get rid of the stuff you don’t need (a month before you start locums):

To crush your student debt you need to become a “locum tenens nomad.”

Here, you purge all the ~~CRAP~~ stuff you don’t need. You will not need any furniture (and yes, that includes your favorite coffee table!).

Anything bulky that is too precious to your heart can go into storage.

Now, when all the preparation is done, you can start your first locums job ever!

Step #8 Refinance your student loan (as soon as you graduate from residency)

Even if you pay the loan balance off in a year or two, you’ll save thousands on interest by refinancing. Check out this resource list for more info.

Step #9 - First months of locums work (month 0 to 3):

Ah…you’re gonna have fun times!

You’ll travel to new places, meet a lot of people and make new friends.

There will be lots of learning too: from new EMR’s and billing to how to talk to your colleagues and patients when responsibility is all yours.

That said, after the rigors of your residency years, it’s doable.

At the end of the first few months, you’ll figure out what hospital(s) is your “tier 1” and which ones are “tier 2” (back up).

Step #10 - Cranking out until your student debt is paid off (month 4 through 12 to 24):

This is probably gonna be the easiest part:

You…keep going!

Just keep freaking doing it until you’ve paid off your student debt!

Step #11 Celebrate:

Thanks to locum tenens, your student loan is crushed, destroyed, eliminated…

You deserve a celebration, so spend a couple of days (weeks/months) doing something you’ve always wanted to but kept postponing due to college, medical school, residency…

You are free!

My confession...

Now, I want to confess…

I was a little sneaky:

I’ve not only taught you how to pay off your debt fast, I’ve also showed you how to make maximum dollars in minimum time working locum tenens.

I hope you forgive me…

The good news – you can use this knowledge to:

Retire at the age of 40…
Buy a ranch…

Travel the world…
Start a business…multiple businesses…
Save lots of cash just because…

The end.

P.S. Now, I want to hear your thoughts on this approach to crushing your student debt.

Does it sound appealing to you?

Are you ok with living out of a suitcase for a year or two?

Let me know in the comments below!

As featured on

Locum Tenens Contract: How to read the agreement in one minute or less

July 16, 2021 by LocumTenensGuy

Vlad Dzhashi, MD

Today, I am going to teach you how to glance at and make sense of the locum tenens agreement in less than a minute.

You may be thinking: I’ve got better things to do with my life than reading “stupid” contracts.

Wrong!

The truth is that you ALWAYS have to look at the contract. Medicine is a risky business, so you want to cover all your bases!

Now, this post is not going to make you a contract lawyer. Instead, it will give you a perfect recipe on where to look for potential “red flags,” and you’ll learn a simple way to quickly scan locum tenens agreements.

I’ll also give you examples from real-life contracts. This way it’s going to be easy to make sense of the confusing legal jargon. (BTW, you won’t find this info anywhere else on the web!)

I mention another important hack in this post: keywords that you can search within a contract document (typically a pdf file or webpage) and find the exact section you need to review it super fast.

Disclaimer: I am not a lawyer, and this article is just for self-education purposes. It’s not meant to replace professional advice. Consider getting legal consultation for detailed contract review.

What is a locum contract?

A locum contract is the work agreement between a physician and a locum tenens company or a hospital/clinic. At the core, it’s a contract a physician independent contractors sign with their temporary employers that determines how much they will be paid, contract termination, and other important clauses.

Now, let’s look at all the “moving parts” of the locums agreement in more detail.

Are you looking for a locums job?

My agency offers the Highest Pay Rates in the Industry

malpractice insurance

The standard type of malpractice insurance hospitalists get is claims-based, which means you are covered only when both the incident and the claim (when they actually sue for that incident) happen when the policy was active.

Since you may stop working with the locum agency at some point or they could go out of business, it’s important that you get a guaranteed “tail.”

This would extend the locum tenens malpractice coverage for all the incidents, regardless of when the legal claim was made.

How much coverage is enough?

$1M/3M is a standard for hospitalists. The first number ($1 million) is how much is covered for each particular incident. The second number ($3 million) is how much total coverage you get.

The more the better, but anything less – no bueno!

