Beat Medical Blog

The Pied Piper - And Other Fairy Tales About Locums And Agencies

Posted by Beat Medical

Fairytale 1: Hospitals own their doctors

We know that there are not enough doctors in Australia- especially so for emergency, critical care, anaesthetics, and general practice jobs. The health system (public and private) relies on casual/locum doctors to hold things together, and keep hospitals going.

In a previous article, we wrote about how one state in Australia seems to be doing everything in its power to actually reduce the amount of locum doctors available to hospitals, and the community. One concerning trend we are seeing is the commodification of medical staff - and the perception from health departments, and individual hospitals that they actually "own" the doctors in their employ.

A number of the locum doctors who work with us have received letters, emails, and threats from their health services regarding 'secondary employment' as a locum. They generally read: "Dear Doctor XYZ.... it has come to our attention that you have taken time off to work at ABC Hospital recently as a locum. I must caution you that you may face disciplinary action if this continues.....etc". They then go on to cite policies, and of course - OH&S risks. There is a valid concern about doctors working too many hours, and all employers ought to be attentive to that fact. However, the message doctors are generally receiving is: "It is dangerous to work so many hours as a locum, but if you do it here, we will turn a blind eye".

Fairytale 2: Pirates and dragons

There is an entrenched idea in health services that locums, and locum agencies are nothing but a ragtag bunch of mercenaries and pirates - selling their services to the highest bidder. Managers are told to discourage use of locums and locum agencies (the dragons) at all costs - for the sake of the system. This is because the cost is prohibitive, locums are dangerous, and all agencies do is take "their" doctors to work someone else.

To those hospitals objecting to doctors on their payroll working in other places in their off time, we have a suggestion. Review every single locum you are employing at your facility - and stop using those who are usually employed somewhere else. You have plenty of well-trained doctors waiting in the wings to take their place - right? No?

Fairy tale 3: Locum agencies are the pied pipers

We sometimes recieve feedback from some employers that they feel locum agencies are some fanciful type of pied pipers for doctors, leading their doctors astray. Hospital managers need to consider that locums are contributing to the healthcare needs of mainly regional and rural communities- locums are without question, highly skilled envoys who should be commended by their home health service for taking time away from family, social life, recreation time to help others.

Fairy tale 4: Locums are money-hungry

Sure, locums are usually on a higher rate than a regular employee. I am no economist, but from what I can remember, where demand outstrips supply, price increases. The point is that the market dictates the economy for locums - it's not as if the locum is going to ask for less than the going rate. However, employers need to consider whether "their" staff are going other places because they want more money, or are they going for another reason? Perhaps it is because the roster they are working is inhuman, they don't have a good relationship with their supervisor, or for a far less sinister reason - do they just want a change?

Fairy tale 5: All hospital administrators are ogres

As a former hospital manager, I must come to the defence of my former colleagues. Being a hospital administrator is a difficult, thankless job - especially when upper management and "The Department" are throwing everything in the way of effective recruitment and rostering. Here is an example - in one state, hospitals are being forced to enter all locum shifts onto an online system in order to attract locums directly (and thereby avoid agencies, and any possible hint of human interaction). So, instead of spending time developing relationships with salaried and locum staff (like good managers do), the new priority is data entry. I can already see the doctors lining up to use the system to organise their shifts, flights, accommodation, rates, medical registration, orientation, and more. The online system does all of that, right?

Are locum agencies the pied piper? Who is really leading the health system off the cliff?

Tell us what you think by posting a comment below.