Locuming in Ontario
What is a locum?
"Locum tenens" – or "locum" is a critical component of the physician workforce. Locum refers to a physician who assumes another physician’s clinical duties on a temporary basis.
These placements offer unique opportunities for new physicians seeking diverse clinical experiences in new locations, as well as for established physicians who wish to explore new ways of practice or hone different skills. For some, locuming may signal the start of a shift toward retirement. Locum placements help meet the medical needs of the physician community, making it an important component of government physician retention programs.
Locums allow the incumbent physician time away for travel, illness, maternity/paternity leave, or professional development. A physician may locum anywhere from a few hours to several months or longer. A physician may locum for several days, a few weeks or longer. Locum placements may occur in any geographic location or specialty.
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Locum placements in Ontario
Locum placements can be arranged through formal programs or privately. Many locums, particularly in urban areas, are arranged outside of formal programs through physician-to-physician arrangements. HFOJobs is a free and easy-to-use online portal that allows for the posting of locum jobs and positions.
In Ontario three locum programs are administered by the Ontario Physician Locum Programs (OPLP) of the HealthForceOntario Marketing and Recruitment Agency:
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What you need to be ready to locum
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Insurance: The cost of insurance will vary depending on the nature of service/specialty being provided (e.g. obstetrics, surgical assisting, family medicine, emergency) as well as the geographic jurisdiction in which the service is being delivered. Further information can be accessed through the Canadian Medical Protective Association.
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Provincial practice licence: Locums must have a license from the College of Physicians and Surgeons of Ontario (CPSO).
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Hospital privileges: If a locum physician expects to be involved in a hospital setting, approved hospital privileges will be required. The process to acquire hospital privileges can take a few days to weeks. A current provincial licence, documentation of adequate insurance coverage, and letters of reference are usually minimum requirements.
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Billing number: Locums need an active Ontario Health Insurance Plan (OHIP) billing number. Payment mechanisms range from a flat daily rate to a percentage of the fee-for-service billings.
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Tips on locuming
Being a locum brings with it unique challenges, risks, and rewards. Here are some tips to make the experience a positive one for both the locum physician and the patients.
- Be aware that serving as a locum will not necessarily provide the physician-patient relationships or integration into a health care team that comes with an established practice and a commitment to the community.
- Be prepared for the physical demands of travel, as well as isolation from personal and professional supports.
- It's advisable to have a written contract prior to the start of the locum. Payment should reflect all aspects of clinical service, including billing costs, third-party services, uninsured services and on-call stipends. Generic contract template.
- Make realistic commitments. Never strand a physician or community with a last-minute cancellation.
- Determine the range of clinical duties required and self-evaluate accordingly. Rural care typically requires a more diverse skill set. Make clear up front any discomfort in performing certain services so backup can be arranged. Similarly, find out if the physician you are covering for has a particular procedure or area of specialty.
- Tie up loose ends. Follow up on laboratory results, finish paperwork, and clarify orders at the nursing station and pharmacy prior to the completion of the placement.
- Document problems. Alert the returning physician to troublesome interactions with patients or patients upset by other issues, and note patients who died or received serious diagnoses.
See related article from Canadian Family Physician
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