Here are some examples of coverage terms:

1 – “Company shall provide professional liability insurance coverage for each Physician to cover all incidents which may occur during an Assignment, in limits of $1,000,000 per incident and $3,000,000 in the aggregate.”
2 – “Provider will be insured under the terms of “Agency name” group professional liability insurance policy or similar professional liability insurance provided by Client (i.e. hospital).”
3 – “Professional liability insurance will cover Provider, for a medical incident arising out of Provider’s rendering of, or failure to render, professional services while working on an Assignment. Upon expiration of the policy, “Agency name” will purchase group tail coverage or prior acts coverage with the new policy.”
4 – “Company will procure professional liability insurance, including post-termination continuation coverage or tail coverage, as applicable, based on Company’s insurance policy.”

TIPS:

♦ For malpractice coverage, look for $1M/3M.

♦ For claims-made insurance, make sure you get a “tail” coverage.

♦ Keywords for quick “scanning”: malpractice, liability, insurance, tail, coverage, policy.

SHIFT CANCELLATION OR OUT CLAUSE in locum contract

You can typically cancel any shifts 30 days in advance, and the same goes for the hospital you work for.

Here, you need to make a note of the time frame required for termination and how termination is made – written, via phone call, etc.

Here are examples:

1 – “At all times during the Term of this Agreement, this Agreement may be terminated without cause or liability by either party upon thirty (30) days’ prior written notice to the other party.”
2 – “If Physician is not able to fulfill an assignment they have accepted, then Physician will give at least thirty days’ notice.”

The next important thing is to look at what happens when you cancel less than 30 days in advance.

Here you need to avoid the “strict lingo,” e.g:

If you fail to comply…you shall promptly pay to “Agency name” a cancellation fee equal to…”
or
“Provider will be charged for Company’s unrecoverable expenses.”

You should have wiggle room in the contract to get you off the hook if you have a legitimate excuse to cancel your shifts: e.g., illness, family emergency, etc.

Here’s an example of better wording:

Professional may cancel any scheduled placement less than 30 days in advance by giving written notice…if Professional becomes unable by reason of emergency or medical condition to fulfill an agreed placement.”
or
“If Physician becomes incapacitated or otherwise physically unable to perform Services…Physician’s cancellation shall be in writing.”

TIPS:

♦30-day cancellation window is a standard.

♦Avoid “strict” cancellations.

♦You should able to cancel any time in the event of sickness, emergency, etc. Consider adding this to the contract.

♦Keywords for quick “scanning”: cancel, schedule, notice, term.

NON-COMPETE CLAUSE in locum tenens contracts

In a nutshell, the non-compete clause in locum tenens contracts doesn’t allow you to work with the hospital through another locum company or directly for a certain period of time.

Here, you have to make sure the term is no longer than 2 years after the official end of the agreement.

Let’s look at one example:

Physician may not solicit or contract with Client or any of its affiliates…for temporary staffing assignment nor accept a permanent position…”

TIPS:

♦The non-compete clause should not be longer than 2 years after contract termination.

♦Keywords for quick “scanning”: non-compete, covenant, clause.

TERMINATION and RENEWAL of locum tenens physician contract

You should be able to terminate the locum tenens agreement any time with a 30-day written notice. It means that you officially “break up” with an agency.

But why would anybody need to do it?

Because if you don’t, it will be auto-renewed. So even if you don’t work with the agency for a while, you are still in a binding relationship with them, including the non-compete clause.

Why is this important?

A few years after my last shift at one local hospital, I decided to pick up some shifts there again. This time I wanted to connect with them directly to have a long-term locum tenens hospitalist gig close to home.

Guess what?

Since I didn’t terminate my contract with an agency that placed me there in the first place, I either had to use them again (which kills the point) or terminate my agreement and wait for 2 years.

Another example: if your agency loses the contract with the hospital, a non-compete clause will not allow you to work at that facility either as a per-diem or through another agency’s services.

In my situation, I ended up terminating my contract and had to wait for the 2-year non-compete clause to expire.

TIPS:

♦Keep in mind that a locum tenens contract is auto-renewed unless you terminate it.

♦Terminating the contract will cancel the “non-compete” clause typically in 2 years.

♦Keywords for quick “scanning”: automatically, renew, terminate.

Sample locum tenens contract template:

If you want to dig a little deeper and actually look at a sample locum tenens contract, you can check out this resource. Although this agreement seems to be much shorter compared to the ones I’ve signed in the past, it has all the important parts in it.

