3 Different Types of Locum Tenens Contracts Explained

     When starting in the world of locum tenens work, it can be confusing to determine the differences between the types of assignments available as well as the type of compensation to expect from each assignment. Three major assignment types are as follows:

     1.) Government contracts :
          One type of government contract out there is with military bases. These contracts can be anywhere from six months to a couple of years in length. In order for a provider to be accepted at a military base, agencies will submit what is called a bid, or the price at which a provider will work at that base. Based on this process, one would think money is the only factor when accepting a provider; however, this is not one hundred percent true. Each base will send out a practice description detailing what type of candidate they are looking for. After the quality and abilities of each candidate is reviewed, the price comes in to play. Compensation for government contracts is usually on the lower to middle section of the pay spectrum. The great thing about government work, however, is the prevalence of long term assignments. Longer assignments with lower pay usually end up being more worthwhile than a shorter contract with more money. In this case, the security of a long term paycheck usually wins out.

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     2.) FQHC/Community health centers/State facilities:
          Different from hospitals and private practices, Federally Qualified Health Centers (FQHC) and other state facilities offer a great way to expand your patient experience. Many locum tenens providers choose this type of setting as a way to give back to their community, and help the under-served populations. In this setting, providers will experience more Medicare and Medicaid reimbursements than in many other settings. Compensation in these types of facilities is dependent upon the budget and funding provided by the state to each individual facility. Typically, FQHC and other state supported facilities will pay less than most hospitals, but are still competitive with their rates.

     3.) Hospitals:
          Hospitals are a popular choice for many locum tenens providers because they house many specialties including (but not limited to) emergency medicine physicians, hospitalists, internal medicine physicians, cardiologists, general surgeons, etc. Also, hospitals usually have the funding capabilities to offer a wider range of pay along with a generous travel package often including hotel accommodations as well as airfare when necessary.

     When choosing which locum tenens contract is right for you, it is important to look at what is driving you to work; is it money, location, patient population, community, or overall experience? Each type of assignment discussed here has different things to offer providers, including a variety of compensation structures. If any of these types of opportunities seem appealing to you, please contact Medestar for more details.
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Laura Shirley is a Director of Account Management and Scheduling at Medestar.
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Physician Assistant Specialty Trends

     From its inception, the role of physician assistant was created as a way to ease the chronic shortage of primary care physicians. In fact, entry-level physician assistant training focuses on primary care with more clinical rotations in an outpatient setting than any other setting.

     Despite this fact, however, more and more physician assistants are choosing to pursue careers not in primary care, but in other medical specialties such as surgery, internal medicine, and as hospitalists. Further increasing this trend, the demand for physician assistants in surgical and medical subspecialties is increasing at a greater rate than that of primary care, creating more employment opportunities for physician assistants in subspecialties.

     The field of medicine has grown since physician assistants first started practicing. Because of this growth, physician assistants are branching out of the primary care specialty as the need for extra assistance in other specialties increases.

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Nurse Practitioners: Growing Need, Responsibilities, and Practices

     With the growing primary care physician shortage discussed in last week’s articles, there is a debate emerging about whether nurse practitioners can and should step in to ease the pains of the primary care physician shortage. In part one of this two-part blog, we discussed the possible concerns that could arise with an increased role for nurse practitioners. In part two, we will be discussing ways in which nurse practitioners can be used to help patients and ease the physician shortage.

     The current shortage of primary care physicians has created an increased demand for physician’s assistants and nurse practitioners, which will only increase as the shortage continues to grow. Along with the growing demand for additional nurse practitioners and the shortage of primary care physicians, there have been a number of states which have enacted legislation which has expanded the roles of the nurse practitioners to nearly 80% of the average primary care physician. In addition, nearly half of all U.S. states have also created legislation allowing nurse practitioners to practice independently, without a supervisory primary care physician. With far fewer years of schooling and far less debt, nurse practitioners are currently entering the health care system at a rate of nearly five times that of primary care physicians.

