The Art of Medicine, Episode #2, Interview with a Locum Tenens Recruiter-Part II

Dr. Andrew Wilner interviews Nichole Paskett, a senior staffing agent for CompHealth. Part I was posted on February 19, 2020, and set records for views for this series! In this 20-minute continuation, Nichole reveals how to get a good locum tenens assignment, highlights the importance of being responsive, comments on the growing locum tenens marketplace, and provides insight and tips to help locum tenens physicians succeed in their careers.

For more on locum tenens, check out my book, "The Locum Life: A Physician's Guide to Locum Tenens."

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Transcript

Andrew Wilner, MD Andrew Wilner, MD  0:06  
Welcome. I'm Dr Andrew Wilner, author of The locum life, a physician's guide to locum tenants. And this is our continuing series about locums. And today I have the opportunity to speak with Nicole pasquette. Nicole is a staffing agent for comp health, one of the largest and the oldest staffing agencies for locum tenants. I thought it was really important to hear about the agents. Point of View. I've written about locum tenens and interviewed a lot of physicians about it, but I thought it would be really valuable to have a staffing agent's point of view. So welcome Nicole. So say I'm a physician, and we've talked and I want an assignment, yeah. What can I do to make sure I get I'm sure if some assignments are better than others. How do I get a good one? What do I need to do to get a good assignment? Yeah,

Nicole Paskett  1:05  
so I think, personally, the first thing you need to do is figure out what is good to you and what makes a good assignment to you. Like what is your goal and what's most important to you? Is it location? Is it the amount of time? Is it the pay, you know, guess a combination of all three, and communicate that with your recruiter, because once we know what your goals are and what's most important to you, we can help build a plan based off of that. So in my opinion, so if it's, let's just say it's location, and that's you want a better location, as far as you know, I'll have people that call me and they want, you know, New York City or Hawaii, or Southern California, some of those more heavily saturated areas, what's important would be to move quickly, then to be responsive. If you see a job that's in a location that is important to you, move quickly, because those go fast, just like in the permanent sector, and there will be more candidates applying for that position. And it'll, it'll locums is a fast moving business, as you you know. And then, if it's pay,

Nicole Paskett 2:25  
communicate

Nicole Paskett 2:26  
that with your

Nicole Paskett  2:30  
representative, like myself, you know, I'll have physicians that well let me know this is what I need to be making to ensure it's worth my time to close my practice for a week, or for me to leave my permanent contract, I need to be making X amount for the year. You know, pay is the most important factor to me, because I'm trying to pay off my medical school loans or whatever it might be. And then we specialize in negotiating, you know the best pay that we can for you, and ensuring your CV is up to date. All of your qualifications are on there. You're up to enter your CME and different factors that can set you apart from other candidates.

Andrew Wilner, MD  3:13  
Now, you've been doing this for more than a dozen years. What's the the marketplace like now. So I'm a neurologist. I'm thinking of doing locums. Are there? Is it hard for me to find a position? Are there a lot of positions? How does what is the market now? The markets? Gosh, it's

Nicole Paskett  3:33  
growing. It's crazy to see how much it's grown. And I mean, even the last five years, but especially since I started, you know, over 10 years ago, and your specialty is a very high in demand. Specialty, neurology and it for locums. It mirrors, or I found, in my opinion, it mirrors the permanent job market. So specialties that are in high demand, you know, hospital based specialties right now, hospitalists, internal medicine, neurology, even psych, cardiology, you know, all of those are in high demand. I can confidently say that I can for my specialty, where I'm where I'm the you know, I guess my focus being neurology, I can confidently say, if I have a neurologist coming to me that has

Unknown Speaker  4:27  
some flexibility, we

Nicole Paskett  4:28  
can keep you as busy as you want. If you go on our website, on compel.com, right now, I think there's over 5500 jobs, or all of our specialties right now for locum so if that gives you an idea, we're the largest locums agency, and then whether comp health and whether it be our sister company right behind us. So I can confidently say, CHG, you know, continues to lead the market. And. And we can keep you as busy as you want to be.

Andrew Wilner, MD  5:02  
Well, that's fantastic. Yeah, you know, there's, there are some thorny details about working locums, and I want to talk about those. One is licensing. So obviously, if I'm a physician and I want to work in South Dakota, I gotta get a South Dakota license, you do work in Minnesota, I have to have a Minnesota license. And the more licenses I have, the more job opportunities I'm going to have. But the licenses, you have to keep up the CME and of course, you have to pay for the licenses. How does comp health help out in that respect? And and before you answer that, how many licenses should I get?