CONCLUSION: reading a locum tenens physician agreement

Now you know the quickest way to scan through the locum tenens agreement.

The good news is that your contract is always negotiable. So if you’ve noticed anything you want to be changed, do not hesitate to reach out and request it.

If you are too lazy to dig through the contract yourself, just ask your agency/hospital to point specifically to the important sections I mentioned.

At the end of the day, it doesn’t matter how you do it. Just do yourself a favor – ALWAYS review your agreement!

Locum Tenens Medical License Guide: Tips For Docs Who Can’t Stand The Licensing Process!

December 4, 2019 by LocumTenensGuy

Vlad Dzhashi, MD

Without a license you cannot practice medicine, it’s as clear as that.

For employed docs the decision is simple — you apply for a license in the state where you work and live.

It’s more complicated for locums physicians, because in case you didn’t know, you DO need a license in each state you work locum tenens.

Now, I don’t have to explain to you how annoying the locum tenens licensing is.

What I do want is to teach you how to make it as seamless as possible.

I doubt you’ll ever enjoy applying for new licenses, but after reading this post you’ll become a “power user.”

Here’s what I’ll cover:

1 – How to stay on top of your licensing for locum tenens forever
2 – Shortcuts to getting a new license fast
3 – How to work all over the country with only one license
4 – Real costs of a medical license
5 – Keeping multiple licenses
6 – Whether you should let your license lapse or switch to “inactive” status to save money.

Buckle up and let’s get going!

Locum tenens license definition

Locum tenens license is defined as either any permanent state license that lets you practice medicine in that state (including locums) or a special license that is active only for a short period of time (see below).

So, for most docs, there’s really no difference whether you are applying for a regular state license to take the permanent job or locum tenens gig.

How to stay on top of your locum tenens licensing forever

Bad news: You’ve got some work to do!

Good news: Once it’s done, this will save you a TON of time.

So…listen up!

👉 1 – Get your cr@p together!

To get started, you need to scan important documents and create a virtual folder for all of them. You can use a scanner or your smartphone camera.

Here’s a minimal list:

Education certificates – medical school, residency/fellowship, ECFMG, etc.

Copies of state licensures

DEA certificate(s)

Proof of continuing medical education

Immunization Records (such as flu, TB, Hep B)

Malpractice records (if applicable)

Driver’s license/ID

The next thing is to save the documents on both your personal computer and on cloud storage (e.g. Dropbox, Google Drive, Apple iCloud, etc.).

When you apply for a new license, you can upload these documents from your computer or download them from the cloud and attach them to an email.

Here’s how I do it:

Make sure you update your documents every year or so.

Once you’ve created your “database,” you are ready for the next step.

👉 2 - Sign up for FCVS

Once you decide you need a new license, FCVS verifies core credentials (identity, medical school and residency training) and submits the report to one or multiple state medical boards.

Why is FCVS a MUST?

First of all, some states REQUIRE FCVS and will not issue the license without an active FCVS profile. So using FCVS will give you more options.

Second, it can cut your licensing time by months!

I used it for a Florida license and got it within three weeks after submitting all the documents. Without FCVS it would have taken three to four months. Not bad, and it can help when you need to get licensed quickly – e.g., if you find a great gig in a new state.

You can also negotiate a better deal compared to unlicensed docs (check my guide on how to negotiate locum rates for some advice).

👉 3 – Get at least two DEA registrations

DEA registration allows you to prescribe controlled substances. It’s not controlled by any state medical boards, but you won’t be able to practice without it.

One caveat for locum tenens is that you need to have a separate DEA registration for each state you work.

However, you can transfer DEA license to another state.

Let me explain:

Personally, I have two DEA registrations. The first I use for WA state, where I work 90% of the time. The second one I use for other states, and recently I “linked” it to California.

If, let’s say, I decide to work in Idaho, I would need to simply send an email to the DEA agent requesting a “switch,” and shortly after (a day or two), my registration would be “assigned” to a different state.

That’s why it’s a good idea to have at least one “spare” DEA registration number.

Once you have it, you can keep switching it among the states you work in.

Also, having an extra DEA number will save you lots of time on the hospital credentialing (an active DEA number is typically required for that) so that you can get started with a new locum gig quickly.

Onward.

