Locumming

Re: Locumming

Alet Engelbrecht — Mon, 23 Apr 2012 20:17:24 GMT

I started locuming about 6 years ago, also after just over 2 years in the same practice. My motivation was similar to yours - I wanted to compare different practices and management styles, as well as do a bit of travelling. I found it to be very rewarding - I worked for myself, so got some experience with marketing myself. I tried to go for the longer term jobs rather, as it gave me some continuity. Wherever required, I also went to interviews and that is always good experience.

Locum agencies, in the beginning at least, are great - I registered with many of them and quickly weeded them out to about 3 that were actually matching me with suitable jobs according to my experience and requirements. After the first couple of years, I had build up a good 'client base' and was asked to go back to some of the initial jobs (although always make sure that you let your locum agency know if you are still in the required referral period). I made amazing friends and learnt a lot from different colleagues and was forced to face some of my biggest nightmares and become confident doing it - walking into a brand new place and having to fit in immediately. I also learnt to be flexible and a little more relaxed about not always getting my way, although I always tried to adhere to principles where I was in disagreement with some strange practice policies. Generally, we are really lucky in the UK as many practices offer a high standard of service - just pick those if possible.

About 3 years ago, I took an ongoing job (which was essentially a permanent position) for the next couple of years, returning to a practice where I already knew the staff, equipment, system and practicing style. At the time, I craved more continuity and wanted to see my patients getting old. The locum market also seemed to slow down at the time with the recession hitting - being out of the game, I would not know how it is currently, but I wish you all the best!

Re: Locumming

HMC — Sat, 21 Apr 2012 19:05:08 GMT

[quote user="Evelyn Barbour-Hill"]"Acting in the capacity of locum tenens." Let's get this right, please![/quote]

'To act in the capacity of locum tenens' could be shortened to 'locum tenere'

My latin/grammar is not good enough to work out what 'acting...' would be.

Re: Locumming

Evelyn Barbour-Hill — Sat, 21 Apr 2012 16:39:13 GMT

"Acting in the capacity of locum tenens." Let's get this right, please!

Re: Locumming

plantagenet — Sat, 21 Apr 2012 11:02:52 GMT

[quote user="John Rimmer"]Locuming only has one m. [/quote]

Surely locummming is just a useful made up word anyway, even the alternative of 'to locum' is a bit grammatically tenuous.

Re: Locumming

John Rimmer — Fri, 20 Apr 2012 16:51:08 GMT

Locuming only has one m.

Re: Locumming

patrick murphy — Thu, 19 Apr 2012 12:45:26 GMT

wow this brings back memories.I got in trouble in one practice for ordering one box of needles, he reused the vacc needles, and I got tired of pushing the cats off the table when trying to inject them with the only antibiotic there.

also coming new from cap,gown and mask cat speys in Canada, I worked one place where a surgical sheet was off of the wall dispenser, and that was with the Immobolin and pentobarbitone anaesthesia.

I am pretty sure we did not have dental machines then.

Re: Locumming

plantagenet — Wed, 18 Apr 2012 18:43:16 GMT

[quote user="Bob Russell"]Rig can be a pain in the ar*e for employers. [/quote]

with you on that one!

Re: Locumming

Robin Grimmer — Wed, 18 Apr 2012 18:42:13 GMT

[quote user="Hannah Bose"]

Has anyone had problems registering for VAT? My boss today said that he would rather I didn't add VAT to my invoice (regardless of claiming it back).

[/quote]

No. I've had no problems since being VAT registered. Are you a Ltd company? Your boss will have to pay for VAT on goods and services for the practice so I don't see why your invoice should be any different.

Re: Locumming

Lorna McHardy — Wed, 18 Apr 2012 18:05:45 GMT

[quote user="Hannah Bose"]

Agree to disagree?

[/quote]

'S what I suggested earlier...

Re: Locumming

HMC — Wed, 18 Apr 2012 17:53:59 GMT

[quote user="Lorna McHardy"]The things you list above are irritating and annoying and substandard and undoubtedly should be fixed. But they're not unmanageable in the short term. [/quote]

Short term. Exactly.

Agree to disagree?

Re: Locumming

Lorna McHardy — Wed, 18 Apr 2012 17:44:55 GMT

[quote user="Hannah Bose"]

So, what would you do if you were in a practice where the blood tubes were out of date and the practice has debts with the lab that means they will not provide more tubes? Tell the clients that the service they are paying for cannot be relied upon? Buy blood tubes yourself?

[/quote]

Well, first I'd phone the lab and find out just how problematic the use of out of date tubes actually is - never having had nowt but out of date ones left, I don't know. Then, assuming that any results really are null and void, I would explain to the clients that we are not in a position to run blood tests. Then I would consider the following options, depending on the case:

- rely on a decent examination and refrain from running bloods (what, after all, do you do when your client can't afford blood tests?)

