When the Royers started their locum tenens agency, Mark said, it was very common for independent practices of four or five physicians to sell their practices to a local hospital and then become employed by that hospital. The way those hospitals measure productivity is in work relative value units (wRVUs). “ Then, two or three years into their contract, the hospital would tell the physicians they weren’t meeting their wRVU targets, and their contracts would be adjusted with a new salary that was usually less than the initial guarantee,” he said. “They’re working more because there are fewer of them, and they have to be on call every other night or weekend, but they’re actually taking a pay cut.”
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November 2022Also according to Mark, when doctors would press their administrators about taking on more work that wasn’t being reflected in their compensation, those administrators would cite federal fair market value laws, Stark anti-kickback laws, and an assortment of rules and regulations that essentially meant a ceiling on compensation.
Dr. Tennant has enjoyed the quality of his life this past year, particularly the autonomy of being able to create his own schedule. He has worked with several locum tenens companies providing contracted services, mixing and matching different types of work and seeing how different health systems operate. “I’m not good at not being busy,” he said, adding that this type of variety has been fun. “I don’t have a health policy background, but I have an undergraduate political science degree, and being in multiple healthcare systems has really grown my perspective. In academics, when you’re in one place it can be really insulated.”
The pay for locum tenens work is competitive, particularly in otolaryngology, where there tends to be a paucity of specialists in rural areas. But unlike travel nurses, who reportedly make a great deal more than their colleagues who work for one institution, the pay difference isn’t that stark. According to Dr. Tennant, locum tenens tends to pay more for time than for productivity.
“It’s been an interesting way of valuing my time, because I’ve always felt like my time wasn’t valued to the degree that it ought to be,” he said. “With head and neck oncology, you’re doing 12- to 15-hour surgeries and often not eating dinner with your family and not seeing your kids before they go to bed. I never felt like the compensation accounted for that.”