Locum tenens license shortcuts

If you’ve done all the prep work I talked about so far, you are on the fast track to cut your licensing time by months.

But there are other ways to get you up and running for new locum gigs fast:

👉 1 – The Interstate Medical Licensure Compact (IMLC):

IMLC allows you to get one or multiple licenses using a simple and fast application process.

You qualify if you are licensed in one of the sponsoring states (32 at this point) as long as your primary practice and tax residence are in that state.

Check out the IMLCC map below for the visual.

Another requirement is a “clean” practice history, i.e. no board investigation, no disciplinary actions and no malpractice history.

IMLC application is not cheap– it’s $700 plus the cost of the each state license you apply for.

The beauty of this is that it works very quickly and you can get multiple licenses (32 states participate as of now) using the same application.

Although I’ve never used it myself, I know hospitalists who got new licenses in a matter of two weeks.

Check out my detailed Interstate Medical Licensure Compact guide to learn more.

👉 2 – Temporary medical license:

A temp license lets you practice shortly after you’ve applied for a full license, while it’s still “cooking.”

Eighteen state medical boards give you this option: AR, GA, IA, ID, IN, KS, KY, MA, ME, MO, ND, OK, OR, SD, TX, UT, WA, WY.

👉 3 – Locum tenens license:

A locum tenens license is different from temporary: it has a separate application and it’s good for 60-180 days, depending on the board.

If you later decide to stick around and work for a longer period of time in the state, you’ll need to apply for a regular license.

States with locum tenens license

Here are the states with locum tenens license: Alaska, Arizona, Indiana, Maine, Massachusetts, Nebraska, Nevada, New Hampshire, South Dakota, Tennessee, Wisconsin.

Check out this pdf document for more details.

How to work all over the country with only one locum tenens medical license

You may be surprised, but you can work all over the US with only one state license if you pick government locum gigs (VA, Tribal Health, etc.).

They tend to pay less compared to “commercial” locum tenens, but some docs prefer them since there’s no personal malpractice risk.
Please see the following screenshot from the VA website:

To find those gigs, just google “government locum tenens hospitalist” and see what comes up.

There are a few locum tenens agencies that specialize in this type of set-up, with AB staffing and Eskridge & Associates coming to mind first.

Costs of medical licenses:

Although there are good ways to save time on licensing, there’s not much you can do to save money on them.

The licensing fees range from $140 for a Wisconsin license to almost $1,300(!!!) for an initial California license.

The only good news here is that you can deduct all of the licensing expenses from your 1099 income.

Now, before you go too crazy and apply for licenses in all 50 states along with Guam and the American Virgin Islands, you should keep in mind the additional hidden costs of licensing:

FCVS – $375 for the initial application to create your profile, $95 for a subsequent application and $65 for each state you apply.
DEA – Each new DEA registration is $731, and it must be renewed every three years.
CSR (Controlled Substance Registration) – It’s required to prescribe controlled substances in 25 states on top of your DEA registration. On average it costs about $100 and has to be renewed every two to three years.
Licenses verification: Services like VeriDoc connect state boards directly with each other to verify your existing licenses when applying for a new one. The cost runs $10-60 for each board you are already licensed with.
Misc expenses: fingerprinting services, postage: $20-$100 for each state

And, of course, license renewal fees…

Maintaining multiple licenses for locum tenens

Here’s a problem, my friends:

Medical licenses are like cars – the more you own, the more you pay to maintain them.

So even if you don’t practice in all the states you are licensed in, you need to pay to renew them every two to three years.

For example, keeping my five licenses active costs me about $1,000 every year.

But it doesn’t end there!

You also have to fulfill each state’s CME requirements by getting 20 to 50 CME hours per year.

Some of the states got “carried away” and decided the doctors have to take more “exotic” CME courses.

Here are some examples:

And guess what?

You have to pay for “state-approved” training courses which can be hundreds of dollars on top of your renewal fees.

Should you let your locum tenens license(s) lapse?

Since it is not cheap to keep your licenses, you may wonder if it is a good idea to let them lapse.

I think if you are 100% sure you don’t plan on working in that state, it is ok not to renew your license.

But, if you are not, I would only get rid of licenses that are expensive to renew and easy to get if needed again.

Also, feel free to let the state Controlled Substance Registrations (CSR) lapse, as they are not required to maintain a license and you can typically renew them fast.