     To recap, there are three major advantages of having nurse practitioners step in to help ease the primary care physician shortage. First, they are able to accomplish eighty percent of what primary care physicians can which means many patients can have their clinical needs met without seeing a physician at all. Second, nurse practitioners are able to practice on their own in 22 states thus reducing the number of primary care physicians needed in those states. And finally, they are entering the work force much faster than primary care physicians which would allow them to impact the healthcare workforce faster than primary care physicians could and ease the pain of the shortage.

     The growing shortage of primary care physicians is sure to continue to drive the need for an increased number of nurse practitioners. After reading both sides of the argument, where do you stand on this issue?
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Belinda Bowman is Director of Business Development at Fidelis Partners.
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Nurse Practitioners: Growing Need, Responsibilities, and Practices

     With the growing primary care physician shortage discussed in last week’s articles, there is a debate emerging about whether nurse practitioners can and should step in to ease the pains of the primary care physician shortage. In this two-part blog, we will be discussing the way in which nurse practitioners can be used to help patients and ease the physician shortage as well as the possible concerns that may arise if nurse practitioners step into this role.

Image: FreeDigitalPhotos.net

     Three concerns associated with having nurse practitioners practice without a supervising physician include:
   
     1. The amount of clinical hands-on training done prior to entering practice.
         When nurse practitioners reach the point of certification, they have acquired between 500 and 1,500 hours of clinic training while a family physician, newly graduated, has more than 15,000 hours of hands-on clinical training in addition to 4 years of medical school. Furthermore, a 2004 survey published in the Journal of American Academy of Nurse Practitioners concluded that nurse practitioners do not feel ready for solo practice after the formal certification process.

     2. The degree of education and ability to handle complex cases.
         Nurse practitioners are trained to recognize and treat common health problems such as strep throat and ear infections as well as to monitor certain chronic conditions such as hypertension. They also often educate patients about chronic conditions, medications, nutrition and exercise. However, primary care physicians are trained to diagnose and treat more complex and difficult cases. Physicians receive training and education beyond that of nurse practitioners, thus giving them the ability to spot more difficult and complex cases.

     3. The price of a nurse practitioners can be deceiving for the healthcare industry as a whole.
         On the surface, it seems as though nurse practitioners are lower cost than physicians because they are paid less and fees paid by third-party payers are lower for nurse practitioners than their physician counterparts. However, often, nurse practitioners will order more tests and consult with specialists more often than resident physicians and attending physicians as found by a study in the journal, Efficient Clinical Practice. A less knowledgeable clinician will order more tests or consult with specialists more because of their uncertainty. The increased fee for tests and consultations offset the amount saved by using nurse practitioners as opposed to physicians.

     Tune in Friday, February 10th for the second part of this blog discussing the many ways nurse practitioners can help ease the burden of the primary care physician shortage.

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Three Ways Social Media is Transforming the Doctor-Patient Relationship

     To wrap up January and our month dedicated to social media in the healthcare industry, it is important to highlight “Three Ways Social Media is Transforming the Doctor-Patient Relationship.” Social media is changing the way doctors and patients interact with one another. Historically, healthcare has been physician-centric; however, because of technology’s impact (including social media) on our world, patients are beginning to play a more active role in their health care. At its core, social media promotes two-way continuous communication between patients and health care providers thus creating a more patient-centered health care experience. According to healthcare technology expert Chris Foster, Principal at Booz Allen Hamilton, three significant ways social media is transforming the health care industry and what it means for the future of patient care are:

     1.) Patient Empowerment
               Patients are using social media to discuss health conditions, seek out information about diseases and treatment options. In addition, social media allows patients to shop around and compare care options—made easy by websites such as PatientsLikeMe.com. Social media puts more control in patients’ hands by giving them access to expansive information, allowing them to be informed and educated advocates of their own care.

