This is my column from August in the Barton Associates blog.



States with cumbersome license applications are less attractive for locum tenens

By Edwin Leap, MD

In the rapidly changing landscape of American healthcare, one unfortunate change seems inevitable.  There are going to be fewer and fewer physicians in rural areas.  This is a potentially tragic development for many families who live outside the reach of our suburban and urban medical centers.

Credentialing PaperworkAs such, those of us who like taking locum tenens jobs face a unique opportunity.  It allows us to enhance our incomes in one of the last bastions of free-market medicine.  And it affords us a chance to use our skills to make a huge difference in the lives of people who have too few physicians to meet their needs.

But there is a problem, and I speak as one who was born and raised in an underserved, rural state.  Let me lay this out.  I’m from West Virginia.  A while back I thought it would be fun to go back to the land of my ancestors and my education to work some shifts.  The needs are great, the pay was good, and part of the assignment would have involved interaction with residents in emergency medicine; lots of reasons to go!

However, there was one main reason not to bother.  The licensure process was simply onerous.  The application was huge, and involved far more background checks, character references, check-boxes, and signatures than seemed reasonably necessary.  Furthermore, it required a visit home to be interviewed.  I ditched the whole process.  It would have been fun, but other places had far more user-friendly licensure processes.

When I moved to South Carolina, I was interviewed by a venerable old surgeon.  I was required to bring my medical school diploma, in its frame.  He perused it over reading glasses and asked me peculiar questions about my personal life and habits. They seemed out of place and unnecessary and required me to emphatically answer, “No sir!”

My feeling is that states which really want and need physicians should streamline their processes. I can contrast my West Virginia and South Carolina experiences with Indiana and Colorado, both of which were delightfully simple licenses to obtain.

We live in an electronic world.  Criminal background checks are readily accomplished.  They render worthless those silly in-person interviews to query about sexual habits or drug use.  All manner of board exam results and residency completion certificates are easily obtained.  Why not make it easier all around?

Furthermore, if one actually graduates from medical school and completes an accredited residency training program, I’m pretty sure all of the right qualifications have been met.  Sure, there are always outliers; people who slip through.  But I’d venture to say they are the minority.

What’s the take away message?  For those of us looking for locum tenens jobs now, keep good records, keep copies of everything handy, and learn to assemble a packet without having to open every box in your office.

My message for locums companies is to make every effort to simplify the process for your physicians.  More than one company has offered to have me fill out one application, then they will populate the data on future applications and I can sign off.  That’s a huge help. Editor’s Note: Barton Associates has a dedicated licensing and credentialing team whose job is to make the licensing process as painless as possible, which includes completing applications for our locums. Learn more in our Credentialing Corner section of the blog.

Finally, for states (and hospitals as well), take a long, hard look at the redundancy and complexity of your applications.  As the need for physicians explodes, and the numbers of physicians diminish, we’ll look for the easiest path to take.

If it takes 50 pages of questions, a note from every person we’ve worked with for ten years, unnecessary and intrusive questions, three explanations of our single malpractice case, all of our previous home addresses, and a personal interview about possible crimes, odds are you won’t be seeing us in your state or at your facility.

That could be the difference between coverage and no coverage. And for someone, sometime, it could be the difference between life and death.

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