Can you avoid renewal fees if you change your physician state license status to “inactive”?

Certain states (e.g. CA, OR, NC) let you switch your license status from “active” to “inactive.”

This way, you won’t need to fulfill the state’s CME requirements but…you still need to pay renewal fees.

Locum tenens licensing CONCLUSION

If you think about it, physician locum tenens licensing is a big mess that we all have to deal with.

I hope I’ve given you enough information to understand how it works and how to navigate it like a pro.

The Ultimate Guide to Locum Housing: I wish I knew this a loooong time ago

January 14, 2019 by LocumTenensGuy

Vlad Dzhashi, MD

There’s nothing worse than feeling exhausted waking up in the morning before starting your first shift at a new hospital.

Believe me, I’ve been there and done that. It really sucks!

And I am not talking about being tired because you stayed up late watching movies on Netflix.

I am talking about losing sleep while staying at a crappy hotel room because you didn’t do your homework beforehand.

What do I mean by that?

Well, if you don’t know your housing options, don’t double check what you are offered, and don’t negotiate and request the quality housing you deserve, sooner or later you’ll have a few (if not many) sleepless nights.

That’s why I’ve created the most comprehensive locum tenens housing guide on the web! (Trust me, I’m not exaggerating! I’ve searched for one and couldn’t find it.)

So read carefully and I promise you’ll find lots of helpful tips, whether you are new to locum tenens or you’ve traveled as a locums doc before.

Here’s what I’ll cover today:

– Locum housing options with their pros and cons.

– Tips on how not to be a “sucker.”

– Locum housing DIY – does it make sense?

– How to negotiate your locum housing to get the most of it.

– At the end, I’ll also reveal a LocumGuy’s “secret” on how to make money “out of a thin air” while traveling for locum work.

So stay tuned and read till the end!

Let’s dive right in!

Locum housing option # 1: Hotels

Hotels come in all shapes and sizes, but 3-star accommodation is a locum industry standard. This is what you are most likely going to get for your locum travel.

The biggest pros of the hotel are that it gives a predictable experience and there are plenty of them to choose from.

Another perk is a hotel rewards program. Every large hotel chain has one. You get free points that you can use later for your personal travel expenses, room upgrades, etc. (Here’s a list of the largest rewards programs that can help you to compare them)

The key is to sign up as early as possible to start accumulating the points.

I actually was surprised by how quickly the reward points added up when I got a late check out after reaching a silver membership status in just a few months.

Now, here’s my word of caution about the hotels: if you work locum tenens long enough, at some point you may end up in a run-down, two-star hotel (disguised as three-star) with an old, noisy heating system and a funny smell coming from the bathroom, like I did a couple of times.

How did it happen?

The truth is that the locum companies don’t care which hotels you stay in. So it’s eventually up to us to screen the hotels beforehand.

How do I do this?

I use the TripAdvisor website or app.

It’s got a super helpful “traveler photos” section where you can see actual rooms and amenities pictures uploaded by the hotel guests, which gives me a very good idea of what I’m actually going to get.

I also always check the hotel rating and would say NO to anything less than 4.0.

This simple routine only takes a couple of minutes but will save you from sleepless nights.

What else do I check beforehand?

I always make sure the hotel amenities include a gym and a kitchenette (aka small kitchen).

Now, even if you don’t want to bother cooking for yourself, rooms with a kitchenette tend to be a little more spacious, and you are guaranteed to have an actual fridge (not just a freezer) and a microwave.

This way, even if you order at a restaurant and take the food home, you’ll be able to keep and finish it the next day.

Hotel tips:
1 – Sign up with the rewards program.
2 – Do not ever agree to anything less than 3 star.
3 – Check TripAdvisor travelers photos and ratings.
4 – Consider getting a room with the kitchenette.

Luxury tenens, anybody?

Ok, what if for some unclear, random reason, you are attracted to the higher standards, and every time you think of a 300 sq ft hotel room, you get nauseous and claustrophobic?

Not a problem!

There’s always an option of upgrading your hotel room to a suite. You could pay out of pocket for this ($30-$50 extra per night on average), use your reward points, or have the agency/hospital cover the difference.

Onward.

