How does locums work for orthopedic surgery?

Nicholas Kusnezov, MD, a board-certified orthopedic surgeon who practices in Tennessee, shares his tips on how to be successful as a locum tenens orthopedic surgeon.

Speaking as an orthopedic surgeon who has been actively and successfully engaged in locums for the past few years, I feel that I have a solid understanding of the intricacies of orthopedic locums and am uniquely qualified to share my experience.

Why do facilities need locums?

Facilities need locums for a variety of reasons. This may include simple call coverage during a planned vacation, periodic coverage due to loss of a provider, or even as a form of “tryout” for facilities seeking a more permanent position in the future. As a result, there will always be a need for locum providers.

What types of procedures do locum tenens orthopedic surgeons do?

Locums is attractive for many reasons. As a locum tenens orthopedic surgeon, you can select assignments requiring procedures that you enjoy but that you may otherwise not have as much exposure to in your primary practice. You have the opportunity to perform whatever procedures you are qualified to do and which you feel comfortable with. As a result, this may involve simple elective procedures such as carpal tunnel releases or outpatient low-acuity traumas like ankle fracture fixation, or it may range to more high-acuity trauma, such as musculoskeletal poly trauma, complex periprosthetic fractures, or joint replacement surgery.

locum tenens orthopedic surgeon in surgery

I would caution you that — despite being a locum and potentially having no follow up with these patients — you should only commit to procedures that you are qualified and comfortable with performing in order to ensure the best possible patient outcomes. Personally, having extensive experience with high-acuity trauma and complex joint reconstruction surgery, so I am comfortable managing anything that presents to my trauma center. However, many of these patients and cases may require staged procedures and prolonged aftercare; therefore, it is paramount to establish and maintain open channels of communication to facilitate optimal patient care, as I always do.

Are there continuity of care issues?

As you can imagine, as a locum surgeon, there may be continuity of care issues if you do not anticipate and plan for this ahead of time. This is applicable to not only those patients you would care for during your assignment but to patients at your primary practice.

It is paramount to ensure continuity of care for your patients, even though you may not personally be seeing them back depending on the structure and time commitment for the given locum assignment. This can be done a number of ways but is most effective in my opinion through direct communication with the local orthopedist or physician assistants with which your patients will be following up.

I personally maintain an open channel of communication with these individuals for all of the assignments that I have undertaken over the years. At the minimum, this entails communicating postoperative restrictions, follow-up, and the overall game plan for your patients. Additionally, this means making sure that you are available in some regard for questions regarding care or even unanticipated complications which may arise. It is easy as a locum physician to write off patient aftercare, given that this is not a requirement, but I would strongly encourage active engagement in your patients’ care to foster quality and ensure the best possible outcomes.

Additionally, depending on how much time you commit to locum assignments, you want to ensure that the patients at your primary practice are not neglected as a result of your absence. This involves, as I touch on previously, communicating a game plan to your partners or mid-levels which can be effectively carried out in your absence, and again, being available for any questions or potential unforeseen issues which may arise in your absence. Orthopedics, like other surgical specialties, is a full-time job. 

Do you have questions for Dr. Kusnezov? Ask them in the comments below.

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