Register
with us

Click here
Register Now

Getting the balance right with the medical locum workforce

Nature teaches us a lot about the need for a rich and balanced ecosystem. Knock out one species and top predators starve, weeds and algae bloom and co-dependent species go extinct.

So it is with the medical workforce which is large, essential and 24/7. Keeping it up and running in an effective manner is a mammoth task (no pun intended).

Locums are an essential part if this particular ecosystem and whilst their use waxes and wanes, the numbers and activity of the locum workforce always seems to return to a state of balance.

And so it should be. Without the flexibility that locums provide the ability to provide medical services when and where needed would be seriously compromised.

So next time you wish you didn't have to rely on locums, imagine for a moment what life would be like if you couldn't. You might find yourself on an endangered species list pretty quickly.

Dr John Bethell, Director Wavelength International

Post your comment

Comments

  • Dr L 05/11/2013 9:01pm (4 years ago)

    I bet most hospital administrators do wonder what it would be like to not have to pay hundreds of thousands of dollars a year in commissions to locum agencies. I bet they imagine being able to spend that money on patient care. I rely on locum work for a living, but haven't used an agency for years. Locums may be an essential part of the healthcare system, locum agencies are not. Charging a hospital $2700 commission for booking a one week consultant position (ie 15%, the industry standard) for sending one email stating "Dr X can do your shifts", while making the hospital agree to a 12 month, anti-competitive exclusivity contract doesn't help patients or hospital budgets one bit.

    Imagine if available locum shifts (information which is actually publicly available, that no agency has special or unique access to) was widely and publicly distributed, for free, to all doctors in the country. Imagine if your health service didn't have to keep paying commissions when doctors who'd used an agency once kept working at the hospital, (regardless of whether the agency was used to book subsequent shifts or not...). Imagine looking patients in the eye and saying "no you don't have to spend the night on an ED trolley, you can go to the ward now because the hospital's saved hundreds of thousands of dollars in locum agency commissions this year and we now have enough ward beds to put patients in...

    Imagine if locum agencies were on the endangered species list...

  • Dr Tony Austin 06/11/2013 11:07am (4 years ago)

    Hi John. I think that it can be stated even more forcefully: Locums are an essential component of a robust and effective permanent health workforce. Locums are not just a default when you cannot get a permanent staff member - they gap fill between permanent contracts, they cover absences due to CPD, other professional development activities or unexpected personal/family crises. Every employer should nurture their locums so that they can maximize productivity when and where needed. They are an essential element of the team - not second class citizens. Now, if you can't get permanent staff and must rely on locums then that is a different issue that needs close examination but don't blame the locums for your problem.

  • Kirsten N Price 06/11/2013 4:01pm (4 years ago)

    You make a very good point. I know that Directors of Medical Services dislike the fact that recruitment is so difficult, and that they must rely on locums. However, this is taken to a whole other level in General Practice. If a locum can be found, the cost is enormous. Both factors result in General Practitioners now taking leave (for either study or recreation) and consequently get burned-out and/or divorced.

  • jbethell66 07/11/2013 7:34am (4 years ago)

    Thanks for your comment L. Some valid points, passionately put.

    You are absolutely right to assume that locum agencies in their currently form will die off the minute they lose relevance. I don't believe that day to be imminent, but who can tell?

    I am not sure if you are aware but the publicly available shift model has been tested a number of times in the market, both by private enterprises and health services directly. Initial enthusiasm on the part of employers, at the prospect of cheaper locums, has been quickly replaced by disappointment as result fail to materialize.

    Career locums who manage their own affairs represent a niche minority. Most doctors who do locums choose not to manage their own job search, because it is a time consuming activity that interferes with their other commitments, hence the lack of popularity of online shift lists.

    With regards to cost, the "one email - one shift" argument is one I hear often and it belies the activity and investment that go on behind the scenes. Where such costs not absorbed by out-sourced agencies they would be hidden in the delivery of health services anyway. Your patient might still have to spend the night on the ED trolley but it will be less obvious who to blame for their woes.

    In-house contracting teams usually prove to be the more expensive and less effective option which is why employers prefer to incur cost at the point of need rather than sinking it into infrastructure.

    However, should the marketplace choose to confine the medical locum industry to the history books I, for one, will do my best to accept extinction with good grace.

  • john d 10/02/2014 9:00pm (4 years ago)

    Rightly the Locums are essential component of a robust and effective permanent health workforce. Locums are not just a default when you cannot get a permanent staff member – they gap fill between permanent contracts, they cover absences due to CPD, other professional development activities or unexpected personal/family crises. Every employer should nurture their locums so that they can maximize productivity when and where needed. They are an essential element of the team – not second class citizens but sometimes I know that Directors of Medical Services dislike the fact that recruitment is so difficult, and that they must rely on locums. However, this is taken to a whole other level in General Practice. If a locum can be found, the cost is enormous. Both factors result in General Practitioners now taking leave.

RSS feed for comments on this page | RSS feed for all comments

The best people, better placed for the best positions

Share, follow and join the conversation