By FlexMedStaff

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So often in life, we want an easy fix. When seeking locums, per diem, or part-time work as a medical professional, we often quickly run to staffing agencies, and why wouldn’t we? Locums companies can offer you an opportunity to work for decent money while not having to find a facility, negotiate a contract and obtain malpractice insurance.

If you understand their motives and what they truly offer, there is nothing wrong with working with locums companies. Let’s face it locums companies are for-profit entities. Although staffing agencies feel they bring significant value to the healthcare system, they actually add to the cost of healthcare in this country. And let’s, please recognize that locums companies do not provide patient care; they leave that to you! Locums companies want to profit from your services while not taking on the liability of practicing medicine. Staffing agencies have made it clear to the medical facilities and government agencies that they do NOT practice medicine; they are just another expensive middleman in the healthcare industry.

If you are willing to put in the time and effort, contracting directly for locums-type work is an excellent option for some. Most practitioners need to recognize that contracting directly is an option. Not everyone needs to run to a locums recruiters to find work, as facilities are willing to contract directly with you.

If you were to put in the effort to contract directly, you got to be motivated and have good reasons to do it. This article provides the top 10 reasons to consider contracting directly with facilities for locums, per-diem, part-time and non-traditional roles rather than working thru a locum agency.

Top 10 Reasons to Contract Directly Rather than Thru a Locums Agency.

10) Why would I want a middleman to negotiate my rates?

Contracting Directly: Wouldn’t it make more sense to speak directly with administrators about your rates rather than have a locums recruiter factor in their margins before they agree to your rates? Understanding “Fair Market Value,” practitioners can negotiate directly for rates that compensate them well while saving the facilities money from using locums agencies.

9)  Why would I want the locums company dictating my schedule?

Contracting Directly: Wouldn’t it make more sense to have absolute control over your schedule by working directly with administrators to arrange the best work days for you? You should be able to take three weeks off if you want without having the fear that the locums company will replace you. Facilities that contract directly with you will make more effort to accommodate your schedule if they like you.

8)  Why would I want to sign a contract with a locums company with a non-beneficial Indemnification clause?

Contracting Directly: Wouldn’t it make more sense to have the ability to remove the indemnification clause that only benefits the locums company? Don’t ever agree to work for a locums company where you must hold them harmless and take on their liability. When contracting directly, it is easier to have these provisions edited or removed. 

7) Why would I want to deal with the “non-competes” and “buy-out” fees associated with locums companies?

Contracting Directly: Wouldn’t removing those non-competes and buy-out fees make more sense? Most locums companies have 1-2 year non-competes with facilities. This means you cannot freely contract directly with a facility for 1-2 years once you have been presented or after your last day working at the facility. If the facility were to hire you directly within the period of the non-compete, the facility would be forced to pay the buy-out fee. The buy-out fee is approximately $30,000 – $90,000 but can be up to 25% of the average salary in your specialty. Simply put, these non-competes are unfair to practitioners and facilities. Why should we have to worry about these buy-out fees?

6) Why would I want to be covered by the locums agency’s malpractice Policy?

Contracting Directly: Wouldn’t it make more sense to have your own individual malpractice policy? The group malpractice policies offered by locums companies are generally not of the greatest quality. Many of the policies are written in such a way to benefit the locums companies over the practitioners to make them cheaper. Why not have control over your own policy? 

5) Why deal with the risk of being canceled by a locum agency?

Contracting Directly: Wouldn’t it make more sense to work directly with facilities to establish a working relationship, minimizing the risk of being canceled or terminated? Facilities can quickly fire a locums company with or without 30-day notice. That means you might be out of work for some time until you can find a new gig. Contracting directly allows you to negotiate a 60-120 day notice so that you have time to figure out your future plans. Let’s be real…. A facility is less likely to fire someone they like whom they contracted directly with rather than one thru a locums agency. Furthermore, let’s not forget the habit of locums recruiters to ghost practitioners and moving on to another practitioner if they can find someone to work for less.

4) Why work with the middleman to speak on my behalf?

Contracting Directly: Wouldn’t it make more sense to speak directly with administrators? Why put so much faith in a locums company to ensure your credentialing is done on time or resolve issues? Contracting directly allows you to speak with administrators so that problems are resolved promptly without needing a middleman.   

3) Why must the locums agencies take a cut off my services?

Contracting Directly: Wouldn’t it make sense for the practitioners to make money rather than the middleman?  Practitioners take all the liability while locums agencies count their cash. Did you go into medicine to sit back and watch a recruiter make money off you while you work you’re a** off? Locums recruiters don’t just make a one-time fee off your services; they make an hourly commission for your services. In other words, the more you work, the more they make. Is that fair?

2) Lack of transparency with locums agencies and their recruiters.

Contracting Directly: Wouldn’t it make more sense to work with medical facilities where you can rid yourself of recruiters that don’t always provide complete transparency? The standard of practice of locums companies to avoid full transparency leads to unfair business practices toward facilities and practitioners. In some cases, the lack of transparency leads to the mistreatment of practitioners that have put their complete faith in a locums recruiter. Let’s not forget their habit of gaslighting practitioners by distorting reality and the truth. Avoid their “games” by working directly with facilities.

Add Drumroll, Please……

1) Why would I want to be associated with a locums company when I can be one of the family?

Contracting Directly: Wouldn’t it make sense to be one of the family then the red-headed stepchild? As a practitioner who contracts directly, facilities will treat you as one of their own. No matter how good or how well you are liked, a facility will always be looking to replace a practitioner that goes thru a locums company. Take the steps necessary to be one of the family by contracting directly with a facility, so they are not always looking to replace you.


This article should raise your suspicion about working with locums agencies and their motives. As medical professionals, we are not in the healthcare industry to take on all the liability while the locums companies profit off our services.  Sadly, not all facilities will be willing to contract directly, which is something we hope to change at FlexMedStaff. We are hopeful that all practitioners learn that contracting directly is an option rather than having to work thru a locums agency.  

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