The Locum Experience

One question medical residents often ask as they embark on their job search is, "What about locum coverage?" Locums offer residents the opportunity to explore different practice settings and communities before settling on a permanent position. At the same time, locums are a great recruitment opportunity for communities in need of physicians. Often, physicians continue to provide locum coverage for a physician group or community long after they have settled into permanent practice elsewhere. The locum experience can be a win-win situation for a community and the physician providing locum coverage!

At HealthForceOntario Marketing and Recruitment Agency (HFO MRA), three of the largest locum programs in the province are administered and managed through the Ontario Physician Locum Programs (OPLP):

• Rural Family Medicine Locum Program
• Northern Specialist Locum Programs
• Emergency Department Coverage Demonstration Project

All three programs have provided countless hours of invaluable locum coverage to underserviced communities across Ontario. The communities and local physicians participating in these locum programs are grateful for the support offered through the OPLP which helps ensure continuous patient care. 

The Rural Family Medicine Locum Program

The Rural Family Medicine Locum Program (RFMLP) maintains ongoing primary medical care in eligible Ontario communities by providing temporary, short-term respite locum coverage for eligible rural family physicians.

Eligibility
To be eligible for RFMLP coverage, the Rural Physician must:

• Practise in a community with a Rurality Index of Ontario (RIO) of 75 or over; or a RIO between 40 and 74 and with either 7 or fewer GP/FPs; or
• Be signatory to a Rural Northern Physician Group Agreement (RNPGA)
• Practice general/family medicine full-time in an eligible community
• Confirm eligibility with HealthForceOntario Marketing and Recruitment Agency (HFO MRA)

To provide locum coverage under the RFMLP, a Locum Physician must:

• Possess a valid, independent CPSO license Active and OHIP billing number
• Be a member of Canadian Medical Protective Association (CMPA)
• Have valid ACLS and ATLS certification

Remuneration
Family physicians providing locum support under the RFMLP are eligible to claim a daily stipend for every pre-approved day of clinic coverage. The amount of the daily stipend depends on the primary care model the rural physician belongs to and the community’s RIO score. Specified expenses are eligible for reimbursement, including travel and accommodations. A travel stipend is also offered.

For further details on remuneration and expense parameters of the RFMLP, visit the HFO MRA website.

RFMLP in action
Bancroft joined the RFMLP in early 2011 and then also joined the EDCDP in the summer of 2011 because the local hospital was having challenges ensuring ongoing ED coverage. EDCDP and RFMLP worked closely with the community to provide guidance and suggestions in ensuring ED coverage. When Dr. Brown, a family physician in Bancroft, took vacation, the clinic decided to access RFMLP to bring in locum coverage.

Not only did the RFMLP locum physician provide clinic coverage during his assignment, he also provided much needed coverage at the local emergency department. The RFMLP locum physician is currently considering joining the family health team in Bancroft and continues to provide both clinic and ED coverage in the community.

The Northern Specialist Locum Programs

The Northern Specialist Locum Programs (NSLP) provide replacement and vacancy specialist locum coverage to designated Northern Ontario communities and consists of two programs:

Urgent Locum Tenens program – The Urgent Locum Tenens Program accounts for a large majority of program usage and was established to provide coverage for vacant specialist positions in designated communities.

Respite Locum Tenens program – The Respite Locum Tenens Program can be accessed by a hospital/community that is at full complement but requires support for local specialist physicians to take vacations, time off for sick/personal leave, or CME training.

Eligibility
To be eligible for NSLP support, the community must be a Northern community within the designated districts of Algoma, Cochrane, Kenora, Manitoulin, Nipissing, Parry Sound, Rainy River, Sudbury, Thunder Bay and Timiskaming, and have a specified complement of physician specialists. 

Physician Eligibility
To provide locum coverage under the NSLP, specialists must be Royal College certified and have a base practice and permanent residence at least 40 km or greater from the locum site.

Remuneration varies by program, and may include travel time, a daily honorarium, travel and accommodation expenses, and sessional fees.

For further details on remuneration and expense parameters of the NLSP visit the HFO MRA website.

NSLP in action
Timmins and District Hospital serves an immediate population of about 46,000, with a catchment area of another 50,000. The region faces human resources challenges affecting family medicine, as well as many specialty services.

Fran Zimmerman, Recruitment Coordinator at Timmins and District Hospital states that "Because of this program (NSLP), services in general surgery, anesthesia, orthopedics, obstetrics/gynecology, psychiatry, radiology, and internal medicine can continue uninterrupted and patients can continue to receive the medical care they need. It also allows our local specialists some much needed respite which we view as a retention initiative. The locum experience also works as a recruitment tool in that it provides physicians with an opportunity to work in the hospital environment allowing both the physician and hospital staff to interact and determine if a full time opportunity may be a good fit."

Emergency Department Coverage Demonstration Project

The Emergency Department Coverage Demonstration Project (EDCDP) provides urgent ED locum coverage as an interim measure of last resort to designated hospitals that are facing significant challenges covering ED shifts.

Under the EDCDP, physicians from EDs in Ontario who are able to maintain their home hospital commitments assist other designated hospitals in the province with coverage for their ED shifts

EDCDP Physicians
Acceptance for limited positions is based on physician eligibility and program needs. Preferential selection is given to physicians currently working full time in an ED in Ontario.  Dependent on the type of contract, EDCDP physicians receive specified travel and accommodation, a stipend and/or travel time reimbursement.

EDCDP in action
Dr. Robert Stuparyk covered two of six urgent open shifts at Grey Bruce Health Services (Owen Sound and Southampton sites), the first weekend of November 2011. His first patient on his first shift in Southampton had been hit by a truck and was taken to the hospital with life-threatening injuries; she was quickly stabilized in Southampton and airlifted to London. If the Southampton ED had been closed, or if there had been any break in physician coverage, the outcome could have been quite different. The patient is now being treated in the London Health Sciences Centre intensive care unit, coincidentally by another EDCDP physician.

Looking to locum in Ontario? Check out www.hfojobs.ca for both locum and permanent positions.