Locum housing option # 2: Airbnb or similar sites

Renting an Airbnb apartment would pretty much always give you more bang for the buck: you get a more spacious place to stay, a better-equipped kitchen and overall a more private, home-like experience.

It also may be a better choice if you plan to bring your spouse or family with you.

Here’s a problem though: anybody can list his property and call himself “a host.” So unlike hotels, there’s really no “big brother” watching and keeping track of the quality.

A few times I’ve had a quite unpleasant experience with both VRBO and Airbnb apartments, so I’ve come up with very strict but simple criteria to filter out the “bad” and the “ugly.”

The first thing I do is read the actual reviews, paying close attention to the most recent ones. I only consider properties with 20+ reviews (the more, the better) and a rating of above 4.5 stars. This is a first proxy for the quality.

Second, I only pick the listing by so-called “super hosts” — those are highly rated hosts with great track records.

Trust me, if you use these two simple criteria, you’ll stay away from trouble 99% of the time.

Now, if you book your own housing, there are a couple other things to keep in mind:

One is the cancellation policy for each particular rental. Unlike hotels, it is usually not that flexible and it may vary among them .

Most hosts won’t let you cancel 24 hours before your stay, and some hosts will only reimburse 50% of your stay even when canceled months in advance.

That’s especially important since as a locum, you could get your shifts canceled (although no later than 30 days before the shift is scheduled). That’s why the only two cancellation options I would accept are “moderate” (lets you cancel 5 days in advance) and “flexible” (can cancel 24 hours in advance).

Another hack I’ve learned booking apartments myself is that you should always start looking for a place ahead of time (at least 3 months before your shift dates), since good rentals (great cost/quality ratio) are gone very early.

Finally, although Airbnb has the most listings, there are many other decent sites you can use for short or long-term rent:

Airbnb checklist:
1 – Rental should have more than 20 reviews, with a minimal rating of 4.5 stars or above.
2 – Stick with “Super hosts.”
3 – Consider only apartments with “flexible” or “moderate” cancellation options (important only if you book your own housing).
4 – Book early (important only if you book your own housing).

Onward.

Locum housing option # 3: Corporate apartment

The corporate apartment has similar pros of a hotel since it’s listed by “professional” people, and much like Airbnb, it gives you more of a home-like experience.

I recently stayed at one of these apartments and had a great experience. So far I think this is probably the best option out of all three.

If you plan to find corporate accommodations yourself, just google “furnished” or “corporate” apartment + your location. I’ve also used some dedicated sites which have lots of listings and can be searched by location.

Keep in mind that most corporate housing lease terms start at 30 days, and there are fewer options to choose from compared to Airbnb housing.

Now, the main drawback of the apartment rentals (both Airbnb and corporate) is that they will have fewer amenities compared to the hotels (e.g. no pool, no vending machines), will have no breakfast and no room service, which may be a dealbreaker for some.

Finding housing yourself - to DIY or not to DIY?

All three housing options can be covered by your locum agency and hospital you work with, or you can do it yourself.

Most of the time I prefer others to take care of my locum housing, but there are times when the DIY option makes sense. This can include times when:

– You work directly with the hospital/clinic and they don’t want to deal with your travel arrangements.

– You prefer a bigger space, and the agency/hospital is not willing to walk an extra mile to make you more comfortable (usually not a good sign).

– You travel with pets and the hotel is very restricting about that.

– You’ve got a taste for something special and/or super expensive (e.g. house at the lake) or something weird (e.g. treehouse). You never know, right?

Housing Negotiation Tips:

Now, it’s time to get down to work and negotiate the best possible accommodation for ourselves.

1 – First thing first: you need to make up your mind and decide on which housing options you would like.

2 – Second, remember that in locum business, everything is negotiable and housing is no exception. And most, if not all, locum companies will agree to rent a decent place for you as long as YOU ASK FOR IT!

So never hesitate to request the housing option you want!

3 – Third, let your agency/hospital know about your housing preferences BEFORE you are “presented” to the hospital. This way there are no surprises on either end.

But what if you haven’t negotiated your housing upfront and you are not happy with where you are staying?

It’s actually very easy to request an upgrade (getting an apartment or a suite), especially if you’ve worked with the agency or hospital for some time.

Here’s the exact script that I’ve used before:

“We’ve worked together for a while and my overall experience has been great. The only thing that bothers me is this tiny hotel room I am staying at. It just gets too depressing spending so much time in a small space! That’s why I wanted to get an upgrade.”