Nicole Paskett  5:48  
Well, it varies licensing. Yes, that can be a paperwork. I don't think that's any physician's favorite thing to do, right? I don't think that's why most of you guys got into medicine. So yeah, I know that can be the thorn in your side and a benefit to working with my licensing team. And so as far as how many licenses, it varies. So it depends. Where do you want to practice? Are you totally flexible and open to going to multiple locations you might need, but you may only need two licenses or one. For that matter, I have some physicians that work full time, welcomes that only hold one, stay licensed. Some that hold 10. Some that, do you know telemedicine, for example, that hold over 20. So it really just varies person to person, and that's why it's really important to communicate to your agency that you're working with what's important to you as far as location and your goals, so that we can best guide you in a plan. The great thing that exists now is the interstate medical compact license. So I

Unknown Speaker  7:01  
think they have 26

Nicole Paskett  7:04  
sounds about right. 26 lice states that participate, and it's a pathway to licensure. The fees are still there, but again, as an agency, we cover, you know, for the most part, we would cover those fees, as it's tied to locums work and but the paperwork Once you're enrolled in that if you qualify, there are some qualifications that need to be met for the interstate medical license compact. But once you qualify, that expedites the licensing process significantly. And if you don't qualify for it based on different factors or that are on their website and ours. And we can suggest certain states where we get most locums work. I have data that I can pull, let's say for my specialty, specifically saying, oh, okay, you know, Washington would be a good state for you, if you're totally open to location and you just want to be doing strictly neuro hospitals work. This is where we get the most neuro hospitals work up here in Washington State or Pennsylvania or wherever that might be. And or there are certain states that are just easier to obtain. They have either local tenants licenses or an easier process. So it all just depends on what your goals are.

Andrew Wilner, MD  8:27  
I remember when I got my Nevada license, the agent there was very proud that Nevada was one of the most difficult licenses in the country to get that they had more obstacles finger printing and documentation than anybody else. And so she congratulated me that I actually managed to get all of the required documents to Nevada. And of course, Nevada is one of the states that has one of the biggest physician shortages in the country. I wonder if those two things are associated. Can you tell me, off the top of your head, if I had to pick one state as a neurologist to get a license, where the most most work is where they really need neurology? Do you happen to can you give

Unknown Speaker  9:18  
me I would say I mentioned

Nicole Paskett  9:20  
Washington, Washington State as a neuro hospitalist, and Pennsylvania, those are the two, and being strategic about things, especially where Pennsylvania, right now, takes anywhere between 14 to 16 weeks to obtain that might be something that you would work With your rep to proactively license you for Pennsylvania, where Washington only is taking about five weeks, so you might have time while your hospital privileges are in process to obtain that. But those are a couple offhand. Ohio is another state that I see a lot a.

Andrew Wilner, MD  9:59  
Let me All right, let me switch Yeah, to the the other problematic area for physicians, malpractice. Yeah, malpractice. Okay, so I have my job, but I want to work locums part time. And of course, I have malpractice insurance through my regular job, and now I want to go work locums. So do I need additional malpractice and if so, where do I get it? Yeah, so

Unknown Speaker  10:27  
you would need to

Unknown Speaker  10:29  
obtain malpractice insurance through comp health,

Nicole Paskett  10:33  
if you're working with my agency and most reputable agencies, especially if they're members of nalto would provide you malpractice insurance, and our limits are standard, like any other carrier, and so you aren't, Generally speaking, able to use your own malpractice insurance during a locums assignment, and your malpractice insurance that you would have through comp health would be solely for your work through comp health after your done with your locum assignment. Let's just say you decide to work just a week of locums in between of two permanent jobs. For example, you aren't you don't need to worry about purchasing tail coverage, for example, because you're covered no matter when the claim occurs. So it's lifetime coverage, and if you already have malpractice, let's say a malpractice claim. Rather, you know for going that route as well. That doesn't preclude you from working locums at all. Just like any permanent position that you're applying for, you would just need to communicate that up front, whether it's a pending case or previous payout, just communicate that with your rep, just to ensure that they can communicate that with the facility that you're applying to and allow enough time for licensure or hospital

Unknown Speaker  12:05  
privileges.

Andrew Wilner, MD  12:06  
Oh, that's great. In fact, that was my next question. Okay, let me just summarize what you said, because I think it's really important you have to have additional malpractice for your locums. But if you work through an agency like comp health, they will provide it, and they will also provide that scale. And then if you happen to have a malpractice claim against you, as more than half of physicians do if they're over 55 years old, it's a common thing that will not keep you from working local tenants, but you need to be upfront about it on your application, share that information with your staffing agent. And should you know, maybe, if you have 10 claims, it might become a problem, but one or two certainly wouldn't, wouldn't be. Is that right?

