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September 6, 2012

General Pointers About Locums Work For Anesthesiologist Assistants!

General Pointers About Locums Work from a CRNA Perspective but which also applies to Anesthesiologist Assistants

#1. Since the Anesthesiologist Assistants are moving for licensure in a number of states, they need to stick into their practice act an INTERSTATE AA PRACTICE COMPACT. That would make your Anesthesiologist Assistants license like a drivers license. You could work in any of the Compact states with the license of your home state. You would still have to obey the laws of the state you are working in, but it would save you a TON of money in licenses and you would not have to jump thru the hoops of every state to get “their” license. That is a class “A” headache.

#2. Insurance is going to be a big concern. Make sure you know who is paying it and what kind it is.  A “claims occurred” policy is 1000 times better than a “claims filed.” (If you are interest in the difference, just ask and I can go into that into more detail.) I buy a policy from my agency on a “per day worked” basis and it covers me for anything I did (or failed to do) for that one day. Obviously it is a “claims occurred” policy. If the hospital or group that is hiring you is going to add you to their policy, make sure the policy clearly states locums are covered or that you are a named insured. However, even with that, it probably is a “claims filed” type policy and something you did or did not do can come back to haunt you years later. If you want your “own” policy, keep in mind some insurance agencies require you to have one for each state you work in. That can add up to a LOT of money very quickly. Bottom line, before you do your FIRST locums, know exactly were you stand on insurance.

#3. Hourly pay is the main source of your income. However, you should also get travel expenses, per diem and housing. Travel should be taxi from your house to the airport, the air ticket, and perhaps a rental car for your stay at the locums facility. If you drive, the going rate is around 40 cents a mile. If you are going to drive a great distance, watch out as they may try to short you on the mileage or “pay a set rate.” Per diem is around $30 per day. Lodging can be done a number of ways. They can put you up in a hotel and pay the hotel directly or you can check in and put it on your credit card and then they pay you. I prefer the first method of the two. However, if you have a motor home or travel trailer, you can do something novel. They pay you $50 a day for housing. You stay in an RV park. If you use the RV only for locums, it can be a major tax write off as a business expense. You can write off upkeep, propane and electric, interest and take a pretty good depreciation also.

#4. As the “visitor,” expect to do things their way and not yours. If they are still using morphine and pentothal, you have to adapt. A very quick way to “upset them” is to make demands for stuff that you like that they do not use. BUT…and this is the big one….do not compromise patient safety. If it is a patient safety issue or a standard of care issue, you need to CLEARLY state your position. Do not think that “protesting and documenting” you are safe. If you know there is a safety violation and object, then go on to do it anyway, you are just as liable as they.

((If you are using the insurance company of the agency, you can use that as support for you. THEY will not want you to do cases without the proper equipment either.))

#5. Lastly, locums people are often the vanguard. A hospital who never before used an Anesthesiologist Assistant may hire you to see how it works, as an experiment before they hire Anesthesiologist Assistants permanently. You may be the first Anesthesiologist Assistant they ever met. If you come in and are a jerk, or a pain in the butt, or “nuts” or just not capable of handling the job, that will not only reflect negatively upon you but your whole Anesthesiologist Assistant profession. Little things like showing up in shorts and a T-shirt, strange tatoos, nose and tongue piercings and the like are not going to impress them and may turn them off. If you are going to do locums, you need to be on the ball and at the top of your game.

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