- if there's a microscope available and it would help the case, look at a smear

- phone a neighbouring practice, explain the situation, and ask them very nicely for a sufficiency of tubes to tide you over.

- refer the case.

[quote user="Hannah Bose"]

How about if the fluorescein eye drops were years out of date? Would you feel professionally responsible putting that in a dog's eye? What would you say to clients if you didn't do the fluorescein test?

[/quote]

I wouldn't use them. I would explain to the client that unfortunately, I do not have the wherewithal to make certain whether there is an ulcer or not, but that I have this treatment here that is safe to use in an ulcerated eye. Then I would monitor the case closely, and proceed with treatment according to the animal's response.

[quote user="Hannah Bose"]

How about when the table drapes for your surgical instruments have holes in them?

[/quote]

Use several drapes.

[quote user="Hannah Bose"]

I don't want to disagree with you whole-heartedly.

[/quote]

Go right ahead... I'm disagreeing with you whole-heartedly

[quote user="Hannah Bose"]

I work hard and diligently. However, I get really concerned when I can't do things properly because of the practice I am working in. I don't want the RCVS questioning me.

[/quote]

I don't doubt that you work hard and are diligent; and I think wanting to be able to do things properly is a Good Thing - I too get frustrated by little irritations and prefer to have everything I need to do an optimal job at my disposal. Unfortunately, in most practices, this is not invariably the case; one of the requirements for a locum is the ability to be flexible. The things you list above are irritating and annoying and substandard and undoubtedly should be fixed. But they're not unmanageable in the short term.

I'm actually finding myself feeling sorry for the practice you describe... it sounds to me like a place struggling to survive. But you were there and I wasn't; so if you really believe they're "negligently bad", then you should probably be phoning the RCVS after talking to the principal about your concerns.

It boils down to a very simple question: Is it just less well equipped than you are used to and comfortable with, or is it bad enough to be described as negligent and a risk to patient welfare and safety? If the former, get on with it for the time you have committed to, don't take any more work there afterwards, and be more careful with the work you do take so you don't end up outside your comfort zone again. If the latter, note your concerns, speak to the practice principal, and as a last resort, speak to the RCVS.

As for being questioned yourself, they'd have to be even more unreasonable than their reputation. All you can do as a locum is the best you can with the tools at your disposal. Be honest with the clients about what you can and can't offer them and what it will cost, and work to the highest level possible within the limitations of the practice. Then act according to your judgement about whether or not those limitations actually constitute negligence.

You've said nothing to change my opinion that walking out and leaving people stranded is <edit> justifiable unjustifiable!! <edit> (with the caveat that you later said your agreement with the practice included this option... I'm speaking generally).

Re: Locumming

HMC — Wed, 18 Apr 2012 15:30:05 GMT

[quote user="Lorna McHardy"]

[quote user="Hannah Bose"]

But this is not about me- my comment was fair- and I stand by it- that if you find yourself in a sh*t hole then 1 week's notice gets you out!

[/quote]

As your original comment stands, it's neither fair not reasonable... we'll have to agree to disagree.

[/quote]

How about when the table drapes for your surgical instruments have holes in them?

I don't want to disagree with you whole-heartedly.

I work hard and diligently. However, I get really concerned when I can't do things properly because of the practice I am working in. I don't want the RCVS questioning me.

I think we have different ideas of what I meant by a bad practice- I meant negligently bad!

Re: Locumming

Lorna McHardy — Wed, 18 Apr 2012 13:53:18 GMT

[quote user="Hannah Bose"]

[quote user="Lorna McHardy"]

[quote user="Hannah Bose"]

If the practice is bad then simply hand in one week's notice.

[/quote]

I'd consider that pretty unreasonable, myself... as a locum, you look at the practice, you talk to the principal, you agree on terms. It's generally a limited contract for a specific reason such as holiday or sickness. Backing out with a week's notice because after all, you don't like it for some reason strikes me as unfair. I'd be surprised if there were practices bad enough to make that a justifiable thing to do, especially where it doesn't show before you commit to the work.

[/quote]

I feel a bit villified by this!

[/quote]

I'm at a loss to see why; I was disagreeing with you in a manner I thought polite. My gut response to your post was much stronger.

[quote user="Hannah Bose"]

I should explain. I have only done it once- and the practice was absolutely fine with it (it saved them money as their permanent vet could start earlier). More to the point, it was in my contract that I had one week's notice and I worked an extra few days so my final day was a Friday.

[/quote]

Ah well, that's really quite different from the post I responded to, which said that if the practice was "bad", a locum should "simply hand in one week's notice". Had you written that in the first place, I probably wouldn't have responded at all.