     2.) Real-Time Information and Instantaneous Feedback
               We touched on this idea in our earlier blog article, “5 Advantages of Social Media for Physicians in Practice.” This is an important feature of social media because it allows patients to have constant access to care via social networks and live chats. For instance, if a medication is recalled or an outbreak detected, physicians can push this information to their patients within seconds.

     3.) Improved Doctor/Patient Relationships
               The dialogue created by social media is helping to break down the barrier previously held between physicians and patients. A documentary was recently developed by Discovery Communication Health titled “Health IT—Advancing Care, Empowering Patients” which highlights Dr. Bruce Hopper, Jr. who texts, sends instant messages to, and video chats with his patients as much as possible. He also reaches out via Facebook and Twitter to share the latest health care information. When physicians increase their own availability and access, some patients feel closer to their physicians and feel as though their input is more valued leading them to feel as though they are part of a treatment plan.

     Social media is still a very new medium for physicians and patients alike, and we still have one important challenge to address: regulation of content. With the internet making information so readily available, concerns about patient privacy and ethics have come to the forefront of many discussions regarding the topic of social media and the health care industry. For example, is it ok for a patient to “friend” their physician on Facebook? Should physicians have two Facebook accounts—one for personal use and a second one for purely professional use? What about those physicians licensed in New York who are posting treatment information directed at patients in California?

     Despite this challenge, social media is allowing patients and health care professional to collaborate and generate customized solutions to individual patient health problems like never before. Social media is fresh and it’s changing the way we think about managing our health care. In the coming years, we will no doubt see more health related phone apps, health blogs, and web-based technologies to enhance conventional health care.

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Social Media-Proceed with Caution

     Over the past few weeks we have had several entries discussing the value of social media. Social media can be used to build a positive image; however, it may also unknowingly be used to destroy it. When using social media it is important to proceed with caution. You may think only your friends can see what you post, when in reality, you never know who is looking at your information. Once something hits the internet, there is no turning back. Examples of images being shattered via social media include Pittsburgh Steelers running back, Rashard Mendenhall’s tweet regarding the death of Osama bin Laden. Former Congressman Anthony Weiner will not be remembered for his legislative accomplishments, instead he will be known for the career destroying photo he published on Twitter. The lesson here is if you wouldn’t want your grandmother to see it or read it, don’t upload it, post it or tweet it!

     It is also important to remember that your opinion may not be shared by everyone. In fact some people may find it offensive. It is necessary to show restraint in certain areas, implement a filter, consider your audience and proceed with caution. In my daily activity I’ve even seen it have a negative impact on providers getting interviews. What better place to take something out of context than a social media outlet that displays pictures or quotes? Political preferences, religious views and a hand full of other opinions have cost people jobs and relationships. There is a fine line between freedom of speech and showing respect for all views. Offending people isn’t hard, especially when you have such a saturated mix of audience via social media. The lesson here is when in doubt, leave it out!

     Although it is important to remember to filter while using social media, don’t let it deter you from utilizing the many social networking sites.  It is an effective outlet for both professional and personal networking, just remember: 

 
Proceed with caution.
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This article was written by: Stephen Fish, Director of Business Development for Fidelis Partners.
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Can Online Scheduling Increase Patient Satisfaction?

     Take Care Health Systems, a subsidiary of Walgreens, have introduced online scheduling into their care clinics. Take Care Clinics are in select Walgreens stores throughout the country and provide primary care to patients. The online scheduling option at Take Care Clinics allows patients to review the available appoint times, as well as actually book their appointment on the internet or through an in-store kiosk. According to the American Academy of Family Physicians (AAFP), about 20% of Family Practice physicians offer the opportunity for patients to request appointment times online, however, they still need to call to actually set the appointments.

     Even though Take Care Clinics tend to have quick, less complex appointments than other specialties, the technology is worth consideration. Online scheduling provides another avenue to engage patients through technology. It gives patients the autonomy to decide what time best fits their busy lifestyles and increases patient satisfaction.

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