Now that we know all our options and how to properly negotiate the locum housing, let me reveal a cool hack to make an extra $.

The DIY “hack” for frugal doctors:

Here’s what you need to do:

1 – Find a cheap room/entire place that runs beyond the average $100-130/night hotel rate.

It can be something you found on Airbnb or let’s say one of your colleagues or family member rents out a room or a guest suite for a reasonable price (it really depends on the location, but I’ve seen $30-50/night for a decent room and even studio/apartment).

2 – Look up the 3-star hotel rates in the area you will be staying.

3 – Talk to the agency/hospital you work with and request the housing reimbursement at the rate you’ve discovered (usually runs at about $100-130/night).

4 – Cha-ching! You get your money and say many thanks to the LocumGuy!

Now, let’s calculate how much you can actually make:

Pretax gain: (14 shifts a month which translates into a 16-night stay):

Let’s say you spent $50/night and you got your $100/night reimbursement, so you’ll pocket $50/night difference, which will give you a total of $800/month or $9600/year.

Almost $10K! Out of a thin air!

Not bad!

Now, this approach is not for the faint-hearted, but I know frugal physicians who’ve mastered this strategy for additional income.

Conclusion:

I’ve covered a lot of ground today, and now you know everything you need to get the best locum housing possible to have a home away from home!

P.S. What locum housing do you prefer? Why? Please let me know in the comments below!

practical tips

Vlad Dzhashi, MD

Recipe with two ingredients:

“Secret ingredient” for faster check out:

How to do it?

How much will you save?

Between $25K to $35K annually!

Why locum tenens straight out of the residency?

How long does it take to pay off your medical school debt?

Student Debt Pay Off Time Calculator

Total Student Debt:

Shift/day pay:

Number of shifts per month:

Average Tax rate:

Monthly Expenses (exluding debt):

Your Monthly student loan payment:

Monthly income:

Income after tax:

Money left / month:

Time required (in months):

Number of shifts/work days required:

11 Steps to paying off your student debt working locum tenens:

Step #1 - Figure out where you’re going to work (6 months before you start locums):

Step #2 - Contact the locum agencies and negotiate (5-6 months before you start locums):

Step #3 - Apply for licenses (5-6 months before you start locums):

Step #4 - Credentialing (3-4 months before you start locums):

Step #5 - Schedule your shifts (3-4 months before you start locums):

Step #6 - Get four types of insurance (3 months before you start locums):

Step #7 - Get rid of the stuff you don’t need (a month before you start locums):

Step #8 Refinance your student loan (as soon as you graduate from residency)

Step #9 - First months of locums work (month 0 to 3):

Step #10 - Cranking out until your student debt is paid off (month 4 through 12 to 24):

Step #11 Celebrate:

You are free!

My confession...

The end.

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Vlad Dzhashi, MD

What is a locum contract?

malpractice insurance

SHIFT CANCELLATION OR OUT CLAUSE in locum contract

NON-COMPETE CLAUSE in locum tenens contracts

TERMINATION and RENEWAL of locum tenens physician contract

Sample locum tenens contract template:

CONCLUSION: reading a locum tenens physician agreement

Vlad Dzhashi, MD

Locum tenens license definition

How to stay on top of your locum tenens licensing forever

👉 1 – Get your cr@p together!

👉 2 - Sign up for FCVS

👉 3 – Get at least two DEA registrations

Locum tenens license shortcuts

👉 1 – The Interstate Medical Licensure Compact (IMLC):

👉 2 – Temporary medical license:

👉 3 – Locum tenens license:

States with locum tenens license

How to work all over the country with only one locum tenens medical license

Costs of medical licenses:

Maintaining multiple licenses for locum tenens

Should you let your locum tenens license(s) lapse?

Can you avoid renewal fees if you change your physician state license status to “inactive”?

Locum tenens licensing CONCLUSION

Vlad Dzhashi, MD

Locum housing option # 1: Hotels

Luxury tenens, anybody?

Locum housing option # 2: Airbnb or similar sites

Locum housing option # 3: Corporate apartment

Finding housing yourself - to DIY or not to DIY?

Housing Negotiation Tips:

The DIY “hack” for frugal doctors:

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