[quote user="Hannah Bose"]

But this is not about me- my comment was fair- and I stand by it- that if you find yourself in a sh*t hole then 1 week's notice gets you out!

[/quote]

As your original comment stands, it's neither fair not reasonable... we'll have to agree to disagree.

Re: Locumming

HMC — Wed, 18 Apr 2012 13:04:03 GMT

[quote user="Natasha Wilks"]Hannah, I was talking in general and not referring to your post and no offence was intended.[/quote]

Thanks.

[quote user="Natasha Wilks"]I positioned myself well, looked at what everyone else was charging and charged 10% more and was fully booked within 2 days and turned down a ridiculous amount of work.[/quote]

I'm impressed. I think location matters a lot. Sadly I have much less work in Bristol than I did when I lived in Chichester (and I'm writing this from my job in Newport, which isn't exactly near).

Has anyone had problems registering for VAT? My boss today said that he would rather I didn't add VAT to my invoice (regardless of claiming it back).

Re: Locumming

Natasha Wilks — Tue, 17 Apr 2012 20:44:22 GMT

Being a locum is running your own business so treat it like that. Even if you only plan to do it for a few months.

Go the extra mile, it's a very lonely road out there.

Make the effort for your clients (which are the practices). They will love you and you will have work offers everywhere.

I positioned myself well, looked at what everyone else was charging and charged 10% more and was fully booked within 2 days and turned down a ridiculous amount of work.

If you look after the clinic and take care of their clients very well, you will do well. :)

Re: Locumming

Natasha Wilks — Tue, 17 Apr 2012 20:36:37 GMT

[quote user="Hannah Bose"]

[quote user="Lorna McHardy"]

[quote user="Hannah Bose"]

If the practice is bad then simply hand in one week's notice.

[/quote]

I feel a bit villified by this! I should explain. I have only done it once- and the practice was absolutely fine with it (it saved them money as their permanent vet could start earlier). More to the point, it was in my contract that I had one week's notice and I worked an extra few days so my final day was a Friday.

[/quote]

Hannah, I was talking in general and not referring to your post and no offence was intended.

I've done a lot of sole charge so leaving wasn't an option (even though I wanted to run for the hills) and I've had some very interesting places to work in too...

One clinic where I was sole charge booked me 16 consults in a 2 hr period then 10 surgeries which included 4 bitch speys then double booked for every appointment that afternoon. Stressed was an understatement. I knew I should have charged a lot more! I ended up giving that clinic 1 months notice to as I was offered work somewhere else.

What I learned was to ask a LOT of questions and I must admit as I locum within an hours travel to home, I actually go and visit the clinics so we can both meet each other. I get a feel for them and they get a feel for me. Plus I get a look around. When I first rang and visited that clinic, I had only 1 little red flag come up but I didn't trust my instinct as I needed the work.

My point is to never leave the clinic stranded. They will tell everyone about 'that' locum and perception is everything. Although if they are a dodgy clinic, they will have a reputation as well.

Make it a win/win for everyone and if you can't stand it, find them options for a replacement. Just never leave them stranded.

Re: Locumming

Robin Grimmer — Tue, 17 Apr 2012 18:41:49 GMT

I second what Cat says. When I started locuming I used to travel far and wide but nowadays 95% of my work is within a 30-mile radius.

And yes R1g are a pain in the a***. They keep phoning me about permanent jobs and asking me if I know anyone who might be interested

I can highly recommend Vet Connect.

Re: Locumming

Bob Russell — Tue, 17 Apr 2012 16:20:37 GMT

I can assure you that Rig can be a pain in the ar*e for employers. They are very, very,very persistent! That might mean that they are good at finding work for their locums!

Re: Locumming

Cat Henstridge — Tue, 17 Apr 2012 14:03:08 GMT

Hi,

I started locuming in 2008. For the first 6 months I found all of my work via agencies but since then the vast majority has come by word of mouth and repeat bookings. I did send out letters and CVs to about 30 local practices but this was surprisingly ineffective. However, some did book me subsequently through an agency, so I think a lot just don't pay much attention to stuff like that, or aren't organised enough to keep it on file!

If you are only going to locum for a few months then going through an umbrella company with an agency or being self employed will be fine but if you are going to do it for any longer then I would advise becoming a limited company. This is very easy to do with a good accountant. I can highly recommend Bertram Kidson who are a veterinary specific company. Their number is 01902 422992.

As for getting work in a certain area, there will be plenty, just stick to your guns! I had a lot of agencies offer me work all over the place and try to convince me there wasn't a lot in the region I wanted but once they realised I wasn't going to back down, it would magically appear! I did have one or two occasions where I hadn't got anything booked and I was getting a bit twitchy but something always turned up!