Unknown Speaker  12:56  
That's correct. And

Nicole Paskett  12:58  
even if you did have 10, it may not. It may not be, especially depending on your specialty and your work history. You know there's different factors that our internet internal credentialing department will look at. It may not again. Bar you from working locums. It's just something that we have to make sure you have listed up front, and then also make sure if you do have malpractice, whether it's pending or previous payouts, have your documentation gathered. You know whether it's court documents or whatever it might be, just ensure you have that, because you will be asked to supply that for the licensing board or to comp health, since we will you know would be covering your malpractice insurance as well as hospital privileging applications, as you know, they all ask about it, so it's just important to make sure you're organized and have a

Unknown Speaker  13:50  
explanation available.

Andrew Wilner, MD  13:51  
Right in my book, I talk about making a folder, either on a Dropbox or iCloud or somewhere, with all of your diplomas, letters of recommendation, and state licenses, because somehow these things are always being asked for, and it's it's usually something that isn't, that you don't use every day. So I have PDFs of all of these documents, so I can produce them pretty quickly, and I think that's something that locum tenens physicians probably would benefit from doing. Now we've talked a lot about neurology, I guess I can't help that. I'm a neurologist, right? Can you do you have kind of an overview of which other specialties are in big demand now for local tenants, yeah, you know

Unknown Speaker  14:45  
again, it mirrors,

Unknown Speaker  14:48  
in my opinion, closely to

Nicole Paskett  14:52  
what the market looks like in high demand specialties for permanent staffing, low. Sometimes trends follow the same. So a lot of those same specialties that, like neurology and, you know, cardiology and OB and family medicine, you know, or hospital based specialties that you know, you can find information about online. It's, it's mirrored, in my opinion, on the locums front. So

Andrew Wilner, MD  15:21  
pretty much any specialty, I think I read somewhere that psychiatry is actually in, yeah, big demand, which surprised me somehow. You I, you know, traveling nurse is sort of an image in your brain, but the traveling psychiatrist somehow was it. But that's not as much reality. That's

Nicole Paskett  15:39  
it is. It is. I was reading, reading about that last week as well.

Andrew Wilner, MD  15:44  
Let's see. What about other agencies? So I've worked with comp health, but I went through your 5500 job opportunities, and I don't see what I want if I'm working with you, am I allowed to work with a different agency as well? Yeah,

Nicole Paskett  16:00  
yeah. So I find a lot of the physicians that I that might originally inquire about locums if they're not referred

Unknown Speaker  16:08  
to me, let's say from another physician,

Nicole Paskett  16:13  
they might just be on the prowl, looking at different job opportunities online. So it's not uncommon for them to be originally inquiring with multiple agencies online and not a problem at all. No conflict of interest. Generally, most of the time, I find once they have had an experience with a specific agency and it's gone well, they tend to gravitate to, you know, just primarily working with that agency for,

Unknown Speaker  16:46  
you know, their relationship that they have with their recruiter

Unknown Speaker  16:48  
or agent,

Nicole Paskett  16:51  
and also just for ease of scheduling and other things like that. But, yeah, it's not a problem at all. Again, it just comes down to communication and making sure that you're communicating with each agency about other assignments that you've accepted, so that they can help you ensure that there's not a conflict as far as scheduling goes, even, you know, just travel time and little things that we can take off of your plate, and Then

Unknown Speaker  17:20  
it's generally not a problem at

Andrew Wilner, MD  17:21  
all. Well, Nicole, this has been really fabulous information before we wrap up. I want to give you an opportunity to give Do you have any advice you would give to a physician who's thinking about doing locums?

Nicole Paskett  17:37  
So take a look at this book that Dr Wilner wrote, and super educational. I know you not asking for any plug by me or anything, but truly, I recommended it to several physicians who have just don't have the, you know, even the Anest idea of, you know, what is locums all about. So I think educate yourself. There's lots of resources online. Comp Health's website has a lot of resources about locums, and, you know, just CV writing tips and interviewing, and you know what taxes look like and things like that. So I think educating yourself as much as possible to ensure it's something you want to do, and then speaking with a recruiter, someone like myself, who is the expert in that that field, that can help answer any questions that you might have let you know what you're you know what the job opportunities are, see if it's worth your time, and, you know, kind of just dip your toe into the locums market. I think another thing that I really like to do is connect physicians with other physicians that have worked locums, so you can, you know, speak with someone, even if it isn't the same specialty, someone that's done locums, either at the facility you're interested in working at, or just in general, so you can get their take physician to physician. So that's something I always try to do with the doctors that I work with, and I recommend. And then lastly, just try it. You know, give it a try. That would be my advice is, you know, even if it's something short, you know, try, if you're not sure you want to make that leap, you know, try a weekend or a week and and kind of see, like is, is this something that would help bring me some work life balance? Would it make me happy fulfill my career goals or networking goals, financial goals, whatever they they might be. So that would be my last advice is just give it a shot. That's

Andrew Wilner, MD  19:49  
great. I want to thank you for joining me on this webcast. This is really and it was a lot of fun. Thank you, yes. Thanks for having me. Yes, take care. Bye.

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