I have found work through most of the big companies and they are all OK. Carlton and A1 are staffed by lovely people, Rig are not as bad as their reputation; they are a bit more 'hard sell', especially towards employers but were quite nice to me!

If you want to know anything else, let me know.

Cat

Re: Locumming

HMC — Tue, 17 Apr 2012 13:56:02 GMT

[quote user="Lorna McHardy"]

[quote user="Hannah Bose"]

If the practice is bad then simply hand in one week's notice.

[/quote]

I have put up with bad practices (and ironically worse practices than the one I left) but I think the standards were the straw that broke the camel's back. (I then took 6 week's off to recover).

But this is not about me- my comment was fair- and I stand by it- that if you find yourself in a sh*t hole then 1 week's notice gets you out!

Re: Locumming

KMurphy — Tue, 17 Apr 2012 13:54:01 GMT

[quote user="Natasha Wilks"]Last thing - ring a few days and confirm you are coming. They begin to worry you won't turn up.[/quote]

Great advice! I thought I was the only one who worried about this - I'm glad I'm not alone :)

Re: Locumming

Natasha Wilks — Tue, 17 Apr 2012 12:45:28 GMT

I have so much to tell you & so much advice for vets wanting to locum but not enough space here :)

I was a locum for the 2 years I lived in the UK and have worked at many different clinics the last few years here in Australia - all sole charge. I've always had my own company. Make sure you put money aside for tax/expenses. Don't spend it all and then be forced to work for free to save for your huge tax bill!

Don't do it without insurance - you are mad if you do. You can't afford not to have it!

I have worked at great clinics (all my experiences in the UK were great) and some not so great.

Ask lots of questions and specific questions so you know what you are in for, what is expected. The more you know, the more you can make an informed decision if this practice is right for you and if you can meet their expectations. If you are a bit slower with consults and procedures, make sure to avoid the very busy clinics as you will get overwhelmed very quickly. Buy a diary and write everything down.

Also be very clear about your capabilities, what you are willing to do and not do. You have to be efficient, good communication, great with clients and manage time well.

I found practices are hopeless about giving you guidelines on how their practice operates, pricing & how they like to do things. Ask & write it down so you know because you will forget.

Your reputation is everything so unless the practice is absolutely horrid, you made a commitment, you must honour it. Word gets around quickly of bad locums but also good locums. If you do a great job, then they will call you next time they have work as they know you, you know them and how everything works.

A practices biggest fears are the locum is hopeless, useless, will lose clients, can't do anything, won't bother to charge, work up cases etc etc. Another words cost a lot & cause more headaches than they are worth.

Practices have been burned with bad locums. Don't be one of them.

You are there to work for the practice to represent them and their principles (providing they are good). If they aren't, do they best you can but don't criticise them or put them down to clients or their staff.

Buy a domain name in your name (cheap), get cheap hosting and create a wordpress blog (free) or find a teenager who can do this all for you in about an hour and really cheap. Put up a photo, your experience and a bit about you. That way practices can be familiar with you and puts you ahead of the competition.

Be smart and strategic about advertising.

Last thing - ring a few days and confirm you are coming. They begin to worry you won't turn up.

Contact me directly for more specific advice. :)

Natasha

Re: Locumming

jason davidson — Tue, 17 Apr 2012 10:48:12 GMT

I personally prefer to avoid locum agencies as much as possible. They charge the practice per day that you work there and this can really add up especially if you are there for any length of time.

When I am looking for a locum I always contact the people who have sent in their CVs to me first and also check the locum listing on this site.

I would advise choosing a few surgeries where you would like to work and sending them your CV. This way you can also choose the areas where you would like to work. Don't forget to advertise yourself on this site.

It is also a good idea to register your CV with some of the bigger groups of surgeries as they may be more likely to have work at one of their branches or hospitals and you could end up staying within a familiar set up if you choose to stick with them.

Re: Locumming

Dagmar Steele — Tue, 17 Apr 2012 10:35:51 GMT

[quote user="Neil Wheadon"]

PS I'd love to come to Westward Ho, coming from Devon and my parents living in Bude it would be a grand placement, just I'm busy......

[/quote]

hopefully we'll be in Bishops Tawton in July, but I'm afraid it's just a holyday visiting the in-laws! I wouldn't be able to do work in the UK anyway, I'm not registered :-)

Re: Locumming

Robin Grimmer — Tue, 17 Apr 2012 10:29:15 GMT

[quote user="Lorna McHardy"]

[quote user="Hannah Bose"]

If the practice is bad then simply hand in one week's notice.

[/quote]

Absolutely. Which is why I said make sure you know the practice before you agree to a long term stint of work. My other golden rule of locuming is never let anyone down. Once you've agreed to work - do it - it's not like a normal job. The practices are relying on you to cover holidays, sickness CPD whatever.